An educate, test, and treat programme towards elimination of hepatitis C infection in Egypt: a community-based demonstration project

Shiha, Gamal; Metwally, Ammal M.; Soliman, Reham; Elbasiony, Mohamed; Mikhail, Nabiel; Easterbrook, Philippa

doi:10.1016/s2468-1253(18)30139-0

Cited by 52 publications

(42 citation statements)

References 23 publications

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“…In our study seroprevalence of HCV among study participants was 12.3%. This was in agreement with Shiha [6] who found that (13%) of study rural participants of El Othmaniya village in Northern Egypt were HCV seropositive. However, this was higher than Kandeel [7] who studied the data obtained from EDHS 2015 and found that the seroprevalence of HCV in Egypt as a whole was only 10%.…”

Section: Discussionsupporting

confidence: 91%

Effect of health education intervention on hepatocellular carcinoma risk factor prevention in Menoufia governorate, Egypt

Yehia

Morad

Hendy

et al. 2020

Egypt Liver Journal

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Background: Hepatocellular carcinoma is an important public health problem worldwide and in Egypt. It has a bad prognosis and few treatment options. HCV and HBV infection and exposure to pesticides and aflatoxins are major risk factors for its development, so paying more attention to prevention via raising population awareness about its risk factors may be useful in lowering HCC incidence. This study was implemented to study knowledge, attitude, and practice (KAP) of a rural community of Menoufia governorate, Egypt, pre-and post-health education intervention about HCC and prevention of its risk factors. Results: Seroprevalence of HCV among study participants was 12.3%, and the health education intervention about HCC and the prevention of its risk factors was effective in increasing the percent of pre-intervention good knowledge score groups about HCC, HBV, and HCV, pesticides, aflatoxins, and total knowledge score from 66.5%, 88.8%, 83.8, 41.9%, and 73.7% respectively to 98.9%, 100%, 100%, and 98.9% post-intervention (p value = 0.000 for each) and was also effective in increasing the pre-intervention positive attitude score groups from 61.5 to 98.9% post-intervention. It was also effective in increasing the pre-intervention safe practice score groups of male and female study participants from 20% and 23% respectively to 94.3% and 93.1% post-intervention.Conclusions: Health education intervention was effective in improving KAP about HCC and prevention of its risk factors and could be adopted by MOHP as a part of comprehensive program for HCC prevention in rural communities of Menoufia governorate.

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Section: Discussionsupporting

confidence: 91%

Effect of health education intervention on hepatocellular carcinoma risk factor prevention in Menoufia governorate, Egypt

Yehia

Morad

Hendy

et al. 2020

Egypt Liver Journal

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“…Similar programmes could be further enhanced by integrating other elements to improve the entire cascade of HCV care, such as adapted community‐based point‐of‐care testing , same‐day anti‐HCV and HCV RNA tests , nurse‐led services that facilitate linkage to care and integration of HCV care in the drug and alcohol setting , especially for individuals with comorbid AUD. Community‐based ‘test‐and‐treat’ approaches have also proved effective in local contexts, and may inspire future programmes targeting PWID . In France, entry points in care for PWID consist of specialized care centres for addiction (CSAPA, CAARUD) and general medical practice, and there is still a strong need for better HCV care integration.…”

Section: Discussionmentioning

confidence: 99%

Untreated alcohol use disorder in people who inject drugs (PWID) in France: a major barrier to HCV treatment uptake (the ANRS‐FANTASIO study)

