HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme
Background & Aims: Strategies to implement HBV screening and treatment are critical to achieve HBV elimination but have been inadequately evaluated in sub-Saharan Africa (sSA). Methods: We assessed the feasibility of screen-and-treat interventions in 3 real-world settings (community, workpla...
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Elsevier
2022-10-01
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| Series: | JHEP Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555922001057 |
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| author | Amina Sow Maud Lemoine Papa Souleymane Toure Madoky Diop Gora Lo Jean De Veiga Omar Thiaw Pape Khady Seck Gibril Ndow Lamin Bojang Arame Kane Marina Oudiane Jess Howell Shevanthi Nayagam Jude Moutchia Isabelle Chemin Maimuna Mendy Coumba Toure-Kane Mark Thursz Mourtalla Ka Yusuke Shimakawa Souleymane Mboup |
| author_facet | Amina Sow Maud Lemoine Papa Souleymane Toure Madoky Diop Gora Lo Jean De Veiga Omar Thiaw Pape Khady Seck Gibril Ndow Lamin Bojang Arame Kane Marina Oudiane Jess Howell Shevanthi Nayagam Jude Moutchia Isabelle Chemin Maimuna Mendy Coumba Toure-Kane Mark Thursz Mourtalla Ka Yusuke Shimakawa Souleymane Mboup |
| author_sort | Amina Sow |
| collection | DOAJ |
| description | Background & Aims: Strategies to implement HBV screening and treatment are critical to achieve HBV elimination but have been inadequately evaluated in sub-Saharan Africa (sSA). Methods: 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: 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%, p = 0.617). Of HBV-infected participants successfully linked to care, full clinical staging was obtained in 47.5% (66/139), 59.5% (69/116), and 71.1% (329/463) from the community, workplaces, and hospitals, respectively (p <0.001). The proportion eligible for treatment (EASL criteria) differed among community- (9.1%), workplace- (30.4%), and hospital-based settings (17.6%, p = 0.007). Acceptability of antiviral therapy, adherence, and safety at 1 year were very good. Conclusions: 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: 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. |
| first_indexed | 2024-04-12T20:20:24Z |
| format | Article |
| id | doaj.art-2e37f63ee3db4720a20853b951f90100 |
| institution | Directory Open Access Journal |
| issn | 2589-5559 |
| language | English |
| last_indexed | 2024-04-12T20:20:24Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
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| series | JHEP Reports |
| spelling | doaj.art-2e37f63ee3db4720a20853b951f901002022-12-22T03:18:01ZengElsevierJHEP Reports2589-55592022-10-01410100533HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programmeAmina Sow0Maud Lemoine1Papa Souleymane Toure2Madoky Diop3Gora Lo4Jean De Veiga5Omar Thiaw Pape6Khady Seck7Gibril Ndow8Lamin Bojang9Arame Kane10Marina Oudiane11Jess Howell12Shevanthi Nayagam13Jude Moutchia14Isabelle Chemin15Maimuna Mendy16Coumba Toure-Kane17Mark Thursz18Mourtalla Ka19Yusuke Shimakawa20Souleymane Mboup21Institut de Recherche en Santé de Surveillance Epidemiologique et de Formation (IRESSEF) Laboratoire CHNU Dalal Jamm Guediawaye, IRESSEF Diamnoadio Dakar, Senegal; Laboratoire de Virology, Hopital Le Dantec, Dakar, SenegalDepartment of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Section of Hepatology, St Mary’s Hospital, Imperial College London, London, UK; Medical Research Council the Gambia Unit at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia; Corresponding author. Address: Department of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Section of Hepatology, St Mary’s Hospital, South Wharf Street, Imperial College London, London, UK. Tel.: +44-2033-125212.UFR des Sciences de la Sante, Thies, Senegal; Centre hospitalier de Tivaoaune, Service de Medecine interne, Thies, SenegalUFR des Sciences de la Sante, Thies, SenegalInstitut de Recherche en Santé de Surveillance Epidemiologique et de Formation (IRESSEF) Laboratoire CHNU Dalal Jamm Guediawaye, IRESSEF Diamnoadio Dakar, Senegal; Laboratoire de Virology, Hopital Le Dantec, Dakar, SenegalHopital Saint Jean de Dieu, Service d’Hepatologie et Gastroenterologie, Thies, SenegalHopital