Barriers to the Prevention and Control of Hepatitis B and Hepatitis C in the Community of Southwestern China: A Qualitative Research

Li, Tingting; Su, Shu; Zhao, Yong; Deng, Runze; Fan, Mingyue; Wang, Ruoxi; Sharma, Manoj; Zeng, Huan

doi:10.3390/ijerph16020231

Cited by 13 publications

(11 citation statements)

References 30 publications

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“…LTFU may result from different factors including expensive services, long test processing times, logistical difficulties with referrals, patient stigma or burdens and poor communication/ follow-up from health facilities. [22][23][24][25][26] In addition, HCV services often involve working with marginalised populations at higher risk of attrition. Special focus is needed to ensure that screening programmes are effective and that context-specific reasons for patient LTFU are identified and addressed.…”

Section: Challenges and Opportunitiesmentioning

confidence: 99%

Initial success from a public health approach to hepatitis C testing, treatment and cure in seven countries: the road to elimination

et al. 2020

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With political will, modest financial investment and effective technical assistance, public sector hepatitis C virus (HCV) programmes can be established in low- and middle-income countries as a first step towards elimination. Seven countries, with support from the Clinton Health Access Initiative (CHAI) and partners, have expanded access to HCV treatment by combining programme simplification with market shaping to reduce commodity prices. CHAI has supported a multipronged approach to HCV programme launch in Cambodia, India, Indonesia, Myanmar, Nigeria, Rwanda and Vietnam including pricing negotiations with suppliers, policy development, fast-track registrations of quality-assured generics, financing advocacy and strengthened service delivery. Governments are leading programme implementation, leveraging HIV programme infrastructure/financing and focusing on higher-HCV prevalence populations like people living with HIV, people who inject drugs and prisoners. This manuscript aims to describe programme structure and strategies, highlight current commodity costs and outline testing and treatment volumes across these countries. Across countries, commodity costs have fallen from >US$100 per diagnostic test and US$750–US$900 per 12-week pan-genotypic direct-acting antiviral regimen to as low as US$80 per-cure commodity package, including WHO-prequalified generic drugs (sofosbuvir + daclatasvir). As of December 2019, 5900+ healthcare workers were trained, 2 209 209 patients were screened, and 120 522 patients initiated treatment. The cure (SVR12) rate was >90%, including at lower-tier facilities. Programmes are successfully implementing simplified, decentralised public health approaches. Combined with political will and affordable pricing, these efforts can translate into commitments to achieve global targets. However, to achieve elimination, additional investment in scale-up is required.

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Section: Challenges and Opportunitiesmentioning

confidence: 99%

Initial success from a public health approach to hepatitis C testing, treatment and cure in seven countries: the road to elimination

et al. 2020

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“…21 The routine work of community health centers generally involves caring for patients with high blood pressure, diabetes, heart disease and so on; however, professional treatment provided for patients with chronic liver disease is rare. 33 This condition can contribute potential trust issues that can affect patient's adherence to HCC surveillance in the community. This highlights the need for additional training to community physicians and specialist supporting mechanisms as well as a practical complete HCC surveillance system to help improve the current practice.…”

Section: Dovepressmentioning

confidence: 99%

<p>Adherence to Hepatocellular Carcinoma Surveillance and Perceived Barriers Among High-Risk Chronic Liver Disease Patients in Yunnan, China</p>

Dai¹,

Zhao²,

Du³

et al. 2020

CMAR

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Background: Data concerning adherence to hepatocellular carcinoma (HCC) surveillance among chronic liver disease (CLD) patients at high risk of developing HCC in China are limited. We aimed to examine the relationship between HCC-related knowledge dimensions and adherence to HCC surveillance procedures among chronic liver disease patients at high risk of developing HCC and to identify potential barriers. Methods: A total of 380 patients with chronic liver disease at high risk of developing HCC were recruited between May and August 2018 to complete a survey during the first week of their first hospitalization at the Third People's Hospital of Kunming in China. We followed up each patient up to 7 months by telephone to confirm whether the patient returned to complete investigations for HCC surveillance. Patient's socio-demographic characteristics, HCC-related knowledge, and perceived barriers to HCC surveillance were measured using a structured questionnaire during their hospitalization. Factor analysis was performed on the knowledge questions to reduce the dimensions. Univariate and multivariate analyses were performed to examine the association between dimensions of HCC-related knowledge and patients' adherence to HCC surveillance. Results: A total of 327 eligible patients had been successfully contacted in the follow-up phase. Only a quarter of patients completed HCC surveillance within 7 months after their first admission to hospital. High costs and perceived poor test efficacy were the two major barriers for HCC surveillance. Three common factors were derived from the factor analysis of HCCrelated knowledge, namely, "Surveillance", "Lifestyle", and 'Prognosis'. Knowledge of HCC surveillance and lifestyle but not prognosis had an influence on adherence to HCC surveillance. Patients with better surveillance and lifestyle knowledge domain had better adherence to HCC surveillance. Conclusion: Adherence to HCC surveillance procedures is low in the study area. Closing the gap in HCC-related knowledge, particularly regarding surveillance and lifestyle, may help to increase adherence rates.

