Health professionals' attitudes toward caring for people with hepatitis C

Knowledge, Attitude and Factors associated with Self-efficacy in Screening and Treatment of Hepatitis C among Primary Care Doctors in Selangor

Introduction

Primary care doctors (PCDs) play an increasingly important role in the management of hepatitis C. It is essential for PCDs to have good self-efficacy in screening and treating hepatitis C to achieve good outcomes. This study aimed to determine the knowledge and attitude towards and other factors associated with self-efficacy in screening and treating hepatitis C.

Methods

This cross-sectional study was conducted using an online Google Form. PCDs working at primary healthcare clinics were selected via simple random sampling. The online form contained items on sociodemographic and practice characteristics and a validated questionnaire on knowledge, attitude and self-efficacy towards screening and treating hepatitis C. Data were statistically analysed.

Results

A total of 242 PCDs were included in the analysis. The median age was 35 years (interquartile range [IQR]=5). The majority of the PCDs were women (83.9%) and Malay (71.9%) and had a median working experience of 6 years (IQR=6). The mean self-efficacy score was 12.67 (standard deviation=3.38). The factors associated with a higher level of self-efficacy in screening and treating hepatitis C were postgraduate qualification, training within the last one year, better knowledge and attitude scores and prior experience in treating hepatitis C.

Conclusion

The identified factors are crucial in improving the self-efficacy among PCDs in hepatitis C care services. Policymakers are suggested to implement training programmes and encourage continuous medical education, exposure to patient management and postgraduate certification in family medicine to help PCDs in treating hepatitis C better.

Knowledge and Attitude of Undergraduate Health Professions Students towards Hepatitis B and C

The current study sought to establish the attitude and knowledge level of medical science students in Tibah University towards hepatitis B and C. A cross-sectional study involving 369 students drawn from the faculties of medicine, dentistry, applied medical sciences, pharmacy, nursing, and medical rehabilitation sciences was conducted where a standardised questionnaire was used to determine the attitude and knowledge level of undergraduate students drawn from the college of medicine in Tibah University, Saudi Arabia, regarding viral infections. With a mean of 0.71, 0.69, and 0.66 and a standard deviation (SD) of 0.24, 0.34, and 0.24 for virology and transmission, symptoms and clinical outcomes, and treatment and prevention, respectively, the knowledge level of the health professions students towards hepatitis B and C infections was significant. The knowledge level about the infections was higher among male students than among female students. Similarly, students in their final years of medical school had significantly higher knowledge levels about hepatitis B and C than their counterparts in their first years of medical school. There was also a positive correlation between the attitude of the health professions students towards the disease and their knowledge levels of the disease. Findings indicate that enhanced instruction on the nature, virology, transmission, symptoms, treatment, clinical outcomes, and prevention of hepatitis B and C can help improve the knowledge levels and attitude of the health professions students towards the disease and its management.

Evaluation of Health Care Professionals' Knowledge, Attitudes, and Practice to Prevent the Pandemic Spread of COVID-19: A Questionnaire-Based Cross-Sectional Study from Abha, Saudi Arabia

BACKGROUND

Pharmacists and other healthcare professionals (HCPs) are at risk of transmitting the lethal COVID-19 virus globally and increasing its prevalence.

AIM

The aim of this study was to assess knowledge, attitudes, and practices (KAP) about coronavirus disease 2019 (COVID-19) among HCPs in the Asir region for the first time.

METHODOLOGY

A cross-sectional analysis with 491 healthcare professionals was tested using a pre-tested questionnaire in a tertiary care facility. The association between research variables and questions was determined using Chi-square tests and Kruskal-Wallis tests.

RESULTS

Pharmacists and other HCPs exhibited good knowledge, a positive attitude, and a negative practice pattern regarding COVID-19. There was a strong association between knowledge and attitude (correlation coefficient: 0.17; p < 0.001). However, healthcare practitioners had a suboptimal practice score of 2.09 ± 0.62 regarding COVID-19.

CONCLUSION

This study discovered that despite relatively insufficient practices for adherence to recommended techniques regarding COVID-19 prevention during the outbreak, pharmacists and other healthcare professionals have a high level of awareness and a positive attitude towards COVID-19 as a medical condition. There is a need for more involved HCPs, improved COVID-19 management training, and approaches to make healthcare providers feel less anxious.

Substance Use Disorder Treatment Providers' Knowledge and Opinions Toward Testing and Treatment of Chronic Hepatitis C in Rural North Carolina

Poor access to care has made western North Carolina vulnerable to an outbreak of hepatitis C viral infection (HCV), particularly among persons who inject drugs (PWID). As substance use disorder (SUD) treatment providers could potentially improve linkage to HCV testing and treatment, we sought to understand SUD providers, clinic and client characteristics; referral patterns; HCV knowledge; willingness to participate in additional trainings; and local linkage-to-care pathways for treatment of substance use and HCV. Online survey data were collected from 78 SUD providers serving PWID in eight western rural North Carolina counties. Providers' attitudes toward working with HCV+ clients were very positive. One-third of providers reported a low fund of knowledge regarding HCV, HCV treatment, and financial assistance opportunities. Non-prescribing providers rarely initiated discussions about HCV testing/treatment, but were receptive to training. Respondents indicated that HCV testing and treatment were best delivered at local health departments or primary care clinics but were open to other venues where PWID access care. The vast majority of prescribing and non-prescribing providers expressed interest in obtaining training in HCV treatments, how to obtain HCV medications and topics on advanced liver disease. Data from prescribing and non-prescribing SUD providers suggest opportunities to develop or expand integrated care models for HCV testing/treatment in PWID in rural Appalachian North Carolina.

Sources, purification, immobilization and industrial applications of microbial lipases: An overview

Microbial lipase is looking for better attention with the fast growth of enzyme proficiency and other benefits like easy, cost-effective, and reliable manufacturing. Immobilized enzymes can be used repetitively and are incapable to catalyze the reactions in the system continuously. Hydrophobic supports are utilized to immobilize enzymes when the ionic strength is low. This approach allows for the immobilization, purification, stability, and hyperactivation of lipases in a single step. The diffusion of the substrate is more advantageous on hydrophobic supports than on hydrophilic supports in the carrier. These approaches are critical to the immobilization performance of the enzyme. For enzyme immobilization, synthesis provides a higher pH value as well as greater heat stability. Using a mixture of immobilization methods, the binding force between enzymes and the support rises, reducing enzyme leakage. Lipase adsorption produces interfacial activation when it is immobilized on hydrophobic support. As a result, in the immobilization process, this procedure is primarily used for a variety of industrial applications. Microbial sources, immobilization techniques, and industrial applications in the fields of food, flavor, detergent, paper and pulp, pharmaceuticals, biodiesel, derivatives of esters and amino groups, agrochemicals, biosensor applications, cosmetics, perfumery, and bioremediation are all discussed in this review.

