HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme.
ALP, alkaline phosphatase
ALT, alanine transaminase
APRI, AST-to-platelet ratio index
AST, aspartate aminotransferase
Africa
Diagnosis
GGT, gamma-glutamyl transferase
HBsAg, hepatitis B surface antigen
HCC, hepatocellular carcinoma
Hepatitis B
LSM, liver stiffness measurement
POC, point of care
PROLIFICA, Prevention of Liver Fibrosis and Cancer in Africa
Screening
TDF, tenofovir disoproxil fumarate
Treatment
WHO, World Health Organization
aOR, adjusted odds ratio
cOR, crude odds ratio
eGFR, estimated glomerular filtration rate
qPCR, quantitative polymerase chain reaction
sSA, sub-Saharan Africa
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
01
11
2021
revised:
10
06
2022
accepted:
14
06
2022
entrez:
2
9
2022
pubmed:
3
9
2022
medline:
3
9
2022
Statut:
epublish
Résumé
Strategies to implement HBV screening and treatment are critical to achieve HBV elimination but have been inadequately evaluated in sub-Saharan Africa (sSA). We assessed the feasibility of screen-and-treat interventions in 3 real-world settings (community, workplace, and hospital) in Senegal. Adult participants were screened using a rapid HBsAg point-of-care test. The proportion linked to care, the proportion who had complete clinical staging (alanine transaminase [ALT], viral load, and FibroScan®), and the proportion eligible for treatment were compared among the 3 intervention groups. In 2013-2016, a total of 3,665 individuals were screened for HBsAg in the community (n = 2,153) and in workplaces (n = 1,512); 199/2,153 (9.2%) and 167/1,512 (11%) were HBsAg-positive in the community and workplaces, respectively. In the hospital setting (outpatient clinics), 638 HBsAg-positive participants were enrolled in the study. All infected participants were treatment naïve. Linkage to care was similar among community-based (69.9%), workplace-based (69.5%), and hospital-based interventions (72.6%, HBV screen-and-treat interventions are feasible in non-hospital and hospital settings in Senegal. However, the continuum of care is suboptimal owing to limited access to full clinical staging. Improvement in access to diagnostic services is urgently needed in sSA. Hepatitis B infection is highly endemic in Senegal. Screening for infection can be done outside hospitals, in communities or workplaces. However, the hepatitis B continuum of care is suboptimal in Senegal and needs to be simplified to scale-up diagnosis and treatment coverage.
Sections du résumé
Background & Aims
UNASSIGNED
Strategies to implement HBV screening and treatment are critical to achieve HBV elimination but have been inadequately evaluated in sub-Saharan Africa (sSA).
Methods
UNASSIGNED
We assessed the feasibility of screen-and-treat interventions in 3 real-world settings (community, workplace, and hospital) in Senegal. Adult participants were screened using a rapid HBsAg point-of-care test. The proportion linked to care, the proportion who had complete clinical staging (alanine transaminase [ALT], viral load, and FibroScan®), and the proportion eligible for treatment were compared among the 3 intervention groups.
Results
UNASSIGNED
In 2013-2016, a total of 3,665 individuals were screened for HBsAg in the community (n = 2,153) and in workplaces (n = 1,512); 199/2,153 (9.2%) and 167/1,512 (11%) were HBsAg-positive in the community and workplaces, respectively. In the hospital setting (outpatient clinics), 638 HBsAg-positive participants were enrolled in the study. All infected participants were treatment naïve. Linkage to care was similar among community-based (69.9%), workplace-based (69.5%), and hospital-based interventions (72.6%,
Conclusions
UNASSIGNED
HBV screen-and-treat interventions are feasible in non-hospital and hospital settings in Senegal. However, the continuum of care is suboptimal owing to limited access to full clinical staging. Improvement in access to diagnostic services is urgently needed in sSA.
Lay summary
UNASSIGNED
Hepatitis B infection is highly endemic in Senegal. Screening for infection can be done outside hospitals, in communities or workplaces. However, the hepatitis B continuum of care is suboptimal in Senegal and needs to be simplified to scale-up diagnosis and treatment coverage.
Identifiants
pubmed: 36052221
doi: 10.1016/j.jhepr.2022.100533
pii: S2589-5559(22)00105-7
pmc: PMC9424572
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100533Subventions
Organisme : Medical Research Council
ID : MR/R015600/1
Pays : United Kingdom
Informations de copyright
© 2022 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).
Déclaration de conflit d'intérêts
ML, YS, SM, and MT have received consultancy fees and research support from Gilead Sciences. Please refer to the accompanying ICMJE disclosure forms for further details.
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