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BackgroundThe coronavirus disease 2019 (COVID-19) that emerged from Wuhan, China in 2019 rapidly spread throughout the globe in less than 6 months. In June 2020, Rwanda was a home of approximately 149,602 refugees. About 92% of the refugees were living in camps including Kiziba, Gihembe, Nyabiheke, Kigeme, Mugombwa, and Mahama. While entire world was in some level of lockdown, people living in refugee camps and other similar settings were more vulnerable to the pandemic than their counterparts who were staying in their homes. Prevention measures such as social distancing, handwashing, and face mask wearing were often difficult to implement in these settings. Current study aimed to assess perspectives of HCPs working in refugee camps on prevention of COVID-19 in camp settings. MethodsThis study was a cross-sectional study and due to movement restriction from March 14 to November 3, 2020, we collected data remotely by sharing a structured questionnaire, in google form, to HCPs via WhatsApp and email. The questionnaire collected HCPs’ perspectives on the feasibility of COVID-19 prevention measures, the prevalence of COVID-19 comorbidities, and how the pandemic can be prevented in refugee camp settings. Data were analyzed using descriptive statistics of IBM SPSS V.21. ResultsThis study shows that handwashing, social distancing and wearing masks are feasible measures in refugee camp settings, voted by 71 to 100% of the HCPs. However, lockdown or stay home can be hardly applied in such settings, supported by 80.6% of the respondents. Regarding COVID-19 comorbid conditions, pregnant women in their late or recent term and Heart disease like Hypertensive disorders were voted the most common in refugee camps by 56% and 50% of the HCPs, respectively. Steps to COVID-19 prevention in camps include community awareness, preparing and activating the pandemic response task force, stopping non-essential mass gathering activities, and monitoring of COVID-19 prevention measures during essential service delivery. ConclusionsAll in all, except lockdown or stay home, other COVID-19 prevention measures like social distancing, handwashing, and face mask wearing can be easily applied in refugee camp and other similar settings.

As Rwanda inches closer to the UNAIDS HIV first 95 of knowing one's HIV status by 2030, finding the remaining HIV-positive individuals could be difficult by use of passive methods. Index testing is an approach whereby the exposed contacts of an HIV-positive person are notified and offered an HIV test. We aimed to assess the factors related to the HIV-positive outcome among older people (aged 50 years and above) in Rwanda.In Rwanda, adults (aged ≥18 years) on antiretroviral therapy (ART) who reported having had sexual partners with unknown HIV status, and individuals with newly diagnosed HIV, described as index cases, were asked to provide details of their sexual partners and invite them to the health facility for HIV testing through client referral, provider referral, or dual referral. We used logistic regression to model the odds of identifying partners who were HIV-positive or aged 50 years or older through partner notification services and to assess predictive factors related to index case and partner, after adjusting for partner related variables (age group, gender, relationship between index and sexual partner, province of residence, notification used) and index case related variables (type of index case, multiple partnership, had unprotected sex in past 12 months, viral load suppression, age difference between notified sexual partner and index case). Written informed consent was obtained from each participant before inclusion in the study. The Rwanda National Ethics Committee approved the protocol for implementation.Between October, 2018, and September, 2021, 18 453 index cases were recruited and 31 227 partners were notified and tested, of whom 3156 (10·0%) were aged 50 years and older. Of the partners aged 50 years and older, 877 (27·8%) were female and 2279 (88·1%) were male, and 1638 (51·9%) were notified by index cases who were younger than them. Among partners aged 50 years and older, 6·0% (3156) were HIV-positive, with a higher prevalence in partners notified by newly diagnosed index cases 14·7% (46 of 313). In the multivariable analysis, among partners aged 50 years and older, the adjusted odds ratio was 2·66 (95% CI 1·78-3·98) for female partners compared with male partners, 3·14 (2·08-4·77) for partners of newly HIV-diagnosed index cases compared with those of index cases who were already taking ART, and 1·89 (1·07-3·37) for partners who were 15 years older than the index case compared with partners who were 5 years older or younger.Partners of people with newly diagnosed HIV, older individuals who engaged in sexual relationship with younger individuals, and female partners had an increased risk of being diagnosed with HIV. Index testing successfully identified older people with undiagnosed HIV.None.

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Introduction As part of the integration of refugees into Rwanda’s national hepatitis C elimination agenda, a mass screening campaign for hepatitis B (HBV) and hepatitis C (HCV) was conducted among Burundian refugees living in Mahama Camp, Eastern Rwanda. This cross-sectional survey used data from the screening campaign to report on the epidemiology of viral hepatitis in this setting. Methods Rapid diagnostic tests (RDTs) were used to screen for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) among people of ≥15years old. We calculated seroprevalence for HBsAg and anti-HCV by age and sex and also calculated age-and-sex adjusted risk ratios (ARR) for other possible risk factors. Results Of the 26,498 screened refugees, 1,006 (3.8%) and 297 (1.1%) tested positive for HBsAg and Anti-HCV, respectively. HBsAg was more prevalent among men than women and most common among people 25–54 years old. Anti-HCV prevalence increased with age group with no difference between sexes. After adjusting for age and sex, having a household contact with HBsAg was associated with 1.59 times higher risk of having HBsAg (95% CI: 1.27, 1.99) and having a household contact with anti-HCV was associated with 3.66 times higher risk of Anti-HCV (95% CI: 2.26, 5.93). Self-reporting having HBV, HCV, liver disease, or previously screened for HBV and HCV were significantly associated with both HBsAg and anti-HCV, but RDT-confirmed HBsAg and anti-HCV statuses were not associated with each other. Other risk factors for HBsAg included diabetes (ARR = 1.97, 95% CI: 1.08, 3.59) and family history of hepatitis B (ARR = 1.32, 95% CI: 1.11, 1.56) and for anti-HCV included heart disease (ARR = 1.91, 95% CI: 1.30, 2.80) and history of surgery (ARR = 1.70, 95% CI: 1.24, 2.32). Conclusion Sero-prevalence and risks factors for hepatitis B and C among Burundian were comparable to that in the Rwandan general population. Contact tracing among household members of identified HBsAg and anti-HCV infected case may be an effective approach to targeted hepatitis screening given the high risk among self-reported cases. Expanded access to voluntary testing may be needed to improve access to hepatitis treatment and care in other refugee settings.