Australian health and medical workers' concerns around providing care to people living with hepatitis B

There is established literature on health workers' attitudes towards working with people living with stigmatised health conditions and behaviours, such as HIV, hepatitis C and injecting drug use. Less is known about health workers' attitudes and concerns around providing care to people living with hepatitis B virus (HBV), which is concerning as research indicates that negative attitudes may impact on the quality of care provided to these populations, with adverse health outcomes for clients. The aim of this paper is to examine health and medical workers' concerns about providing care to people living with HBV, and the factors that may influence these concerns. Australian health and medical workers (n = 551) completed an online survey measuring their concerns about providing care to people living with HBV, stigmatising attitudes towards this group, perceived comfort of themselves and colleagues in providing care towards clients with HBV, and witnessing their colleagues behaviour in a discriminatory way towards clients with HBV. Multiple regression was used to ascertain factors predictive of health workers' concerns about working with clients with HBV. Results showed that older participants and those who had spent less time working in the health and medical field had greater concerns about caring for people living with HBV. Workers who did not know someone living with HBV, who were less comfortable around clients with HBV, who perceived their colleagues to be less comfortable working with clients with HBV, and who had more negative attitudes towards this group also had greater concerns around providing care to people living with HBV. Efforts should be made to improve health and medical workers' attitudes towards working with people with HBV. This may also improve workers' level of comfort with people with HBV and reduce the reported reticence they have towards working with this client group.

Stigmatising attitudes towards people who inject drugs, and people living with blood borne viruses or sexually transmissible infections in a representative sample of the Australian population

Stigma has significant detrimental health outcomes for those affected. This study examined socio-demographic characteristics that were associated with stigmatising attitudes among the general population towards people who inject drugs, and people living with blood borne viruses or sexually transmissible infections. Questions were included in the Australian Survey of Social Attitudes (total sample = 1,001). Attitudes towards each of the target populations were measured by 5-item stigma scales. Bivariate analyses and multiple regression analyses were conducted to identify socio-demographic characteristics associated with stigmatising attitudes. Knowing a person affected by a stigmatised attribute was associated with reduced stigmatising attitudes, while voting for a conservative political party was associated with increased stigmatising attitudes. Age, gender, education, income, and marital status were each related to some stigmatising attitudes. Results also highlight differences between attitudes towards a stigmatised behaviour (i.e., injecting drug use) and stigmatised conditions (i.e., blood borne viruses and sexually transmissible infections). Identifying socio-demographic characteristics that are associated with stigmatising attitudes may have global implications for informing stigma reduction interventions, in order to promote positive health outcomes for affected communities.

The testing of people with any risk factor for hepatitis C in community pharmacies is cost-effective

New antiviral drugs with high efficacy mean the hepatitis C virus (HCV) can now be eliminated. To achieve this, it is necessary to identify undiagnosed cases of HCV. However, the costs of testing should be considered when judging the overall cost-effectiveness of treatment. This study describes the cost-effectiveness of a community pharmacy testing service in a population of people at risk of HCV living on the Isle of Wight (United Kingdom). Dry blood spot testing was conducted in anyone with a known risk factor for HCV in 20 community pharmacies. The outcomes and costs were entered into a Markov model. Cost and health utilities from the model were used to calculate an incremental cost-effectiveness ratio (ICER). In 24 months, 186 tests were conducted, 13 were positive for HCV RNA and six of these (46%) received treatment during the follow-up period. All achieved a sustained virological response at 3 months. The overall cost of the testing and treatment intervention was £242 183, and the ICER for the service was £3689 per quality-adjusted life year (QALY) gained. If screening had been restricted to just people with a history of injecting drug use (PWID) the ICER would have been £4865 per QALY gained. The service was effective at identifying people with HCV infection, and despite the additional cost of targeted testing, its cost-effectiveness was below the commonly accepted thresholds. In this setting, restricting targeted testing to PWID would not improve the cost-effectiveness.

Mitigating the Risk of Infectious Diseases Among Rural Drug Users in Western North Carolina: Results of the Southern Appalachia Test, Link, Care (SA-TLC) Health Care Provider Survey

PURPOSE

To characterize how health care providers in western North Carolina (NC) manage patients with substance use disorders and to inform strategies for preventing injection drug use (IDU)-associated outbreaks of bloodborne infectious diseases.

METHODS

We collected data on practice characteristics, provider sociodemographics, and attitudes and beliefs about hepatitis C virus (HCV), human immunodeficiency virus (HIV), opioid use, and IDU via online survey. Providers in 8 counties of western NC were invited to participate by email. Results were analyzed using descriptive and bivariate statistics.

FINDINGS

Of 84 respondents participating between 30 July and 3 December 2018, 81% were practicing clinicians and 46% served a county identified as being vulnerable to IDU-associated outbreaks of HCV or HIV. A substantial proportion was unsure about injecting behaviors among patients. Scores reflected comfort working with opioid users, though this varied by medical specialty. One-quarter of respondents "never" discussed harm reduction or HCV treatment with patients known to inject drugs; 22% "never" discussed HIV screening with injectors; and 1 in 3 referred at-risk patients out for HCV or HIV testing rather than ordering a test themselves. Scores indicated low levels of stigma toward persons living with HCV or HIV. Respondents identified HIV treatment, HCV treatment, and liver disease management as training needs.

CONCLUSIONS

Our findings provide insights to inform health infrastructure improvement, with the goal of preventing HCV or HIV outbreaks in southern Appalachia. Rural health care workers are willing to receive additional training if it can improve care for patients affected by substance use disorders.

