ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
El-Serag HB, 2012. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 142: 1264–1273.
-
2.
Kramvis A, Kew MC, 2007. Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes. Hepatol Res 37: S9–S19.
-
3.
World Health Organization, 2024. Global Hepatitis Report 2024: Action for Access in Low- and Middle-Income Countries. Available at: https://www.who.int/publications/i/item/9789240091672. Accessed July 29, 2024.
-
4.
Yang JD, et al., 2015. Hepatocellular carcinoma occurs at an earlier age in Africans, particularly in association with chronic hepatitis B. Am J Gastroenterol 110: 1629–1631.
-
5.
Jaka H, Mshana SE, Rambau PF, Masalu N, Chalya PL, Kalluvya SE, 2014. Hepatocellular carcinoma: Clinicopathological profile and challenges of management in a resource-limited setting. World J Surg Oncol 12: 246.
-
6.
Yang JD, Hainaut P, Gores GJ, Amadou A, Plymoth A, Roberts LR, 2019. A global view of hepatocellular carcinoma: Trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol 16: 589–604.
-
7.
Yang JD, et al., 2017. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: A multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol Hepatol 2: 103–111.
-
8.
Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi LE, Sagnelli E, Coppola N, 2015. Hepatitis B virus burden in developing countries. World J Gastroenterol 21: 11941–11953.
-
9.
Komas NP, Vickos U, Hübschen JM, Béré A, Manirakiza A, Muller CP, Faou AL, 2013. Cross-sectional study of hepatitis B virus infection in rural communities, Central African Republic. BMC Infect Dis 13: 286.
-
10.
Quadri NS, Debes JD, 2020. The waiting room project: An approach to community health education in hepatitis B. Am J Trop Med Hyg 103: 537.
-
11.
Quadri NS, Shah SM, Rodin H, Debes JD, 2021. Promoting hepatitis B awareness: Evaluating an educational approach through health care workers in Tanzania. Ann Glob Health 87: 1–6.
-
12.
McMahon BJ, 2018. Meeting the WHO and US goals to eliminate hepatitis B infection by 2030: Opportunities and challenges. Clin Liver Dis (Hoboken) 12: 29–32.
-
13.
Kilonzo SB, Gunda DW, Mpondo BCT, Bakshi FA, Jaka H, Hepatitis B, 2018. Hepatitis B virus infection in Tanzania: Current status and challenges. J Trop Med 2018: 4239646.
-
14.
Kilonzo SB, Nkandala I, Rudovick L, Jaka HM, Mirambo MM, Mshana SE, Kajogoo VD, Shao ER, 2024. Prevalence of hepatitis B virus infection in Tanzania: A systematic review and meta‐analysis. J Trop Med 2024: 4178240.
-
15.
The United Republic of Tanzania M of H, 2018. National Strategic Plan for the Control of Viral Hepatitis. Available at: https://www.globalhep.org/sites/default/files/content/resource/files/2020-02/Tanzania%20National%20Strategic%20Plan%20for%20the%20Control%20of%20Viral%20Hepatitis%202018-19-2022-23.pdf. Accessed May 9, 2024.
-
16.
Martelli G, Van Duffel L, Kwezi EC, Cavallin F, Salehe IA, Torelli GF, Putoto G, Hermans S, Rinke de Wit TF, Pozniak A, 2022. Community- and facility-based HIV testing interventions in northern Tanzania: Midterm results of Test & Treat Project. PLoS One 17: e0266870.
-
17.
Sundararajan R, Ponticiello M, Nansera D, Jeremiah K, Muyindike W, 2022. Interventions to increase HIV testing uptake in global settings. Curr HIV/AIDS Rep 19: 184–193.
-
18.
McNaughton AL, et al., 2020. Hepatitis B virus seroepidemiology data for Africa: Modelling intervention strategies based on a systematic review and meta-analysis. PLoS Med 17: e1003068.
-
19.
Ford JS, Marianelli LG, Frassone N, Debes JD, 2020. Hepatitis B screening in an Argentine ED: Increasing vaccination in a resource-limited setting. Am J Emerg Med 38: 296–299.
-
20.
World Health Organization, 2024. Guidelines for the Prevention, Diagnosis, Care and Treatment for People with Chronic Hepatitis B Infection. Available at: https://www.who.int/publications/i/item/9789240090903. Accessed July 29, 2024.
-
21.
Singal AG, et al., 2023. AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology 78: 1922–1965.
-
22.
