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Pansue K, Promsena P, Songtaweesin WN, Moonwong J, Ryan J, Kawichai S, Thanapirom K, Puthanakit T. High prevalence of hepatitis C virus infection among adolescents and young adults attending HIV and sexual health clinics. Int J STD AIDS 2024:9564624241302231. [PMID: 39693642 DOI: 10.1177/09564624241302231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2024]
Abstract
BACKGROUND The prevalence of hepatitis C virus (HCV) infection among Thai adults is 0.5%-1.0%. This study aims to determine the prevalence of HCV infection among adolescents and young adults (AYA) accessing HIV/sexual health clinics. METHODS A cross-sectional study was conducted among AYA aged 15-24 years attending HIV/sexual health clinics in Bangkok, Thailand. The HCV infection prevalence, defined by anti-HCV antibody positivity using rapid diagnostic tests (SD BIOSENSOR, Korea), were reported with proportions and a 95% confidence interval (CI). Multivariate logistic regression was performed to identify factors associated with HCV infection. RESULTS From March to August 2023, 300 AYAs with a median age of 21 (interquartile range 20-23) years were enrolled into the study. One-third (29.7%) were people living with HIV (PLHIV). The overall prevalence of HCV infection was 2.7% (95%CI 1.2-5.2). Prevalence was higher among PLHIV (5.6%) compared to AYA without HIV (1.4%) (p-value 0.053). The factor most significantly associated with HCV infection was people who used drugs (adjusted odds ratio 15.3, 95% CI 2.9-82.0, p-value 0.001). CONCLUSIONS History of drug use was associated with the highest HCV infection prevalence. PLHIV had a trend of higher prevalence. HCV screening in HIV/sexual health clinics is recommended for early detection, treatment, and transmission reduction.
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Affiliation(s)
- Krisanee Pansue
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | - Pathariya Promsena
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
- Search Research Foundation, Bangkok, Thailand
- Affiliated researcher at Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wipaporn Natalie Songtaweesin
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Juthamanee Moonwong
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | - Juliet Ryan
- MD Program, Weill Cornell Medical College, New York, NY, USA
| | - Surinda Kawichai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kessarin Thanapirom
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
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Draper BL, Yee WL, Shilton S, Bowring A, Htay H, Nwe N, Markby J, Kyi KP, Easterbrook P, Naing W, Win TM, Aung KS, Howell J, Pedrana A, Hellard M. Feasibility of decentralised, task-shifted hepatitis C testing and treatment services in urban Myanmar: implications for scale-up. BMJ Open 2022; 12:e059639. [PMID: 35504640 PMCID: PMC9066562 DOI: 10.1136/bmjopen-2021-059639] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To assess the feasibility considerations for a decentralised, one-stop-shop model of care implemented in Yangon, Myanmar. SETTING Two primary care level clinics in urban Yangon, Myanmar. DESIGN This is a feasibility study of a highly effective care model. Using Intervention Complexity Framework by Gericke et al, we collated and analysed programmatic data and evaluation data to outline key project implementation requirements and experiences. PARTICIPANTS Programmatic data were collected from clinical records, GeneXpert device test and maintenance reports, national guidelines, product and device instructions and site monitoring visit reports. Healthcare providers involved in delivering care model contributed interview data. RESULTS The main feasibility considerations are appropriate storage for test kits and treatments (in response to temperature and humidity requirements), installation of a continuous stable electricity supply for the GeneXpert device, air-conditioning for the laboratory room hosting GeneXpert, access to a laboratory for pretreatment assessments and clear referral pathways for specialist consultation when required. Lessons from our project implementation experiences included the extensive time requirements for patient education, the importance of regular error monitoring and stock storage reviews and that flexible appointment scheduling and robust reminder system likely contributed to high retention in care. CONCLUSIONS Detailed documentation and dissemination of feasibility requirements and implementation considerations is vital to assist others to successfully implement a similar model of care elsewhere. We provide 10 recommendations for successful implementation. TRIAL REGISTRATION NUMBER The trial was registered at ClinicalTrials.gov NCT03939013 on May 6, 2019. This manuscript presents post-results data on feasibility.
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Affiliation(s)
- Bridget Louise Draper
- Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, St Kilda, Victoria, Australia
| | - Win Lei Yee
- Disease Elimination, Burnet Institute Myanmar, Yangon, Myanmar
| | | | - Anna Bowring
- Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
| | - Hla Htay
- Disease Elimination, Burnet Institute Myanmar, Yangon, Myanmar
| | | | | | | | - Philippa Easterbrook
- Department of Global HIV, Hepatitis, and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Win Naing
- Myanmar Liver Foundation, Yangon, Myanmar
- Yangon Specialty Hospital, Yangon, Myanmar
| | - Thin Mar Win
- Disease Elimination, Burnet Institute Myanmar, Yangon, Myanmar
| | - Khin Sanda Aung
- National Hepatitis Control Program, Department of Public Health, Ministry of Health and Sports, Yangon, Myanmar
| | - Jessica Howell
- Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
- St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Alisa Pedrana
- Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, St Kilda, Victoria, Australia
- Health Services Research and Implementation, Monash Partners, Melbourne, Victoria, Australia
| | - Margaret Hellard
- Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, St Kilda, Victoria, Australia
- Hepatitis Services, Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia
- Doherty Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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