Hepatitis C Virus Treatment Status and Barriers among Patients in Methadone Maintenance Treatment Clinics in Guangdong Province, China: A Cross-Sectional, Observational Study

We aimed to evaluate the status and barriers related to hepatitis C virus (HCV) treatment among Chinese methadone maintenance treatment (MMT) clients, and the willingness and barriers of patients to accept directly observed treatment (DOT) service and oral direct-acting antivirals (DAAs). We conducted a cross-sectional survey from July to October 2017 in Guangdong Province, China, involving 678 HCV antibody-positive MMT patients. If they reported being infected with HCV, then their HCV treatment experience, willingness to use DOT and DAAs, along with any barriers, were collected. Logistic regression analysis was used to identify the correlates of initiating HCV treatment. Among those reporting HCV infection (54%, 366/678), 39% (144/366) initiated treatment; however, 38% (55/144) interrupted and 55% (79/135) delayed treatment for 15 months. Seventy-five percent (273/366) and 53% (195/366) were willing to use DOT and DAAs, respectively. Unaffordable medical costs and insignificant symptoms were the major barriers to HCV treatment and accepting DOT or DAAs. The lack of a stable residence, being a woman, and having ever injected drugs were all associated with a low probability of initiating treatment (p < 0.05). This study highlights a limited uptake of HCV treatment among MMT patients, and a need to strengthen the popularity of DOT and DAAs and integrate them into Chinese MMT clinics.

Middle East Respiratory Syndrome (MERS): Comparing the knowledge, attitude and practices of different health care workers

Background

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness that was recently recognized in humans. Recently, the Ministry of Health in Saudi Arabia reported a substantial increase in MERS cases, primarily from the Riyadh region. The objective of the present study was to evaluate knowledge, attitude and practices towards MERS among physicians, nurses, pharmacist and technicians individually.

Methods

A cross sectional study conducted at King Khalid University Hospital, Riyadh, Saudi Arabia among individual healthcare workers. The survey questionnaire was self-administrated and consisted of five sections: Demographic; Source of MERS information; Knowledge; Attitude; and Practice of healthcare workers towards MERS.

Results

A total of 391 participants of which physicians (162; 41.4%), pharmacists (18; 4.6%), nurses (130; 33.3%) and technicians (81; 20.7%) were included with a response rate of 95.71%. The majority of the participants were female (53.70%) and mostly in the nurse’s category (40.5%). The participants reported the highest main source of information was seminars and workshops (n = 191; 48%) followed by social media (n = 179; 45%). The overall score indicates good knowledge among physicians (95.7%), pharmacists (88.9%), nurses (86.2%) and technicians (91.4%) and showed statistically significant (p = 0.039). The study showed a positive attitude among physicians (96.3%), pharmacist (94.4%), nurses (94.6%) and technicians (90.1%) with no statistically significant (p = 0.273). However, the majority of the participants showed average practices towards MERS. However, the least practice among participants was the use of facemask in the crowds (24.2%). The demographic characteristic’s age, gender and professions showed significantly associated with mean knowledge score. Similarly, statistical significance observed in gender and experience demographic variables with a mean attitude score.

Conclusions

The study concludes that different health workers showed good knowledge and positive attitudes, but low to average practices towards MERS with low adherence to facemask practice. When comparing workers, physicians have a high degree of knowledge and attitude when compared to nurses, pharmacist and technicians.

Chronic hepatitis C infection: how much are physicians aware of?

AIM

The purpose of our study is to measure the awareness of hepatitis C among physicians employed in Istanbul, and investigate the relationship between awareness and the specialization field, age and presence of chronic hepatitis/positive family history.

MATERIAL AND METHODS

Level of awareness of 125 family physicians and 76 internal medicine physicians, employed within Istanbul Province, on hepatitis C infection were evaluated using standard questionnaire. Relationship between their awareness and age, specialization, presence of any chronic hepatitis and chronic hepatitis C in any relatives were investigated.

RESULTS

The mean age of the physicians was 30.9 ±7.1 years (range: 23-45 years) and 58% of them were women. Seventy-five (37.3%) physicians were between ages of 23-28, 67 (33.3%) physicians were between ages of 29-32, and 59 (29.4%) physicians ages was greater than 32. Twenty-one (10.4%) physicians had hepatitis or a first-or second-degree relative with hepatitis. Physicians were found to be insufficient in answering the questions on hepatitis C virus transmission routes and who should be screened. When examined based on transmission routes, there were no significant differences between physicians' specializations and positive familial history, but physicians aged 23-28 had significantly poorer awareness at some points. Internal medicine specialists had better awareness on screening tests compared to family physicians but there were no significant differences between positive familial history and physicians' age.

CONCLUSIONS

Physicians' awareness should be improved to prevent hepatitis C virus transmission and to identify existing conditions.

Willingness to care for blood-borne virus-infected patients in Thailand

Background

Although stigma and discrimination by nurses against patients infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) have been reported, potential determinants of nurses' willingness to care for these patients have not been well studied in Thailand.

Aims

To identify factors associated with Thai nurses' willingness to care for patients infected with HIV or HCV.

Methods

Multivariable logistic regression analysis of data from a questionnaire completed by nurses at a large hospital in Bangkok, Thailand.

Results

Of 626 nurses, 546 (87%) nurses participated. Eleven per cent (59) and 6% (34) had previously experienced HIV- or HCV-infected blood contamination incidents, respectively. Forty-four per cent (240) and 38% (208) reported unwillingness to care for HIV- or HCV-infected patients, respectively. Willingness to care was less common [adjusted odds ratios 0.51 (0.34-0.74) for HIV and 0.62 (0.42-0.89) for HCV] in nurses aged ≥ 40 years and in those who feared HCV [0.63 (0.37-0.99)], but not HIV [0.84 (0.5-1.26)] transmission. Nurses who had confidence in protecting themselves against infection with HIV [1.84 (1.52-2.04)] and HCV [1.87 (1.45-2.18)], and accepting attitudes towards HIV-infected co-workers [1.39 (1.08-1.66)] but not HCV-infected co-workers [1.16 (0.83-1.5)], were more willing to care for HIV- and HCV-infected patients.

Conclusions

Around 4 in 10 Thai nurses in our sample were unwilling to care for HIV- or HCV-infected patients. Minimizing the risk of nosocomial transmission and improving the public perception of infected individuals may help improve nurses' willingness to care for such patients, in Thailand or elsewhere.

The caring behaviours of Danish pharmaconomists: insight for pharmacy technician practice around the world

OBJECTIVES

Pharmacy workforce support personnel are being accorded greater scopes of practice, especially Danish pharmaconomists [pharmacy technician, experts in pharmaceuticals with a 3-year degree]. The aims of this study were to assess pharmaconomists' caring behaviours and identify factors related to those behaviours.

METHODS

A self-administered survey was distributed to a random sample of pharmaconomists in Denmark. The survey assessed caring behaviours using the Caring Behaviours Assessment and acquired data to ascertain their employers' culture, respondent's need for achievement, personality traits, commitment and work-related characteristics. Descriptive statistics provided insight into pharmacomomists' predispositions, and bivariate analyses were used to identify associations of pharmaconomists' caring with other variables under study.

