Values and preferences for hepatitis C self-testing among the general population and healthcare workers in Rwanda

Abstract

Background In 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030. To improve awareness of HCV status, strategies are needed to ensure easy access to HCV testing by as-yet unreached populations. HCV-self-testing, an innovative strategy, could further increase HCV testing uptake. This assessment explores perceptions around HCV self-testing among members of the public and healthcare workers in Rwanda. Methods A qualitative study was undertaken in Masaka District Hospital, comprising individual interviews, group interviews and participatory action research (PAR) activities. Purposive and snowball sampling methods guided the selection of informants. Informed consent was obtained from all participants. A thematic analysis approach was used to analyse the findings. Results The participants comprised 36 members of the public and 36 healthcare workers. Informants appreciated HCV self-testing as an innovative means of increasing access to HCV testing, as well as an opportunity to test privately and subsequently autonomously decide whether to seek further HCV care. Informants further highlighted the need to make HCV self-testing services free of charge at the nearest health facility. Disadvantages identified included the lack of pre/post-test counselling, as well as the potential psychosocial harm which may result from the use of HCV self-testing. Conclusion HCV self-testing is perceived to be an acceptable method to increase HCV testing in Rwanda. Further research is needed to assess the impact of HCV self-testing on HCV cascade of care outcomes.

Assessing Values and Preferences Toward SARS-CoV-2 Self-testing Among the General Population and Their Representatives, Health Care Personnel, and Decision-Makers: Protocol for a Multicountry Mixed Methods Study

“…Similar to that seen for other diseases—such as HIV, and recently, hepatitis C—self-testing can provide a convenient, private, and safe approach to scale-up testing [ 8 - 10 ]. However, as with HIV and hepatitis C self-testing, with SARS-CoV-2 self-testing, there are important concerns about lack of counseling for test results, potential for psychosocial harm, and ensuring timely reporting of test results to national surveillance systems [ 11 ].…”

Usability and acceptability of oral fluid hepatitis C self-testing among people who inject drugs in Coastal Kenya: a cross-sectional pilot study

“…Increasing access to HCV testing among high-risk groups in low-and middle-income countries is essential to achieve WHO viral hepatitis elimination goals by 2030. Recently published reports showed high usability and acceptability of HCV self-testing in the general population in Egypt, South Africa and Rwanda [36,40,41] as well as in high-risk populations in Vietnam [37]. We conducted the first study to assess the usability and acceptability of self-testing for HCV among PWID in Kenya.…”

“…Similarly, many participants did not perform the self-swabbing technique correctly, with many swabbing more times than required, and many read the results at the incorrect time. Previous studies on usability of oral fluid based HCV self-tests also reported difficulties with these two steps [36,40]. For the majority, these problems did not result in invalid test results; nonetheless, this confusion could be addressed by modifying the test tube and/or the stand, clarifying written or pictorial instructions, or providing additional training or materials before self-testing, including videos.…”

Assessing Values and Preferences Toward SARS-CoV-2 Self-testing Among the General Population and Their Representatives, Health Care Personnel, and Decision-Makers: Protocol for a Multicountry Mixed Methods Study (Preprint)

“…Similar to that seen for other diseases-such as HIV, and recently, hepatitis C-self-testing can provide a convenient, private, and safe approach to scale-up testing [8][9][10]. However, as with HIV and hepatitis C self-testing, with SARS-CoV-2 self-testing, there are important concerns about lack of counseling for test results, potential for psychosocial harm, and ensuring timely reporting of test results to national surveillance systems [11].…”