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The presence of other pathologies increases the risk of complications in a patient with the new coronavirus. Hence the importance for people with HIV or former tuberculosis patients to be extra vigilant. Interview.
The professor Jean-Marie Kayembe is head of the pulmonology department at the university clinics of Kinshasa. He is also the dean of the Faculty of Medicine in Kinshasa, in the Democratic Republic of Congo (DRC).
Wednesday April 22, he was the guest ofprogram Health priority, on RFI.
RFI: What has this pandemic changed in your exercise for a lung health specialist like you?
Pr Jean-Marie Kayembe: Breathing difficulty being included among the reference consultation reasons, anyone with these signs, associated with fever, immediately forgets bacterial or viral pneumonia … All attention is focused on this rapid killer that is the coronavirus. Chronic conditions are still there, but attention is being capitalized on by this pandemic, which teaches us all to be humble.
Is there an additional risk for someone who has had pulmonary tuberculosis in the past with coronavirus? Do we have any feedback on this comorbidity?
We still learn a lot from this affection. At this time, we are not aware of any of our patients treated for tuberculosis who have contracted Covid-19. Tuberculosis as a chronic condition is cured when treated properly. Our countries and health systems are well organized around this chronic condition. On the other hand, the Covid-19 falls to us as a kind of fatality, for which we must keep a cool head and the humility to learn more every day.
A series of chronic diseases is an increased risk factor. The same is true for immune deficiencies. We are of course thinking of the situation of people with HIV. Is there targeted awareness-raising in services dedicated to HIV-AIDS?
Effectively. Most countries in sub-Saharan Africa have national HIV care programs. The most important recommendation is that people on treatment do not give up on it. They must be very attentive to the barrier measures. In a period of confinement, an HIV subject should adapt better than anyone else to all these barrier measures, which have proven to be effective in all countries.
In case of pulmonary symptoms, is there also a recommendation for a screening for HIV or tuberculosis, during a Covid-19 consultation ?
It is important to remember that the Covid-19 is there, but that we still have this procession of chronic diseases whose symptoms are known. It doesn’t have to distract attention from these other illnesses. For example, I was contacted by an asthmatic patient. He takes inhaled corticosteroids that stabilize him. After learning that nonsteroidal anti-inflammatory drugs were banned in Covid-19, he didn’t know what to do. Treatments that stabilize patients must be continued! Asthma is a chronic inflammatory disease. The current pandemic does not justify that patients stop their treatment.
Is the prevention message going well with the populations?
I do not think that the awareness-raising work should stop in any way. We face in our countries another common enemy: poverty which calls for overcrowding and daily resourcefulness to survive. Despite this, wearing a mask has just been made compulsory in public places in our country. We welcome it as an additional barrier measure that will protect sick people from their environment, but also those who are not. We have liberalized the availability of imported surgical masks. These masks are not within the reach of all budgets, we encourage the wearing of the fabric mask, manufactured by our local tailors. The advantage of this mask is that it can be cleaned and used more than once. We must not witness a vertiginous rise in the price of these masks, even made locally. It’s a story of national solidarity. This is especially not the time to seek illicit enrichment which risks going out of common sense.
When you have a chronic disease, in no case should you take treatment for self-medication, without notifying your doctor because there can be interactions and contraindications, right?
We can see the place that comorbidities occupy in the prognosis of Covid-19 infection, in particular hypertension, diabetes, obesity, sleep apnea syndrome, etc. It is important not to forget the patient’s medical card only because he is now Covid positive.
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