Uptake of hepatitis B treatment eligibility tests among hepatitis B patients; The case of Yumbe regional referral hospital, Uganda

Abstract

Background:Despite hepatitis B virus infection being a vaccine preventable liver disease, 257 million people are estimated to be chronically infected globally making it one of the commonest infections, causing more than 820,000 deaths annually worldwide. Uganda is one of the SSA that continues to be highly endemic with a prevalence of 4.3%, associated with poor clinical management of those infected. Objectives:Assess factors associated with uptake of recommended HBV treatment eligibility tests among HBV patients at YRRH. Methods: Data was collected using both quantitative and qualitative approaches. Chi square and modified Poisson regression analyses were undertaken to determine association of factors. 01 FGD and 04 KI interviews were conducted to explore factors affecting the provision of recommended hepatitis B treatment eligibility tests. Data was analyzed using inductive thematic analysis. Results. 1.01% patients took all 4 tests and 26.6% received at least one test. CBC was mostly consumed, 38.2% while USS was the least -7%, 7.5% patients were screened for HIV with 33.3% being HIV/HBV coinfected. 61.3% patients did not take any main test and 31.2% had a main test taken. Only 7.5% had both main tests. Uptake of main tests was associated with timing of tests (χ2 = 94.9, P< 0.000), HIV/HBV coinfection (χ2 = 20.46, P<0.000), duration in care, (χ2=68.9, P<0.000), average distance to hospital (χ2 = 15.5, P<0.017). Timing of tests was the only factor statistically associated with uptake of main recommended tests (PR = 0.44, 95% CI 0.210 – 0.92). Facilitators for provision of HBV tests included availability of commodities, HCWs’ knowledge of the treatment guidelines and good infrastructure while barriers were insufficient human resource, commodity stock outs and language barrier. Conclusion. There was poor uptake of recommended tests by HBV patients at YRRH. HCWs should endeavor to provide all recommended tests before HBV treatment initiation.