Decentralised hepatitis C testing and treatment in rural Cambodia: evaluation of a simplified service model integrated in an existing public health system
| العنوان: | Decentralised hepatitis C testing and treatment in rural Cambodia: evaluation of a simplified service model integrated in an existing public health system |
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| المؤلفون: | Pascal Jolivet, Jennifer Craig, Daniel O'Keefe, Suna Balkan, Mickael Le Paih, Voeurng Bunreth, Jean-Philippe Dousset, Meiwen Zhang, Tonia Marquardt, Keo Samley |
| المصدر: | The Lancet Gastroenterology & Hepatology. 6:371-380 |
| بيانات النشر: | Elsevier BV, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Pyrrolidines, Daclatasvir, Adolescent, Sustained Virologic Response, Referral, Sofosbuvir, Pilot Projects, Antiviral Agents, Health Services Accessibility, Young Adult, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Mass Screening, Aged, Aged, 80 and over, Rapid diagnostic test, Hepatology, business.industry, Rural health, Public health, Imidazoles, Gastroenterology, Valine, Hepatitis C, Middle Aged, medicine.disease, Treatment Outcome, 030220 oncology & carcinogenesis, Emergency medicine, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, Carbamates, Public Health, Rural Health Services, Cambodia, business, Viral load, Follow-Up Studies, Program Evaluation, medicine.drug |
| الوصف: | We regret that this article is behind a paywall. To access this article, please visit this link: https://www.thelancet.com/journals/langas/article/PIIS2468-1253(21)00012-1/fulltext. Background: Direct-acting antiviral treatment for hepatitis C virus (HCV) has provided the opportunity for simplified models of care delivered in decentralised settings by non-specialist clinical personnel. However, in low-income and middle-income countries, increasing overall access to HCV care remains an ongoing issue, particularly for populations outside of urban centres. We therefore aimed to implement a simplified model of HCV care via decentralised health services within a rural health operational district in Battambang province, Cambodia. Methods: The study cohort included adult residents (≥18 years) of the health operational district of Moung Russei who were voluntarily screened at 13 local health centres. Serology testing was done by a rapid diagnostic test using SD Bioline HCV (SD Bioline HCV, Standard Diagnostics, South Korea) with capillary blood. HCV viral load testing was done by GeneXpert (Cepheid, Sunnyvale, CA, USA). Viraemic patients (HCV viral load ≥10 IU/mL) received pretreatment assessment by a general physician and minimal treatment evaluation tests at the health operational district referral hospital. Viraemic patients who did not have additional complications received all HCV care follow-up at the local health centres, provided by nursing staff, and patients who had decompensated cirrhosis, previously treated with a direct-acting antiviral, HBV co-infection, or other comorbidities requiring observation continued receiving care at the referral hospital with a general physician. Patients deemed eligible for treatment were prescribed oral sofosbuvir (400 mg) and daclatasvir (60 mg) once a day for 12 weeks, or 24 weeks for patients with decompensated cirrhosis or those previously treated with a direct-acting antiviral. HCV cure was defined as sustained virological response at 12 weeks after treatment (HCV viral load |
| تدمد: | 2468-1253 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::64ae838d5d72ec96f228c90e81556b87 https://doi.org/10.1016/s2468-1253(21)00012-1 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....64ae838d5d72ec96f228c90e81556b87 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 24681253 |
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