Affiliation:
1. Partners In Health Freetown Sierra Leone
2. Division of Global Health Equity: Department of Medicine Brigham and Women's Hospital Boston Massachusetts USA
3. Department of Pediatrics Boston Children's Hospital Boston Massachusetts USA
4. Ministry of Health and Sanitation Freetown Sierra Leone
Abstract
AbstractDespite a high prevalence, there are few successful models for de‐centralizing diagnosis and treatment of chronic hepatitis B virus (HBV) infection among rural communities in Sub‐Saharan Africa. We report baseline characteristics and 1 year retention outcomes for patients enrolled in a HBV clinic integrated within chronic disease services in a rural district hospital in Sierra Leone. We conducted a retrospective cohort study of patients with HBV infection enrolled between 30 April 2019 and 30 April 2021. Patients were eligible for 1 year follow‐up if enrolled before 28 February 2020. Treatment eligibility at baseline was defined as cirrhosis (diagnosed by clinical criteria of decompensated cirrhosis, ultrasonographic findings or aspartate‐aminotransferase‐to‐platelet ratio >2) or co‐infection with HIV or HCV. Retention in care was defined as a documented follow‐up visit at least 1 year after enrolment. We enrolled 623 individuals in care, median age of 30 years (IQR 23–40). Of 617 patients with available data, 97 (15.7%) had cirrhosis. Treatment was indicated among 113 (18.3%) patients and initiated among 74 (65.5%). Of 39 patients eligible for 1 year follow‐up on treatment at baseline, 20 (51.3%) were retained at 1 year, among whom 12 (60.0%) had documented viral suppression. Among the 232 patients not initiated on treatment eligible for 1 year follow‐up, 75 (32.3%) were retained at 1 year.Although further interventions are required to improve outcomes, our findings demonstrated feasibility of retention and treatment of patients with HBV infection in a rural district in Sub‐Saharan Africa, when integrated with other chronic disease services.
Subject
Virology,Infectious Diseases,Hepatology
Cited by
3 articles.
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