| Title: |
Development and evaluation of a simple treatment eligibility score (HEPSANET) to decentralise hepatitis B care in Africa: a cross-sectional study |
| Authors: |
Minier, Nicolas; Guingané, Alice Nanelin; Okeke, Edith; Sinkala, Edford; Johannessen, Asgeir; Andersson, Monique; Davwar, Pantong; Desalegn, Hailemichael; Duguru, Mary; Fall, Fatou; Mboup, Souleyman; Maponga, Tongai; Matthews, Philippa; Ramírez Mena, Adrià; Ndow, Gibril; Orlien, Stian; Riches, Nicholas; Seydi, Moussa; Sonderup, Mark; Spearman, C Wendy; Stockdale, Alexander; Taljaard, Jantjie; Vinikoor, Michael; Wandeler, Gilles; Lemoine, Maud; Shimakawa, Yusuke; Sombié, Roger |
| Contributors: |
Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology; Institut Pasteur Paris (IP)-Université Paris Cité (UPCité); Bogodogo University Hospital Center Ouagadougou, Burkina Faso; University of Jos Nigeria; University of Zambia Lusaka (UNZA); University of Oslo (UiO); Vestfold Hospital Tønsberg, Norway; University of Oxford; Stellenbosch University (SU); St Paul's Hospital Millennium Medical College Addis Abeba, Ethiopia; Hôpital Principal de Dakar; Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation - Institute of Health Research, Epidemiological Surveillance and Training Dakar, Sénégal (IRESSEF); The Francis Crick Institute London; University College London UCL (UCL); Universität Bern = University of Bern = Université de Berne (UNIBE); Liverpool School of Tropical Medicine (LSTM); Imperial College London; London School of Hygiene & Tropical Medicine Banjul, The Gambia; Centre Hospitalier National et Universitaire de Fann-Dakar Dakar, Sénégal; University of Cape Town; University of Liverpool; Malawi Liverpool Wellcome Trust Clinical Research Programme (MLW); Liverpool School of Tropical Medicine (LSTM)-University of Liverpool-Wellcome Trust-University of Malawi; University of Alabama Birmingham (UAB); Centre Hospitalier Universitaire Yalgado Ouédraogo Ouagadougou, Burkina Faso (CHUYO); HEPSANET has received funding from EASL Foundation and John C Martin Foundation. The research groups of ML in The Gambia and Senegal were funded by the Medical Research Council in the UK.; We also express our gratitude to Yoann Madec of Insitut Pasteur (Paris) for his statistical advice. |
| Source: |
ISSN: 2468-1253. |
| Publisher Information: |
CCSD; Elsevier |
| Publication Year: |
2024 |
| Subject Terms: |
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| Description: |
International audience ; Background: Hepatitis B virus (HBV) elimination requires expanding and decentralising HBV care services. However, peripheral health facilities lack access to diagnostic tools to assess eligibility for antiviral therapy. Through the Hepatitis B in Africa Collaborative Network (HEPSANET), we aimed to develop and evaluate a score using tests generally available at lower-level facilities, to simplify the evaluation of antiviral therapy eligibility in people living with HBV.Methods: We surveyed the availability of clinical and laboratory parameters across different health-care levels in sub-Saharan Africa. We used data from the HEPSANET dataset, the largest cross-sectional dataset of treatment-naive people living with HBV in sub-Saharan Africa, to derive and validate the score. Participants from this dataset were included in the analysis if they were aged 18 years or older and had liver fibrosis stages determined by a liver stiffness measurement or liver histopathology. Participants with co-infections or metabolic disorders were excluded. We allocated participants to the derivation and validation sets by geographical site. In the derivation set, we used stepwise logistic regression to identify the best performing parameters for identifying participants that met the 2017 European Association for the Study of the Liver (EASL) criteria. Regression coefficients were converted into integer points to construct simplified algorithms for different health-care levels. In the validation set, we estimated the area under the receiver operating characteristic, sensitivity, and specificity of the simplified algorithm for identifying antiviral therapy eligibility defined by the 2017 EASL criteria.Findings: At 11 sites from eight countries that returned surveys, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count were generally available at district hospital levels, and hepatitis B e antigen and point-of-care HBV DNA tests were available only at regional and provincial ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://pasteur.hal.science/pasteur-04613423v1; info:eu-repo/semantics/altIdentifier/pmid/38367633; PUBMED: 38367633; PUBMEDCENTRAL: PMC7616035 |
| DOI: |
10.1016/S2468-1253(23)00449-1 |
| Availability: |
https://pasteur.hal.science/pasteur-04613434; https://doi.org/10.1016/S2468-1253(23)00449-1 |
| Accession Number: |
edsbas.90D156D8 |
| Database: |
BASE |