Abstract:

It is estimated that 3% and 4% of Rwandans living with hepatitis B and C respectively. Both HBV and HCV are more infectious than HIV and untreated chronic hepatitis B and C infection can result in liver cirrhosis and liver cancer. Despite to severity of these diseases numerous challenges exist for effective management of chronic HBV and HCV infections, particularly in resource-limited regions. The aim of this study was to explore the treatment of hepatitis B and C infection as well as challenges related to its treatment at Ruli District Hospital.

A non-experimental quantitative descriptive cross-sectional was used and sampling strategy was total population sampling (TPS).

Of all participants 22% to 68.3% and 22% to 61% reported that people in risk groups are screened routinely for HBV and HCV respectively, the percentage vary according to each specific category. Lamivudine and Tenofovir were selected by the majority 58.5% and 61% respectively, as very commonly used drugs for HBV while most of participants reported that they’re not sure about the usage of treatment on WHO essential list for HCV. Numeral challenges and barriers for the treatment of HBV and HCV were found; these include difficulties to reach specialized care, lack of Accurate Statistics Regarding the Burden of HBV and HCV Infections, low public Awareness and Education and Limited knowledge of health care providers on viral hepatitis B/C.

There are still numerals challenges to be addressed for improvement of the treatment viral hepatitis infections.

Keywords: Hepatitis B, Hepatitis C, Treatment, Challenges.

References:

[1].   WHO, 2013, Global policy report on the prevention and control of viral hepatitis in WHO member states, Geneva.

[2].   Mohd H. K., Groeger J., Flaxman AD., Wiersma ST., 2013, Global epidemiology of hepatitis C virus infection: new estimates of age-specifi c antibody to HCV seroprevalence. Hepatology, 57:1333–1342.

[3].   Kateera F., Timothy D., Walker, Mutesa L., Mutabazi V., Musabeyesu E, Mukabatsinda C, Bihizimana P, Kyamanywa P, Karenzi B and T.Orikiiriza J, 2015, Hepatitis B and C seroprevalence among health care workers in a tertiary hospital in Rwanda. Royal Society of Tropical Medicine and Hygiene; 109: 203–208.

[4].   Lozano R et al., 2010, Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study. Lancet, 2012, 380(9859):2095–2128.

[5].   The Florida Department of Health Bureau of HIV/AIDS, 2003, The Co-infection of HIV/AIDS and Hepatitis B and C: The Socio-Economic Impact on the State of Florida, http://www.theaidsinstitute.org.

[6].   WHO, 2015, Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection Geneva Switzerland: World Health Organization.

[7].   WHO, 2016, Guidelines for the prevention, care and treatment of persons with chronic hepatitis C infection. Geneva Switzerland: World Health Organization.

[8].   Nwokediuko SC., 2011, Chronic Hepatitis B: Management Challenges in Resource-Poor Countries. Hepat Mon; 11(10):786-93.

DOI: 10.5812/kowsar.1735143X.757.

[9].   Dore GJ, Ward J, Thursz M., 2014, Hepatitis C disease burden and strategies to manage the burden (Guest Editors Mark Thursz, Gregory Dore and John Ward). J Viral Hepat 2014; 21: 1–4.

[10].  Nathan F., Swan T., Beyer P., Gottfried H., Philippa E., Stefan W., 2014, Simplification of antiviral hepatitis C virus therapy to support expanded access in resource-limited settings. Journal of Hepatology vol. 61 j S132–S138.

[11].  Timothy D. W., Emmanuel M., 2015, Hepatitis B in Rwanda: Closing the gaps to end an epidemic. Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 1, 2015.

[12].  Nsanzimana, Kirk CM.., Uwizihiwe JP., Bucher HC., 2015, Increasing Access to Hepatitis C Treatment in Rwanda: The Promise of Rwanda’s Existing HIV Infrastructure, Infectious Diseases & Therapy. 2015, 3:5.

[13].  WHO, 2011, Outreach services as strategy to increase access to health workers in remote and rural areas, WHO Library Cataloguing-in-Publication Data, http://whqlibdoc.who.int/publications/2011/9789241501514_eng.pdf.

[14].  Ruli District Hospital, 2017, presntion and background www.rulihospital.com/.

[15].  Abby F., Amena A., Miriam L., Irene V., Angela B., Justine T., Simone N., P., Jan H. Richardus, Ralf R., 2014, Current Hepatitis B and C Screening, Treatment and Patient Management Practices. HEP screening 201478.

[16].  Adekunle, Ndububa DA, Olowookere SA, Ijarotimi O1, Ijadunola KT., 2015 Virus Infection, Immunization with Hepatitis B Vaccine, Risk Perception, and Challenges to Control Hepatitis among Hospital Workers in a Nigeriann Tertiary Hospital.

[17].  Emeka B. K., Kenechi U., Eshiobo I., Andrew D., Kefas J B., and Bamidele J. Alegbeleye, 2011, Knowledge of Hepatitis B Vaccine among Operating Room Personnel in Nigeria and Their Vaccination Status, Hepatitis Research and Treatment Volume 2011: 10.1155/2011/157089.

[18].  WHO, 2016, Guidelines for the Screening, Care and Treatment of Persons with hepatitis infection, https://apps.who.int/iris/bitstream/10665/205035/1/9789241549615_eng.pdf?ua=1.

[19].  Astone JM, Strauss SM, Vassilev ZP, Des Jarlais DC., 2003, Provision of hepatitis C education in a nationwide sample of drug treatment programs. Drug Education. 2003;33(1):107–117 [PubMed].

[20].  Miriam L., Abby F. Cristina T. Amena A., Irene V. Giuditta N., Angela B., 2016, Referral of newly diagnosed chronic hepatitis B and C patients in six EU countries: results of the HEPscreen Project, European Journal of Public Health, Volume 26, Issue 4, Pages 561–569, https://doi.org/10.1093/eurpub/ckw054. Published: 19 April 2016.

[21].  Anna S. F., Lok and Brian J. M., 2009, Chronic hepatitis B: Update 2009 Volume50, Issue3 https://doi.org/10.1002/hep.23190.

[22].  Lok AS., McMahon BJ. Chronic hepatitis B., 2007, Hepatology. 2007; 45:507–539. [PubMed].

[23].  McGowan, Christopher E., and Michael W. Fried. 2018, BARRIERS TO HEPATITIS C TREATMENT., Liver international: official journal of the International Association for the Study of the Liver 32.0 1 (2012): 151–156. PMC.

[24].  Giles-Vernick T, Hejoaka F, Sanou A, Shimakawa Y, Bamba I, Traoré A., 2016, Barriers to Linkage to Care for Hepatitis B Virus Infection: A Qualitative Analysis in Burkina Faso, West Africa. The American Journal of Tropical Medicine and Hygiene. 2016;95(6):1368-1375. doi:10.4269/ajtmh.16-0398.

[25].  Morrill JA, Shrestha M, Grant RW., 2005, Barriers to the Treatment of Hepatitis C: Patient, Provider, and System Factors. Journal of General Internal Medicine. 2005;20 (8):754-758. doi:10.1111/j.1525-1497.2005.0161. x.