KEY FINDINGS

Over 300 pharmaconomists responded (52.2% response rate). Pharmaconomists reported generally high levels (well above the median on the 5-point scale) of caring behaviours. They reported higher levels (upper range of 5-point scale) of empathic behaviours, such as treating patients with respect and seeing things from the patient's point of view but somewhat lower levels of encouraging the patient to talk about how they feel and praising the patient's efforts, which could otherwise help patients cope with and improve their self-efficacy for disease management. Pharmaconomist caring was associated with practice setting, organisational culture and commitment to their employer.

CONCLUSIONS

Pharmaconomists reported performing behaviours that were empathic, but less frequently those associated with facilitating greater patient autonomy. Caring behaviours were associated with a number of variables related to practice setting. The findings can help to inform educational pedagogy and pharmacy personnel management.

A dirty little secret: stigma, shame and hepatitis C in the health setting

While recent medical innovation shows great promise in treating hepatitis C (HCV), it remains a condition associated with profound stigma. HCV is a bloodborne virus (BBV) most commonly transmitted in high-income countries by injecting drug use, and it is the stigmatising association between the two which is deeply problematic for those with HCV. A qualitative study undertaken in 2002 found that disclosure in health settings places those with HCV in positions of pronounced vulnerability. Disclosure is a primal scene, an interface, where the stigma of HCV, replete with connotations of disease and deviance, potentially transforms those affected into shamed subjects. Standard precautions protect health workers and minimise the transmission of contagion, measures which, in theory, also mitigate the requirement of those with BBVs to unnecessarily disclose their blood status. However, questions on pre-employment health checks, concerns that health treatments might adversely affect the liver and an ethical need to pre-emptively inform healthcare professionals undertaking exposure prone procedures are occasions when those with HCV confront the decision to disclose their blood status. This paper employs Goffman's model of actual and virtual social identities, along with Douglas' notion of dirt and pollution, to examine the dilemmas around disclosure those with HCV negotiate within the health setting. Discriminatory responses by healthcare professionals elucidate the stigmatising potential HCV carries. The subsequent reticence by those with HCV to disclose their blood status risks less than optimum healthcare. Recent studies indicate that stigma occurring in health settings remains a perennial concern for those with HCV.

'Sussing that doctor out.' Experiences and perspectives of people affected by hepatitis C regarding engagement with private general practitioners in South Australia: a qualitative study

BACKGROUND

Australians with chronic hepatitis C (HCV) can access affordable Direct Acting Antiviral (DAA) treatments with high cure rates (>90%), via General Practitioners (GPs). Benefits from this treatment will be maximised if people with HCV readily disclose and engage with private GPs regarding HCV-related issues. Investigating the perceptions and experiences of people affected by HCV with GPs can allow for this pathway to care for HCV to be improved.

METHODS

In 2013-2014, 22 purposively sampled participants from South Australia (SA) were interviewed. They a) had contracted or were at risk of hepatitis C (n = 10), b) were key workers who had clients affected by HCV (n = 6), and c) met both a) and b) criteria (n = 6). The semi-structured interviews were recorded, transcribed and thematically analysed.

RESULTS

People affected by HCV viewed GPs as a source of general healthcare but, due to negative experiences and perceptions, many developed a strategy of "sussing" out doctors before engaging with and disclosing to a GP regarding HCV-related issues. Participants were doubtful about the benefits of engagement and disclosure, and did not assume that they would be provided best-practice care in a non-discriminatory, non-judgemental way. They perceived risks to confidentiality and risks of changes to the care they received from GPs upon disclosure.

CONCLUSION

GPs may need to act in ways that counteract the perceived risks and persuade people affected by HCV of the benefits of seeking HCV-related care.

Knowledge, attitude and behaviour regarding hepatitis C virus infection amongst Brazilian dental students

AIM

Dental health professionals, including dental students, are at high risk of exposure to infection with the hepatitis C virus (HCV) through occupational percutaneous injuries and eye exposure. Further, fear of HCV infection is associated with discriminatory attitudes. The current study aimed to evaluate the knowledge about HCV infection amongst dental students and their attitudes towards patients infected with HCV.

METHODS

A cross-sectional survey was conducted amongst 340 Brazilian dental students from two public universities using an instrument containing information regarding demographic characteristics, knowledge of HCV and attitudes towards patients with HCV infection. Descriptive statistics, Fisher's exact test, Student's t-tests, Mann-Whitney U-test and multiple logistic regression (MLR) were carried out (P < 0.05 was considered significant).

RESULTS

Response rate was 90% (n = 306), and more than half (54%, n = 165) of participants had high knowledge level (above the mean); 97.7% (n = 299) demonstrated positive attitudes. MLR showed that high knowledge of dental students regarding HCV was substantially influenced by advancement in year of study (last year; P < 0.001) and type of university (federal; P = 0.049). Positive attitude towards HCV-infected patients was mainly influenced by age (P = 0.004) and male gender (P = 0.022).

CONCLUSIONS

These results demonstrated a satisfactory knowledge about HCV infection amongst dental students, but some gaps were observed, suggesting the importance of continuous education about HCV in this population to prevent HCV infection as well as discrimination and prejudice towards patients with hepatitis C.

Nurses' Knowledge toward Hepatitis B and Hepatitis C in Guilan, Iran

Background:

Health care workers (HCWs) represent high risk population for viral hepatitis infection.

Objectives:

This study sought to assess the knowledge of HCWs regarding hepatitis B (HBV) and hepatitis C (HCV) infection.

Methods:

In a multi-center cross sectional study, all HCWs from eight teaching hospitals were invited to participate in the study and to fill in a self-administered questionnaire.

Results:

A total of 1008 eligible HCWs have responded to the study. A high proportion of the study participants (55.4% and 52.9%) had unsatisfactory knowledge about HBV and HCV. Mean knowledge score toward HBV was significantly higher among more educated staff, p <0.001 and vaccinated personnel, P=0.02. Majority of responders answered correctly to transmission questions toward HBV and HCV (90% and 80%, respectively). There was statistically significant difference in only transmission domain score between various hospitals (p<0.05). The highest scores were related to surgical hospital.

Conclusion:

Although more than ninety percent of our participants were educated about HBV and HCV, knowledge about nature of disease, prevention, treatment and vaccine availability was unsatisfactory. Continuous training program toward viral infection is a matter of necessity.

