| Autor: |
Jagpreet Chhatwal, Shahnaz Murad, Suresh Kumar, Fatanah Ismail, Philippa Easterbrook, Rozainanee Mohd Zain, Jessica Markby, Sonjelle Shilton, Xiaohui Sem, Huan Keat Chan, Rosaida Md Said, Sasikala Siva, Zalwani Zainuddin, Norasiah Abu Bakar, Haniza Omar, Ryan Jose III Ruiz, Mary Gaeddert, Alexander Tyshkovskiy, Madeline Adee, Jean-Michel Piedagnel, Caroline Menétrey, Fazidah Yuswan, Nazrila Hairizan Nasir, Isabelle Andrieux-Meyer, Rozita Zakaria, Ruziaton Hasim, Muhammad Radzi Abu Hassan |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
BMJ Open, Vol 11, Iss 12 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2044-6055 |
| DOI: |
10.1136/bmjopen-2021-055142 |
| Popis: |
Introduction To achieve the elimination of hepatitis C virus (HCV), substantial scale-up in access to testing and treatment is needed. This will require innovation and simplification of the care pathway, through decentralisation of testing and treatment to primary care settings and task-shifting to non-specialists. The objective of this study was to evaluate the feasibility and effectiveness of decentralisation of HCV testing and treatment using rapid diagnostic tests (RDTs) in primary healthcare clinics (PHCs) among high-risk populations, with referral of seropositive patients for confirmatory viral load testing and treatment.Methods This observational study was conducted between December 2018 and October 2019 at 25 PHCs in three regions in Malaysia. Each PHC was linked to one or more hospitals, for referral of seropositive participants for confirmatory testing and pretreatment evaluation. Treatment was provided in PHCs for non-cirrhotic patients and at hospitals for cirrhotic patients.Results During the study period, a total of 15 366 adults were screened at the 25 PHCs, using RDTs for HCV antibodies. Of the 2020 (13.2%) HCV antibody-positive participants, 1481/2020 (73.3%) had a confirmatory viral load test, 1241/1481 (83.8%) were HCV RNA-positive, 991/1241 (79.9%) completed pretreatment assessment, 632/991 (63.8%) initiated treatment, 518/632 (82.0%) completed treatment, 352/518 (68.0%) were eligible for a sustained virological response (SVR) cure assessment, 209/352 (59.4%) had an SVR cure assessment, and SVR was achieved in 202/209 (96.7%) patients. A significantly higher proportion of patients referred to PHCs initiated treatment compared with those who had treatment initiated at hospitals (71.0% vs 48.8%, p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