Anugwom CM, Allaire M, Akbar SMF, Sultan A, Bollipo S, Mattos AZ, Debes JD, 2021. Hepatitis B-related hepatocellular carcinoma: Surveillance strategy directed by immune-epidemiology. Hepatoma Res 7: 23.
-
23.
Tanaka H, 2020. Current role of ultrasound in the diagnosis of hepatocellular carcinoma. J Med Ultrason 47: 239–255.
-
24.
Revill PA, et al., 2019. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol 4: 545–558.
-
25.
Ford JS, Kayandabila J, Morrison JC, Seth S, Lyimo B, Mukhtar A, Schick M, May L, Debes JD, 2024. Combined hepatitis B virus and hepatocellular carcinoma screening using point-of-care testing and ultrasound in a Tanzanian emergency department. Am J Trop Med Hyg 110: 399–403.
-
26.
Orlien SMS, Ahmed TA, Ismael NY, Berhe Belay N, Kran AB, Gundersen SG, Johannessen A, 2021. Field performance of HBsAg rapid diagnostic tests in rural Ethiopia. J Virol Methods 289: 114061.
-
27.
Healgen, 2024. Hepatitis B Virus Rapid Test. Available at: https://www.healgen.com/products_197_111.html. Accessed July 6, 2024.
-
28.
Healgen, 2024. Hepatitis C Virus Rapid Test. Available at: https://www.healgen.com/products_197_112.html. Accessed July 6, 2024.
-
29.
Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ, 2015. Estimations of worldwide prevalence of chronic hepatitis B virus infection: A systematic review of data published between 1965 and 2013. Lancet 386: 1546–1555.
-
30.
Miller WC, Shao JF, Weaver DJ, Shimokura GH, Paul DA, Lallinger GJ, 1998. Seroprevalence of viral hepatitis in Tanzanian adults. Trop Med Int Health 3: 757–763.
-
31.
Pellizzer G, Blé C, Zamperetti N, Stroffolini T, Upunda G, Rapicetta M, Chionne P, Villano U, Fabris P, de Lalla F, 1994. Serological survey of hepatitis B infection in Tanzania. Public Health 108: 427–431.
-
32.
Muro FJ, Fiorillo SP, Sakasaka P, Odhiambo C, Reddy EA, Cunningham CK, Buchanan AM, 2013. Seroprevalence of hepatitis B and C viruses among children in Kilimanjaro Region, Tanzania. J Pediatric Infect Dis Soc 2: 320–326.
-
33.
Debes JD, Stauffer WM, Jacobson M, Boulware DR, 2015. Low rates of hepatitis B and human immunodeficiency virus coinfection in rural northern Tanzania. J Glob Infect Dis 7: 47.
-
34.
United States Agency for International Development. Tanzania Immunization, 2023. Available at: https://www.usaid.gov/tanzania/fact-sheet/jul-19-2023-immunization-factsheet. Accessed July 29, 2024.
-
35.
Ministry of Health [Tanzania Mainland], Ministry of Health [Zanzibar], National Bureau of Statistics, Office of the Chief Government Statistician, and ICF, 2023. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022. Dodoma, Tanzania and Rockville, MD: MoH, NBS, OCGS, and ICF.
-
36.
Shah SM, et al., 2020. Hepatitis B awareness and vaccination patterns among healthcare workers in Africa. Am J Trop Med Hyg 103: 2460–2468.
-
37.
Martin S, 2017. Word-of-mouth in the health care sector: A literature analysis of the current state of research and future perspectives. Int Rev Public Nonprofit Mark 14: 35–56.
-
38.
Shen YC, Hsu C, Cheng CC, Hu FC, Cheng AL, 2012. A critical evaluation of the preventive effect of antiviral therapy on the development of hepatocellular carcinoma in patients with chronic hepatitis C or B: A novel approach by using meta-regression. Oncology 82: 275–289.
-
39.
Kew MC, 2013. Epidemiology of hepatocellular carcinoma in sub-Saharan Africa. Ann Hepatol 12: 173–182.
-
40.