Nurses' willingness to care for patients infected with HIV or Hepatitis B / C in Vietnam

OBJECTIVES

This study examined the factors associated with nurses' willingness to care for patients infected with human immunodeficiency virus (HIV) or hepatitis B or C virus (HBV/HCV) in Vietnam.

METHODS

A cross-section of 400 Vietnamese nurses from two hospitals were selected using stratified random sampling, to whom a self-administered questionnaire was administered which included demographic items, previous experience with patients infected with HIV or HBV/HCV, and their attitudes toward these patients. Data was analyzed using descriptive statistics and multiple logistic regression.

RESULTS

The lifetime prevalence of needlestick or sharps injury whilst caring for a patient infected with HIV or HBV/HCV was 9 and 15.8%, respectively. The majority of participants expressed a willingness to care for patients infected with HIV (55.8%) or HBV/HCV (73.3%). Willingness to care for HIV-infected patients was positively associated with being 40-49 years of age and confidence in protecting themselves against infection. Regarding HBV/HCV infection, willingness to care was positively associated with individual confidence in protecting themselves against infection.

CONCLUSIONS

This study revealed that Vietnamese nurses were somewhat willing to care for patients infected with HIV or HBV/HCV, and this was associated with individual confidence in protecting themselves against infection and with negative attitudes towards HIV and HBV/HCV. Establishing a positive safety culture and providing appropriate professional education to help reduce the stigma towards infected patients offers an effective way forwards to improve quality of care in Vietnam, as elsewhere.

Knowledge, Attitudes, and Practices of Health-Care Workers About Viral Hepatitis B and C in South Kivu

Health-care workers (HCWs) are at risk of infections associated with accidental exposure to blood, including viral hepatitis B (HBV) and C (HCV). A survey using a questionnaire was conducted on 250 HCW in Bukavu, an eastern town of the Democratic Republic of Congo, to analyze their attitude and knowledge about these two viruses. A response rate of 86.8% (217/250) was obtained. The mean age of the respondents was 39.6 ± 9.8 years, in majority from paramedical staff (66.4%) and with more than 5 years of professional experience (60.8%). The mean proportion of adequate answers on HBV and HCV was 33.2% (±11%) and 30.6% (±7%), respectively. Ninety-three HCW (42.8%) reported recent experience of blood exposure accident, more frequently among the paramedical staff (50%) than physicians (28.8%; P = 0.002). This was mainly related to inadequate protection resources (76.9%). Among all participants, only 24.4% had a history of at least one injection of HBV vaccine; this was more frequently found among physicians than among paramedical staff (49.3% versus 11.8%; P < 0.001). Moreover, only 3.8% of vaccinated HCW received the complete vaccination schedule of three vaccine doses. The efficiency of this vaccine is not well recognized by HCW, and the majority of them seemed to be more worried about the risk of infection by human immunodeficiency virus than by viral hepatitis. Our study reveals that the level of knowledge about HBV and HCV is rather low among HCW in Bukavu.

Public perceptions about HIV/AIDS and discriminatory attitudes toward people living with acquired immunodeficiency syndrome in Iran

Negative and discriminatory attitudes towards people living with HIV/AIDS (PLWHA) are one of the biggest experienced challenges by people suffering from HIV, and these attitudes have been regarded as a serious threat to the fundamental rights of all infected people who are affected or associated with this disease in Iran. This study aimed to determine the relationship between public perception about HIV/AIDS and discriminatory attitudes toward PLWHA . The present study was conducted using a descriptive and survey design. Data were collected from 450 patients (236 male and 214 female) in Tehran and Yazd cities. The research instruments were modified HIV-related knowledge/attitude and perception questions about PLWHA, and discriminatory attitudes toward PLWHA. The results showed that prevalence of discriminatory attitudes toward PLWHA in the studied population was 60.0%. There was a significant negative correlation between citizens' awareness about HIV/AIDS, HIV-related attitudes, negative perception toward people with HIV/AIDS symptoms and their discriminatory attitudes toward PLWHA (p < .01). The hierarchical multiple regression analysis showed that components of public perception about HIV/AIDS explained for 23.7% of the variance of discriminatory attitudes toward PLWHA. Negative public perceptions about HIV/AIDS in Iran associated with discriminatory attitudes toward PLWHA and cultural beliefs in Iran tend to stigmatize and discriminate against the LWHA.

The Role of Physicians’ Attitudes and the Provision of Hepatitis C Virus Treatment to People Who Inject Drugs

Inadequate hepatitis C virus (HCV) assessment and treatment among people who inject drugs (PWID) is a result of patient, provider and health system level barriers. Low HCV treatment rates continue even though guidelines have been revised to consider HCV treatment among PWID on a case-by-case basis. If accessibility to HCV treatment were increased, especially to PWID this would greatly decrease the pool of communicable disease. In order to successfully control and prevent HCV infection PWID must be actively engaged in the treatment process. Physicians’ attitudes towards HCV treatment can be represented in studies as views that are directly perceived by the physician or indirectly as perceived by the patient who is under the care of the physician. The current review focuses on examining both the indirect and direct views of physician’s attitudes in treating HCV-infected PWID and examines how this influences and impacts provision of HCV treatment. A review of the literature suggests that physician’s have varied attitudes towards their patients who use recreational drugs and who are HCV positive. Moreover it is the negative associations between HCV and drug use that can impact HCV treatment accessibility and affect the number of people who can actively begin treatment.

Barriers to the acceptance of work colleagues infected with Hepatitis B and Hepatitis C in Japan

Background:

Healthcare workers infected with Hepatitis B (HBV) or Hepatitis C virus (HCV) may undertake patient care activities if provider-to-patient transmission risks have been assessed in terms of viral load and clinical procedures. The present study investigated potential barriers to the acceptance of colleagues infected with HBV/HCV in healthcare settings after appropriate risk assessment.

Methods:

We conducted an anonymous, internet-based survey of Japanese nurses. Multivariate logistic analysis was used to assess factors associated with willingness to accept colleagues infected with HBV/HCV after risk assessment.