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“…the expected or unexpected barriers are still existed particularly in remote areas for its less accessibility, high cost and require human and technical resources to eliminate HBV and HCV in the world 10,11 .…”

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confidence: 99%

Evaluation of the efficiency of dried blood spot-based measurement of hepatitis B and hepatitis C virus seromarkers

Yamamoto

Nagashima

Isomura

et al. 2020

Sci Rep

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Although hepatitis B (HBV) and C (HCV) virus infections are still global health issues, measuring sero-markers by standard venipuncture is challenging in areas limited with the adequate human resources and basic infrastructure. This study aimed to inform the usefulness of dried blood spot (DBS) sampling technique for epidemiological study of HBV and HCV in the resources limited areas. We compared specimen recovery rate expressed as analytical sensitivity ratio of HBsAg, HBcAb and anti-HCV between serum specimens and DBS samples (HemaSpot vs Whatman903). Sensitivity ratio was calculated as the ratio of the measured value from DBS to the measured value from serum. Then both the qualitative and quantitative comparisons of HBsAg detection by DBS were done using Cambodian samples. HBsAg, HBcAb and anti-HCV sensitivity ratios for the highest sample dilution (8fold) were 31.2:1, 38.9:1 and 32.0:1 for Whatman903 card and 17.6:1, 23.5:1 and 26.3:1 for HemaSpot respectively. Detection efficacy of HemaSpot (80%) was not inferior to Whatman903 (60%) after 1 month storage, and no significant difference in any hepatitis virus sero-markers was observed in HemaSpot-spotted patient samples stored for 2 weeks at −25 °C and 29 °C. All reference HemaSpot-spotted 400 HBsAg sero-negative samples showed negative. Sensitivity and specificity of HBsAg in HemaSpot were 92.3% and 100%. The recovery expressed as analytical sensitivity ratio of HBsAg, HBcAb and anti-HCV of HemaSpot specimen were not inferior to Whatman903. Therefore, DBS with its usefulness proved as an acceptable tool for large epidemiological study of HBV and HCV in resources limited remote area. Hepatitis B virus (HBV) and hepatitis C virus (HCV) constitute a global health issue. Although there are the effective hepatitis B vaccine since 1982 1 and anti-viral drugs such as interferon alpha, lamivudine and others (tenofovir, adefovir, etc) 2,3 , WHO reported that approximately 257 million people have been infected with HBV and only 16.7% of the people diagnosed with hepatitis B were on anti-viral treatment as of 2016 4. Similarly, even there is no vaccine for HCV till now, the direct-acting antiviral drugs (DAAs) for the treatment of HCV were initially developed in 2011 5 and have since yielded high sustained virologic responses (SVRs) 6. But, WHO reported that 71 million people have been chronically infected with HCV and approximately 19% of global population (13.1 millions) knew their diagnosis and around 5 million only had treated with DAA at the end of 2017 7. Therefore, the World Health Organization (WHO) announced in 2016 a target to eliminate HBV as public health threats by 2030 by reducing the hepatitis B surface antigen (HBsAg) prevalence among children to ≤0.1% 8 and to eliminate HCV by 90% reduction in new diagnosis and 65% reduction in HCV related mortality by 2030 9. However, both

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Barriers to the Prevention and Control of Hepatitis B and Hepatitis C in the Community of Southwestern China: A Qualitative Research

Cited by 13 publications

References 30 publications

Initial success from a public health approach to hepatitis C testing, treatment and cure in seven countries: the road to elimination

Initial success from a public health approach to hepatitis C testing, treatment and cure in seven countries: the road to elimination

<p>Adherence to Hepatocellular Carcinoma Surveillance and Perceived Barriers Among High-Risk Chronic Liver Disease Patients in Yunnan, China</p>

Evaluation of the efficiency of dried blood spot-based measurement of hepatitis B and hepatitis C virus seromarkers

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