et al. 2019

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Background and Aims Although people who inject drugs (PWID) are the core at‐risk population in the hepatitis C virus (HCV) epidemic in industrialized countries, few initiate treatment. Alcohol use disorder (AUD), common within this population, has been identified as a barrier to HCV treatment uptake in the general population. We investigated whether the arrival of new and well‐tolerated HCV treatments (direct‐acting antivirals: DAA) has improved HCV treatment uptake in French PWID compared with former treatments (pegylated interferon‐based treatments: Peg‐IFN). Design Using discrete‐time Cox proportional hazards models based on exhaustive care delivery data, we tested for associations between AUD (defined by AUD‐related long‐term illness status, diagnosis coding during hospitalization and/or AUD pharmacological treatment) and first HCV treatment delivery, after adjusting for gender, age, complementary universal health cover, liver disease severity and type of opioid agonist therapy (OAT) received. Separate analyses were performed for 2012–13 (Peg‐IFN era) and 2014–16 (DAA era). Setting France. Participants All French people chronically HCV‐infected who received OAT at least once during 2012–16 and were covered by the national health insurance (n = 24 831). Measurements Incidence rate of HCV treatment uptake, hazard ratios associated with AUD and other covariates. Findings Incidence rate (IR) of HCV treatment uptake per 100 person‐years was 6.56, confidence interval (CI) = 6.30–6.84; and IR = 5.70, 95% CI = 5.51–5.89 for Peg‐IFN‐based treatment (2012–13) and DAA (2014–16), respectively. After multiple adjustment, people with AUD not receiving related medication had 30 and 14% lower Peg‐IFN‐based treatment and DAA uptake, respectively, than those without AUD [hazard ratio (HR) = 0.70, 95% CI = 0.62–0.80 and HR = 0.86, 95% CI = 0.78–0.94]. No difference was observed between those treated for AUD and those without AUD. Conclusions Despite the benefits of direct‐acting antiviral treatment, untreated alcohol use disorder appears to remain a major barrier to hepatitis C virus treatment access for people who inject drugs in France.

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“…In 2018, the Polaris Observatory reported that only 12 countries were on the track of achieving this result, and Italy is among these . Notably, many countries have already started special programmes to meet this challenge . In this optics, the European Association for the Study of Liver (EASL) International Liver Foundation proposed “micro‐elimination” as a way to eliminate HCV infection.…”

Section: Introductionmentioning

confidence: 99%

HCV point‐of‐care screening programme and treatment options for people who use drugs in a metropolitan area of Southern Italy

Persico

Masarone

Aglitti

et al. 2019

Liver International

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Background and aims People who use drugs (PWUD) represent an active reservoir of HCV infection. The prevalence of chronic HCV infection in PWUD in Italy remains unknown because of the lack of systematic screening. Thanks to direct‐acting antiviral agents (DAAs), hepatitis C can now be cured in most patients. Thus, the next challenge is to provide linkage‐to‐care for these patients. Methods In this scenario, we conducted a screening programme in PWUD attending seven Addiction Centers in Southern Italy, as well as a treatment programme in the Liver Unit of the University Hospital of Salerno. We used the OraQuick HCV antibody test to screen the PWUD (from 1 April to 30 September 2018). Results 593 subjects were consecutively enrolled in the programme; 250 (41.8%) were HCV‐Ab‐positive. 143 (24.1%) were aware of their infection and had been HCV‐RNA‐tested: 83 were positive and 60 negative. The remaining 107 subjects (18.1%) had never previously been tested and were unaware of their infection. A total of 160 (26.9%) HCV RNA‐positive patients were found and offered antiviral therapy with DAAs. The sustained virological response rate was 98.5% and no adverse events were recorded. Two patients voluntarily discontinued treatment. No reinfections have been recorded to date. Conclusions The prevalence of HCV‐Ab positivity was high in the PWUDs enrolled in this study, and almost half the patients were unaware of being HCV‐positive. The linkage‐to‐care provided was safe and effective, and no case of reinfection was recorded.

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An educate, test, and treat programme towards elimination of hepatitis C infection in Egypt: a community-based demonstration project

Cited by 52 publications

References 23 publications

Effect of health education intervention on hepatocellular carcinoma risk factor prevention in Menoufia governorate, Egypt

Effect of health education intervention on hepatocellular carcinoma risk factor prevention in Menoufia governorate, Egypt

Untreated alcohol use disorder in people who inject drugs (PWID) in France: a major barrier to HCV treatment uptake (the ANRS‐FANTASIO study)

HCV point‐of‐care screening programme and treatment options for people who use drugs in a metropolitan area of Southern Italy

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