Results:

In total, 992 nurses responded to the survey, with 16% indicating that colleagues infected with HBV/HCV should not have patient contact after risk assessment. Willingness to accept HBV/HCV-infected colleagues was negatively associated with attitudes regarding the avoidance of contact with HBV/HCV-infected colleagues (OR: 0.49; 95% CI: 0.28-0.85). Previous professional contact with HBV/HCV patients (OR: 1.73; 95% CI: 1.36-2.12), experience of accidental injection from or personal exposure to HBV/HCV patients (OR: 2.00; 95% CI: 1.42-2.61), knowledge of HBV/HCV (OR: 2.00; 95% CI: 1.52-2.49), and female sex (OR: 1.60; 95% CI: 1.17-2.09) were positively associated with a willingness to accept HBV/HCV-infected colleagues.

Conclusions:

This study suggests that attitudes regarding the avoidance of contact with HBV/HCV-infected colleagues may be barriers to accepting these colleagues even after risk assessment has been performed. To protect the employment of nurses infected with HBV/HCV, employers should provide comprehensive education for nurses to reduce stigma and improve understanding about the management of staff infected with infectious diseases, such as HBV or HCV.

Reluctance to care for patients with HIV or hepatitis B / C in Japan

Background

Healthcare workers are faced with various professional dilemmas in the workplace, including at times, a reluctance to care for particular patients. This study investigated personal attitudes and factors influencing Japanese nurses’ reluctance to care for patients infected with HIV, Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV).

Methods

Participants completed an anonymous online survey focusing on potential attitudes towards hypothetical patients, awareness of infection risk and their confidence in using precautions to prevent infection. Statistical associations were analyzed using Poisson regression models.

Results

Regarding personal attitudes, 41 % and 18 % of nurses agreed or somewhat agreed that they would be reluctant to care for a hypothetical patient infected with HIV or HBV / HCV, respectively. Reluctance to care for patients with HIV or HBV / HCV was positively associated with prejudicial attitudes and negatively associated with confidence in personal safety precautions. Hypothetical reluctance to care for patients with HBV / HCV was negatively associated with actual previous experience caring for HBV / HCV patients. Older age among nurses (≥50 years) was positively associated with an increased reluctance to care for hypothetical patients with HIV.

Conclusions

Overall, this study suggests that anxiety arising from perceived infection risk and having a prejudicial attitude might affect the acceptance of infected patients, while personal confidence in universal precautions probably mitigates this situation. Improving nurses’ confidence in using universal precautions therefore represents a positive measure that can help reduce prejudice and improve the quality of healthcare services in Japan, as elsewhere.

Electronic supplementary material

The online version of this article (doi:10.1186/s12884-016-0822-2) contains supplementary material, which is available to authorized users.

Equity in primary health care delivery: an examination of the cohesiveness of strategies relating to the primary healthcare system, the health workforce and hepatitis C

OBJECTIVE

To suggest ways of increasing the cohesiveness of national primary healthcare strategies and hepatitis C strategies, with the aim of ensuring that all these strategies include ways to address barriers and facilitators to access to primary healthcare and equity for people with hepatitis C.

METHODS

A critical review was conducted of the first national Primary Healthcare System Strategy and Health Workforce Strategy with the concurrent Hepatitis C Strategy. Content relating to provision of healthcare in private general practice was examined, focussing on issues around access and equity.

RESULTS

In all strategies, achieving access to care and equity was framed around providing sufficient medical practitioners for particular locations. Equity statements were present in all policies but only the Hepatitis C Strategy identified discrimination as a barrier to equity. Approaches detailed in the Primary Healthcare System Strategy and Health Workforce Strategy regarding current resource allocation, needs assessment and general practitioner incentives were limited to groups defined within these documents and may not identify or meet the needs of people with hepatitis C.

CONCLUSIONS

Actions in the primary healthcare system and health workforce strategies should be extended to additional groups beyond those listed as priority groups within the strategies. Future hepatitis C strategies should outline appropriate, detailed needs assessment methodologies and specify how actions in the broad strategies can be applied to benefit the primary healthcare needs of people with hepatitis C.

Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities

BACKGROUND

An expanding body of literature is exploring the presence and impact of health and health care disparities among marginalized populations. This research challenges policy makers, health professionals, and scholars to examine how unjust and avoidable inequities are created at the societal, institutional, and individual level, and explore strategies for mitigating challenges.

OBJECTIVES

Recognizing the significance of this broader conversation, this scoping review provides an overview of pharmacy-specific research attentive to health-related disparities.

METHODS

Following Arksey and O'Malley's framework, a rigorous screening process yielded 93 peer-reviewed and 23 grey literature articles, each analyzed for core themes.

RESULTS

Lending critical insight to how pharmacy practice researchers are conceptualizing and measuring health inequities, this review highlights three paths of inquiry evident across this literature, including research focused on what pharmacists know about marginalized groups, how pharmacists perceive these groups, and how they provide services. Striving to drive research and practice forward, this review details research gaps and opportunities, including a need to expand the scope of research and integrate knowledge.

CONCLUSIONS

As pharmacists endeavor to provide equitable and impactful patient care, it is essential to understand challenges, and build strong evidence for meaningful action.

Knowledge and attitude of healthcare workers about Middle East Respiratory Syndrome in multispecialty hospitals of Qassim, Saudi Arabia

BACKGROUND

With the increase in prevalence of Middle East Respiratory Syndrome (MERS), healthcare workers (HCWs) are at risk of acquiring and subsequently transmitting this lethal virus. In view of this, HCWs were evaluated for their knowledge of and attitude towards MERS in Saudi Arabia.

METHODS

A cross sectional study was performed in two hospitals of Qassim region in Saudi Arabia. A total of 280 healthcare workers were selected to participate in this study. Knowledge and attitude were assessed by using self-administered and pretested questionnaire. Descriptive statistics were carried out to express participants' demographic information, mean knowledge score and mean attitude score of HCWs. Inferential statistics (Mann-Whitney U test and Kruskal Wallis tests, p < 0.05) were used to examine differences between study variables. Chi squares tests were used to assess the association between study variables and attitude questions. Spearman's rho correlation was used to identify the association between the knowledge, attitude scores.

RESULT

Participants demonstrated good knowledge and positive attitude towards MERS. The mean scores of knowledge and attitude were 9.45 ± 1.69 (based on 13 knowledge questions) and 1.82 ± 0.72 (based on 7 attitude questions). The correlation between knowledge and attitude was significant (correlation coefficient: 0.12; P <0.001). HCWs were less educated about the management (42.4%), source (66%) and consequences of MERS (67.3%), while a majority of them were well aware of the hallmark symptoms (96%), precautionary measures (96%) and hygiene issues (94%). Although the majority of respondents showed positive attitude towards the use of protective measures (1.52 ± 0.84), their attitude was negative towards their active participation in infection control program (2.03 ± 0.97). Gender and experience were significantly associated with knowledge and attitude (P < 0.05).