Saint Jean de Dieu, Laboratoire d’analyse biochimique et hématologique, Thies, SenegalCentre hospitalier régional de Thies, Service de Medecine interne, Thies, SenegalMedical Research Council the Gambia Unit at the London School of Hygiene and Tropical Medicine, Fajara, The GambiaMedical Research Council the Gambia Unit at the London School of Hygiene and Tropical Medicine, Fajara, The GambiaUFR des Sciences de la Sante, Thies, Senegal; Centre hospitalier de Tivaoaune, Service de Medecine interne, Thies, SenegalUFR des Sciences de la Sante, Thies, Senegal; Centre hospitalier de Tivaoaune, Service de Medecine interne, Thies, SenegalDisease Elimination, Burnet Institute, Department of Gastroenterology, St. Vincent's Hospital Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Melbourne, Victoria, AustraliaDepartment of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Section of Hepatology, St Mary’s Hospital, Imperial College London, London, UK; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UKUnité d'Épidémiologie des Maladies Émergentes, Institut Pasteur Paris, FranceINSERM U1052, CNRS 5286, Université Lyon, Université Claude Bernard Lyon 1, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, F-69000, Lyon, FranceInternational Agency for Research on Cancer (IARC), Lyon, FranceInstitut de Recherche en Santé de Surveillance Epidemiologique et de Formation (IRESSEF) Laboratoire CHNU Dalal Jamm Guediawaye, IRESSEF Diamnoadio Dakar, Senegal; Laboratoire de Virology, Hopital Le Dantec, Dakar, SenegalDepartment of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Section of Hepatology, St Mary’s Hospital, Imperial College London, London, UKUFR des Sciences de la Sante, Thies, Senegal; Centre hospitalier de Tivaoaune, Service de Medecine interne, Thies, SenegalUnité d'Épidémiologie des Maladies Émergentes, Institut Pasteur Paris, FranceInstitut de Recherche en Santé de Surveillance Epidemiologique et de Formation (IRESSEF) Laboratoire CHNU Dalal Jamm Guediawaye, IRESSEF Diamnoadio Dakar, Senegal; Laboratoire de Virology, Hopital Le Dantec, Dakar, SenegalBackground & Aims: Strategies to implement HBV screening and treatment are critical to achieve HBV elimination but have been inadequately evaluated in sub-Saharan Africa (sSA). Methods: 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: 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%, p = 0.617). Of HBV-infected participants successfully linked to care, full clinical staging was obtained in 47.5% (66/139), 59.5% (69/116), and 71.1% (329/463) from the community, workplaces, and hospitals, respectively (p <0.001). The proportion eligible for treatment (EASL criteria) differed among community- (9.1%), workplace- (30.4%), and hospital-based settings (17.6%, p = 0.007). Acceptability of antiviral therapy, adherence, and safety at 1 year were very good. Conclusions: 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: 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.http://www.sciencedirect.com/science/article/pii/S2589555922001057Hepatitis BAfricaScreeningDiagnosisTreatment |
| spellingShingle | Amina Sow Maud Lemoine Papa Souleymane Toure Madoky Diop Gora Lo Jean De Veiga Omar Thiaw Pape Khady Seck Gibril Ndow Lamin Bojang Arame Kane Marina Oudiane Jess Howell Shevanthi Nayagam Jude Moutchia Isabelle Chemin Maimuna Mendy Coumba Toure-Kane Mark Thursz Mourtalla Ka Yusuke Shimakawa Souleymane Mboup HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme JHEP Reports Hepatitis B Africa Screening Diagnosis Treatment |
| title | HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme |
| title_full | HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme |
| title_fullStr | HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme |
| title_full_unstemmed | HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme |
| title_short | HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme |
| title_sort | hbv continuum of care using community and hospital based screening interventions in senegal results from the prolifica programme |
| topic | Hepatitis B Africa Screening Diagnosis Treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2589555922001057 |
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