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Abstract:
BACKGROUND & AIMS:Egypt has one of the highest burdens of HCV infection worldwide. It has a large treatment programme, but reaching rural communities represents a major challenge. We report on the feasibility and effectiveness of a comprehensive community-based HCV prevention, testing and treatment model whose goal was to eliminate infection from all adult villagers. METHODS:An HCV "educate, test and treat" programme was implemented in 73 villages across 7 governorates in Egypt between 06/2015 and 06/2018. The programme model comprised community mobilisation facilitated by a network of village promoters to support the education, testing and treatment of patients, as well as fundraising in the local community. Comprehensive testing, linkage to care and treatment were provided for all eligible villagers aged 12 to 80 years. RESULTS:Of 221,855 eligible villagers, 204,749 (92.3%, 95% CI 91.6-93.5) were screened for HCV antibody and HBsAg, of whom 33,839 (16.5%, 95% CI 12.2-16.1) and 763 (0.4%, 95% CI 0.3-0.5) were positive, respectively. Nearly all 33,839 HCV antibody positive individuals had a sample immediately collected for HCV RNA testing, and 15,892 were HCV RNA positive. The overall prevalence of HCV viraemia was 7.8%. A total of 14,495 (91.2%, 95% CI 89.9-96.4) patients received treatment within a median of 2.1 weeks from serological diagnosis (IQR 0.6-3.3 weeks) and a sustained virological response was achieved among 14,238 of the treated cases (98.3%, 95% CI 96.7-98.6). Cirrhosis was present in 3,192 patients (20.1%), of whom 166 (5.2%) were diagnosed with hepatocellular carcinoma. There was treatment coverage and cure of 84.6% of the estimated 17,137 infected persons aged 12-80 years across the 73 villages. CONCLUSION:In this study of more than 200,000 villagers, we demonstrated the feasibility and effectiveness of a community-based "educate, test and treat" programme as a model for the elimination of HCV infection in rural communities. LAY SUMMARY:A large community-based educate, test and treat hepatitis C programme was conducted in more than 200,000 villagers across 73 villages in Egypt. This study demonstrates that a simplified care model can achieve high uptake of testing, linkage to care and treatment, with high cure rates. We consider this a model for the elimination of hepatitis C virus infection in rural communities, which can be applied to other countries highly affected by hepatitis C.
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最新影响因子:30.083 | 期刊ISSN:0168-8278 | CiteScore:8.17 |
出版周期:Monthly | 是否OA:YES | 出版年份:0 |
期刊官方网址:http://www.elsevier.com/wps/find/journaldescription.cws_home/621507/description
自引率:6.00% | 研究方向:医学-胃肠肝病学 |
出版地区:NETHERLANDS |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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Journal of Hepatology publishes original papers reviews and letters to the Editor concerned with clinical and basic research in the field of hepatology. The Journal is published in English.
《肝脏病学杂志》发表有关肝脏病学领域临床和基础研究的原始论文评论和给编辑的信件。这本杂志是用英文出版的。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
GASTROENTEROLOGY & HEPATOLOGY (胃肠肝病学) 1区 |
4/80 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
223 | 193 | 30 |
引文计数(2018)
文献(2015-2017)
11558次引用
1414篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Hepatology
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#2/59
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研究方向:医药科学 消化系统 炎性肝病 感染性肝病
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影响因子:2.995
ISSN:0028-3940
研究方向:医学-核医学
影响因子:2.324
ISSN:1051-2284
研究方向:医学-核医学
影响因子:3.156
ISSN:1869-1439
研究方向:CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & M
影响因子:4.6
ISSN:0150-9861
研究方向:医学-核医学
影响因子:1.764
ISSN:1591-0199
研究方向:CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & M
影响因子:4.966
ISSN:0195-6108
研究方向:医学-核医学
影响因子:3.005
ISSN:0301-0449
研究方向:医学-核医学
影响因子:2.396
ISSN:1793-5458
研究方向:OPTICS-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGI
影响因子:3.632
ISSN:1084-9785
研究方向:医学-核医学
发表一篇学和医学成像类SCI论文
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