CONCLUSIONS

The findings of this study showed that healthcare workers in Qassim region of Saudi Arabia have good knowledge and positive attitude towards MERS. Yet there are areas where low knowledge and negative attitude of HCWs was observed. However, studies are required to assess the knowledge and attitude of HCWs at national level so that effective interventions could be designed as surveillance and infection control measures are critical to global public health.

Knowledge of HBV and HCV and individuals' attitudes toward HBV- and HCV-infected colleagues: a national cross-sectional study among a working population in Japan

Prejudice and discrimination in the workplace regarding the risk of transmission of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are increased by excess concerns due to a lack of relevant knowledge. Education to increase knowledge about HBV and HCV and their prevention could be the first step to reduce prejudice and discrimination. This study aimed to determine the association between the level of knowledge and negative attitudes toward HBV- and HCV-infected colleagues among the Japanese working population. An online anonymous nationwide survey involving about 3,000 individuals was conducted in Japan. The questionnaire consisted of knowledge of HBV and HCV, and attitudes toward HBV- and HCV-infected colleagues in the workplace. Knowledge was divided into three categories: "ensuring daily activities not to be infected"; "risk of infection"; and "characteristics of HBV/HCV hepatitis", based on the result of factor analysis. Multiple logistic regression analysis was applied. A total of 3,129 persons responded to the survey: 36.0% reported they worried about the possibility of transmission of HBV and HCV from infected colleagues; 32.1% avoided contact with infected colleagues; and 23.7% had prejudiced opinions about HBV and HCV infection. The participants were classified into tertiles. A higher level of knowledge of HBV and HCV was significantly associated with these three negative attitudes (P for trend < 0.005). This study suggests that increasing knowledge may decrease individuals' negative attitudes towards HBV- and HCV-infected colleagues. Thus, we should promote increased knowledge of HBV and HCV in stages to reduce negative attitudes toward HBV- and HCV-infected colleagues.

Reinforced biographies among women living with hepatitis C

In a growing body of social research it is suggested that hepatitis C virus (HCV) infection is a low priority for people who inject drugs. We expand on the evidence to explore the link between identity and health using biographical adaptation theories. We examined experiences of HCV infection and illness among women who inject drugs, women who are no longer injecting drugs, and women who have never injected drugs. We investigated the relationship between identity and illness experience and found that illness does not simply dislocate one's biographical trajectory. For women who used drugs the shared symbolism of HCV infection was understood and accepted via a self-identity linked to poverty and experience of injecting drugs. Rather than disrupting their expected life trajectory, the narratives of most women incorporated the disease experience within their life story, confirming their identity as a person who injected drugs and as someone with constant and serious life stressors.

Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection

AIM: To study knowledge levels and attitudes of health care providers toward patients with hepatitis C virus infection in Guilan, a northern province of Iran.

METHODS: This cross-sectional study was performed on 239 health care professionals from the Razi Hospital, including doctors, nurses, and operating room technicians. The questionnaires consisted of questions on demographic characteristics, knowledge levels, and attitudes toward hepatitis C patients. The questionnaire was tested in a pilot study and validated by Cronbach’s alpha coefficient. Data were analyzed using SPSS16 software.

RESULTS: The mean ± SD knowledge score was 17.43 ± 2.65 (from a total of 22). 51.9% of the participants achieved scores higher than the mean. There was a significant relationship between knowledge score and age (P = 0.001), gender (P = 0.0001), occupational history (P = 0.0001), and educational history (P = 0.027). There was also a significant relationship between attitude level and age (P = 0.002), gender (P = 0.0001), occupational history (P = 0.0001), and educational history (P = 0.035). Physicians were significantly more knowledgeable and showed more positive attitudes. There was a positive correlation between knowledge and attitude scores (P = 0.02).

CONCLUSION: Discriminatory attitudes are common among health care providers toward hepatitis C patients. It is therefore necessary to improve their knowledge level and attitude toward this disease.

Chronic hepatitis C: Treat or wait? Medical decision making in clinical practice

AIM: To analyzes the decision whether patients with chronic hepatitis C virus (HCV) infection are treated or not.

METHODS: This prospective cohort study included 7658 untreated patients and 6341 patients receiving pegylated interferon α 2a/ribavirin, involving 434 physicians/institutions throughout Germany (377 in private practice and 57 in hospital settings). A structured questionnaire had to be answered prior to the treatment decision, which included demographic data, information about the personal life situation of the patients, anamnesis and symptomatology of hepatitis C, virological data, laboratory data and data on concomitant diseases. A second part of the study analyzes patients treated with pegylated interferon α2a. All questionnaires included reasons against treatment mentioned by the physician.

RESULTS: Overall treatment uptake was 45%. By multivariate analysis, genotype 1/4/5/6, HCV-RNA ≤ 520 000 IU/mL, normal alanine aminotransferase (ALT), platelets ≤ 142 500/μL, age > 56 years, female gender, infection length > 12.5 years, concomitant diseases, human immunodeficiency virus co-infection, liver biopsy not performed, care in private practice, asymptomatic disease, and unemployment were factors associated with reduced treatment rate. Treatment and sustained viral response rates in migrants (1/3 of cohort) were higher than in German natives although 1/3 of migrants had language problems. Treatment rate and liver biopsy were higher in clinical settings when compared to private practice and were low when ALT and HCV-RNA were low.

CONCLUSION: Some reasons against treatment were medically based whereas others were related to fears, socio-economical problems, and information deficits both on the side of physicians and patients.

Knowledge, attitudes and behaviours associated with the provision of hepatitis C care by Canadian family physicians

The role of primary care physicians in providing care for hepatitis C virus (HCV) infection is increasingly emphasized, but many gaps and challenges remain. This study explores family physicians' knowledge, attitudes and practices associated with providing care for HCV infection. Seven hundred and forty-nine members of the College of Family Physicians of Canada (CFPC) completed a self-administered survey examining knowledge, attitudes and behaviours regarding HCV infection screening and care. Multivariate analyses were performed using the outcome, HCV care provision, and variables based on a conceptual model of practice guideline adherence. Family physicians providing basic-advanced HCV care were more likely to be older, practice in a rural setting, have injection drug users (IDU) in their practice and have higher levels of knowledge about the initial assessment (OR = 1.77; 95% CI = 1.23-2.54) and treatment of HCV (OR = 1.74; 95% CI = 1.24-2.43). They were also less likely to believe that family physicians do not have a role in HCV care (OR = 0.41; 95% CI = 0.30-0.58). Educational programmes should target physicians less likely to provide HCV care, namely family physicians practicing in urban areas and those who do not care for any IDU patients. Training and continuing medical education programmes that aim to shift family physicians' attitudes about the provision of HCV care by promoting their roles as integral to HCV care could contribute to easing the burden on consultant physicians and lead to improved access to treatment for HCV infection.

