Investigating linkage to care following community‐based screening for hepatitis B virus in rural Senegal: A mixed methods study

• Published in: Journal of viral hepatitis Vol. 31; no. 9; pp. 544 - 556
• Main Authors: Coste, Marion, Diouf, Assane, Ndong, Cilor, Diouf, Aissatou, Périères, Lauren, Nishimwe, Marie Libérée, Bureau, Morgane, Ndiaye, Assane, Maradan, Gwenaëlle, Diallo, Aldiouma, Boyer, Sylvie, Bérenger, Cyril, Bousmah, Marwan‐al‐Qays, Carrieri, Patrizia, de Sèze, Maëlle, Djaogol, Tchadine, Marcellin, Fabienne, Treibich, Carole, Ba, Elhadji, Dièye, Fambaye, Faye, Elhadji Bilal, Sokhna, Cheikh, Touré Kane, Coumba, Lo, Gora, Selbé Ndiaye, Anna Julienne, Ndiour, Samba, Halfon, Philippe, Mohamed, Sofiane, Rouveau, Nicolas, Calvo Cortès, Maria‐Camila, Laborde‐Balen, Gabrièle, Audibert, Martine, Fall, Fatou, Gueye, Ibrahima, Lacombe, Karine, Seydi, Moussa, Shimakawa, Yusuke, Tuaillon, Edouard, Vray, Muriel
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.09.2024; Wiley-Blackwell
• Subjects: chronic hepatitis B virus (HBV) infection; Community support; Hepatitis B; Life Sciences; linkage to care; Liver diseases; Management; Santé publique et épidémiologie; Senegal; Senegal; chronic hepatitis B virus (HBV) infection; Senegal; linkage to care; sSA; West African franc; aOR; hepatitis B virus; hepatitis B surface antigen HBV; Health and Demographic Surveillance System IQR; interquartile range; interquartile range pwHBV; confidence interval DBS; sub-Saharan Africa; people living with HBV; adjusted odds-ratios; DBS; pwHBV; HBV; WHO; World Health Organization; adjusted odds-ratios CI; hepatitis B surface antigen; CI; HBsAg; IQR; people living with HBV sSA; XOF; sub-Saharan Africa WHO; World Health Organization XOF; Health and Demographic Surveillance System; confidence interval; dried blood spots HBsAg; hepatitis B virus HDSS; HDSS; dried blood spots
• ISSN: 1352-0504; 1365-2893; 1365-2893
• DOI: 10.1111/jvh.13977

This paper investigates linkage to care following community‐based screening for hepatitis B virus (HBV) in rural Senegal. HBV‐positive participants who completed a biological and clinical examination to assess liver disease and treatment eligibility were referred to a regional hospital (if eligible for treatment), invited to join the Sen‐B research cohort study (adults with detectable viral load) or referred to their local health centre (all others). Logistic regressions were conducted to investigate factors associated with (i) uptake of the scheduled post‐screening examination, and (ii) HBV management initiation. Obstacles to HBV management were identified using thematic analysis of in‐depth patient interviews. Of the 206 HBV‐positive participants, 163 (79.1%) underwent the examination; 47 of the 163 (28.8%) initiated HBV management. Women, people not migrating for >6 months/year, individuals living in households with more agricultural and monetary resources, with other HBV‐positive participants, and beneficiaries of the national cash transfer program, were all more likely to undergo the examination. The likelihood of joining the Sen‐B cohort increased with household monetary resources, but decreased with agricultural resources. Initiation of HBV management in local health centre was higher among participants with a non‐agricultural economic activity. Individuals reported wariness and confusion about HBV management content and rationale at various stages of the care continuum, in particular with respect to venous blood sampling and management without treatment. In conclusion, HBV community‐based test‐and‐treat strategies are feasible, but early loss to follow‐up must be addressed through simplified, affordable management and community support and sensitization.