Psychiatrists' knowledge and practices in screening and assessment of Hepatitis C for inpatients with severe mental illness

OBJECTIVE

The aim of this study was to assess psychiatrists' Hepatitis C virus (HCV)-related knowledge and behaviour practices.

METHOD

A self-report survey was completed by doctors working at an urban psychiatric hospital in Australia.

RESULTS

Doctors working in psychiatry underestimated the prevalence of HCV infection for their patients and less than one-third felt well informed about HCV. Overall, there was good knowledge regarding HCV acquisition epidemiology but knowledge of management was poor.

CONCLUSION

Improving knowledge about HCV, especially current management, may facilitate better health care for patients with severe mental illness.

Hepatitis C virus in primary care: survey of nurses' attitudes to caring

AIM

This paper is a report of a study measuring attitudes of primary care nurses towards caring for people with hepatitis C.

BACKGROUND

Hepatitis C is a major public health problem. Attitudes to caring for people with hepatitis C vary and can have an impact on nursing care practices. International literature has identified discriminating practices amongst healthcare professionals including nurses. There is limited research examining primary care nurses' attitudes to caring for people with hepatitis C.

METHODS

A cross-sectional postal census survey of 981 nurses working in one health board region in the Republic of Ireland was conducted during the period March 2006 to June 2006.

RESULTS

A response rate of 57.1% (n=560) was achieved. Exploratory factor analysis of an attitude scale identified three latent variables: 'infection control behaviour', 'caring' and 'fear'. Attitudes were generally positive towards caring for persons with hepatitis C; however, 51.7% of respondents would use additional infection control precautions if caring for someone with known hepatitis C. Younger nurses and those educated to degree level and above held significantly more positive attitudes to caring. Nurses agreed that they have a central role in managing and treating people with hepatitis C; however, many agreed that they lack the knowledge and skills to care for persons with hepatitis C.

CONCLUSIONS

Negative attitudes can result in discriminatory experiences for persons with hepatitis C or at risk. Nurses require ongoing education on hepatitis C to improve knowledge, to limit concerns and ensure adherence to infection control guidelines.

Hepatitis C virus infection in primary care: survey of registered nurses' knowledge and access to information

AIM

This paper is a report of a study conducted to compare knowledge of hepatitis C virus infection amongst three groups of registered nurses working in primary care, to identify their current sources of information and access to educational resources.

BACKGROUND

Hepatitis C virus infection is a public health problem; no vaccine exists to prevent the disease. Previous studies identified limitations in nurses' knowledge of hepatitis C virus infection and the impact on care. Limited research has been conducted in primary care.

METHODS

A cross-sectional postal census survey of 981 nurses working in one Irish health board region was conducted March-June 2006. Questionnaires measured knowledge of hepatitis C virus infection. Data were collected on demographics, current working practices, information resources and previous education.

RESULTS

The response rate was 57·1% (n = 560). A minority (27·3% 145/531) of respondents agreed they were well informed about the virus. Almost 40% reported having contact with clients with the virus; however, information and service provision differed. Factors influencing higher knowledge included: contact with clients with hepatitis C virus infection (P < 0·0001), working in the addiction services (P < 0·0001), educated to degree level and above (P < 0·010) and previously attending education programmes (P < 0·0001). Only 21·5% (119/553) of respondents had attended any form of education on hepatitis C virus infection.

CONCLUSION

Gaps in nurses' knowledge exist and can limit information and advice. Educational and information resources need to be developed for registered nurses working in primary care; care for clients with hepatitis C virus infection is not the sole remit of the addiction services.

The use of mind-body medicine and prayer among adult patients with chronic hepatitis C

The use of mind-body medicine by patients with chronic hepatitis C has not been reported. The prevalence and reasons for using mind-body medicine and prayer among a cohort of patients with chronic hepatitis C are described. Use of mind-body medicine and prayer was investigated as a component of a larger exploratory, descriptive study of the use of complementary and alternative medicine by patients with hepatitis C attending a tertiary healthcare facility in the United States. An investigator-designed self-administered questionnaire (n = 149) and semistructured interview (n = 28) were completed by participants. Eighty-eight percent (n = 105) of participants had used mind-body medicine in the past 12 months. The most commonly used therapies were prayer for health reasons (90%), deep breathing (29%), and meditation (29%). Mind-body medicine was most commonly used to relieve tension and promote general well-being. The use of mind-body medicine was widespread among patients with chronic hepatitis C. To provide patient-centered healthcare, health providers need to be aware of the alternative support strategies, including mind-body medicine, used by patients.

A support programme for primary care leads to substantial improvements in the effectiveness of a public hepatitis C campaign

INTRODUCTION

Because of its lack of clinical signs, the detection of hepatitis C virus (HCV) infection in the Netherlands remains suboptimal. Therefore, the Dutch Health Council proposed an HCV campaign aimed to inform the general public and motivate people at risk to seek medical advice. Because knowledge and awareness of HCV infection is low among primary care workers, the implementation of a support programme for primary care complementary to a HCV campaign seems appropriate.

OBJECTIVE

To evaluate the added value of a support programme for primary care complementary to a public HCV campaign.

METHODS

We performed a non-randomized controlled intervention study. In two similar regions, a public HCV campaign was organized. In the intervention region, an additional support for primary care was provided by means of brochures, short courses and informative visits.

RESULTS

In the intervention region, the proportional increase in anti-HCV tests was 3.02 (57-172 tests). In the control region, this increase was 1.36 (86-118 tests). In the intervention region, the increase in positive anti-HCV tests was 1.7% (95% confidence interval (CI): -0.2% to -3.7%). In the control region, this number decreased by 0.9% (95% CI: -4.1% to 2.3%).

CONCLUSIONS

The addition of primary care practice support leads to considerable improvements in medical consciousness regarding HCV infection in primary care. Even though the positive effect on case finding cannot be indisputably demonstrated due to low prevalence, our results indicate such a positive effect. Therefore, future campaigns aimed at hepatitis C should invariably implement additional support for primary care to improve diagnostic uptake and optimize case finding.