Wallace J, Pitts M, Locarnini S, Ellard J, Carman M, Chen DS, 2016. Essential components in developing public policy to control viral hepatitis: Lessons from Taiwan. Hepatol Int 10: 355–362.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 538 | 538 | 466 |
| Full Text Views | 22 | 22 | 4 |
| PDF Downloads | 22 | 22 | 5 |
Community-Based Point-of-Care Screening for Hepatitis B Virus and Hepatocellular Carcinoma in Rural Tanzania
Manaswita Tappata
Manaswita Tappata
Department of Medicine, University of Minnesota, Minneapolis, Minnesota;
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James Ford
James Ford
Department of Emergency Medicine, University of California, San Francisco, San Francisco, California;
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Johnstone Kayandabila
Johnstone Kayandabila
Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Joseph Morrison
Joseph Morrison
School of Medicine, University of California, Davis, Sacramento, California;
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Samwel Seth
Samwel Seth
Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Benson Lyimo
Benson Lyimo
Department of Surgery, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Larissa May
Larissa May
Department of Emergency Medicine, University of California Davis Health, Sacramento, California;
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Jose D. Debes
debes003@umn.edu
Jose D. Debes
Department of Medicine, University of Minnesota, Minneapolis, Minnesota;
Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
Department of Gastroenterology, Erasmus Medical Center, Rotterdam, Netherlands
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Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
Department of Gastroenterology, Erasmus Medical Center, Rotterdam, Netherlands
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ABSTRACT.
Sub-Saharan Africa has a high burden of hepatitis B virus (HBV) and hepatocellular carcinoma (HCC). The lack of surveillance programs has led to low rates of diagnosis and treatment, particularly in rural areas. We conducted mobile HBV-HCC screening clinics in rural Tanzania between March 2021 and February 2023. After undergoing informed consent, patients completed a questionnaire about HBV. A rapid point-of-care (POC) assay measured HBV surface antigen (HBsAg), and HBsAg-positive patients underwent POC ultrasound to screen for HCC and POC hepatitis C (HCV) antibody testing. The primary outcome was number of HBV diagnoses, and the secondary outcome was prevalence of liver masses in HBsAg-positive individuals. Data were analyzed with descriptive statistics. Five hundred and one patients were screened for HBV; 63% (n = 303) were female with median (interquartile range [IQR]) age of 40 (28–55) years. Only 6% (n = 30) reported being vaccinated against HBV, 92% (n = 453) reported no vaccination, and 2% (n = 12) did not know their vaccination status. Seventy-six percent (n = 340) did not know they should get vaccinated, and 4% (n = 16) reported that vaccination was too expensive. Two percent (n = 11) of patients were positive for HBsAg, with 55% (n = 6) of those being female with median (IQR) age of 36 (34–43) years. None of the HBsAg-positive patients reported being vaccinated against HBV, and all were negative for HCV. On ultrasound, one patient had a liver mass, and another had ascites. We demonstrated that community-based HBV and HCC screening can be implemented in Africa with local partnerships, and this model could be used to promote awareness and improve early detection of disease.
Author Notes
Financial support:
Current contact information: Manaswita Tappata, Department of Medicine, University of Minnesota, Minneapolis, MN, E-mail: tappa029@umn.edu. James Ford, Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, E-mail: james.ford@ucsf.edu. Johnstone Kayandabila and Samwel Seth, Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania, E-mails: johnskay3@hotmail.com and samwelseth@gmail.com. Joseph Morrison, School of Medicine, University of California, Davis, Sacramento, CA, E-mail: jcmorrison@ucdavis.edu. Benson Lyimo, Department of Surgery, Arusha Lutheran Medical Center, Arusha, Tanzania, E-mail: ben2harris@yahoo.com. Larissa May, Department of Emergency Medicine, University of California Davis Health, Sacramento, CA, E-mail: lsmay@ucdavis.edu. Jose D. Debes, Department of Medicine, University of Minnesota, Minneapolis, MN, and Erasmus MC, E-mail: debes003@umn.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
El-Serag HB, 2012. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 142: 1264–1273.
-
2.
Kramvis A, Kew MC, 2007. Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes. Hepatol Res 37: S9–S19.
-
3.
World Health Organization, 2024. Global Hepatitis Report 2024: Action for Access in Low- and Middle-Income Countries. Available at: https://www.who.int/publications/i/item/9789240091672. Accessed July 29, 2024.
-
4.
Yang JD, et al., 2015. Hepatocellular carcinoma occurs at an earlier age in Africans, particularly in association with chronic hepatitis B. Am J Gastroenterol 110: 1629–1631.
-
5.
Jaka H, Mshana SE, Rambau PF, Masalu N, Chalya PL, Kalluvya SE, 2014. Hepatocellular carcinoma: Clinicopathological profile and challenges of management in a resource-limited setting. World J Surg Oncol 12: 246.
-
6.
Yang JD, Hainaut P, Gores GJ, Amadou A, Plymoth A, Roberts LR, 2019. A global view of hepatocellular carcinoma: Trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol 16: 589–604.
-
7.
Yang JD, et al., 2017. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: A multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol Hepatol 2: 103–111.
-
8.
Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi LE, Sagnelli E, Coppola N, 2015. Hepatitis B virus burden in developing countries. World J Gastroenterol 21: 11941–11953.
-
9.
Komas NP, Vickos U, Hübschen JM, Béré A, Manirakiza A, Muller CP, Faou AL, 2013. Cross-sectional study of hepatitis B virus infection in rural communities, Central African Republic. BMC Infect Dis 13: 286.
-
10.
Quadri NS, Debes JD, 2020. The waiting room project: An approach to community health education in hepatitis B. Am J Trop Med Hyg 103: 537.
-
11.
Quadri NS, Shah SM, Rodin H, Debes JD, 2021. Promoting hepatitis B awareness: Evaluating an educational approach through health care workers in Tanzania. Ann Glob Health 87: 1–6.
-
12.
McMahon BJ, 2018. Meeting the WHO and US goals to eliminate hepatitis B infection by 2030: Opportunities and challenges. Clin Liver Dis (Hoboken) 12: 29–32.
-
13.
Kilonzo SB, Gunda DW, Mpondo BCT, Bakshi FA, Jaka H, Hepatitis B, 2018. Hepatitis B virus infection in Tanzania: Current status and challenges. J Trop Med 2018: 4239646.
-
14.
Kilonzo SB, Nkandala I, Rudovick L, Jaka HM, Mirambo MM, Mshana SE, Kajogoo VD, Shao ER, 2024. Prevalence of hepatitis B virus infection in Tanzania: A systematic review and meta‐analysis. J Trop Med 2024: 4178240.
-
15.
The United Republic of Tanzania M of H, 2018. National Strategic Plan for the Control of Viral Hepatitis. Available at: https://www.globalhep.org/sites/default/files/content/resource/files/2020-02/Tanzania%20National%20Strategic%20Plan%20for%20the%20Control%20of%20Viral%20Hepatitis%202018-19-2022-23.pdf. Accessed May 9, 2024.
-
16.
Martelli G, Van Duffel L, Kwezi EC, Cavallin F, Salehe IA, Torelli GF, Putoto G, Hermans S, Rinke de Wit TF, Pozniak A, 2022. Community- and facility-based HIV testing interventions in northern Tanzania: Midterm results of Test & Treat Project. PLoS One 17: e0266870.
-
17.
Sundararajan R, Ponticiello M, Nansera D, Jeremiah K, Muyindike W, 2022. Interventions to increase HIV testing uptake in global settings. Curr HIV/AIDS Rep 19: 184–193.
-
18.
McNaughton AL, et al., 2020. Hepatitis B virus seroepidemiology data for Africa: Modelling intervention strategies based on a systematic review and meta-analysis. PLoS Med 17: e1003068.
-
19.
Ford JS, Marianelli LG, Frassone N, Debes JD, 2020. Hepatitis B screening in an Argentine ED: Increasing vaccination in a resource-limited setting. Am J Emerg Med 38: 296–299.
-
20.
World Health Organization, 2024. Guidelines for the Prevention, Diagnosis, Care and Treatment for People with Chronic Hepatitis B Infection. Available at: https://www.who.int/publications/i/item/9789240090903. Accessed July 29, 2024.
-
21.
Singal AG, et al., 2023. AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology 78: 1922–1965.
-
22.
Anugwom CM, Allaire M, Akbar SMF, Sultan A, Bollipo S, Mattos AZ, Debes JD, 2021. Hepatitis B-related hepatocellular carcinoma: Surveillance strategy directed by immune-epidemiology. Hepatoma Res 7: 23.
-
23.
Tanaka H, 2020. Current role of ultrasound in the diagnosis of hepatocellular carcinoma. J Med Ultrason 47: 239–255.
-
24.
Revill PA, et al., 2019. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol 4: 545–558.
-
25.
Ford JS, Kayandabila J, Morrison JC, Seth S, Lyimo B, Mukhtar A, Schick M, May L, Debes JD, 2024. Combined hepatitis B virus and hepatocellular carcinoma screening using point-of-care testing and ultrasound in a Tanzanian emergency department. Am J Trop Med Hyg 110: 399–403.
-
26.
Orlien SMS, Ahmed TA, Ismael NY, Berhe Belay N, Kran AB, Gundersen SG, Johannessen A, 2021. Field performance of HBsAg rapid diagnostic tests in rural Ethiopia. J Virol Methods 289: 114061.
-
27.
Healgen, 2024. Hepatitis B Virus Rapid Test. Available at: https://www.healgen.com/products_197_111.html. Accessed July 6, 2024.
-
28.
Healgen, 2024. Hepatitis C Virus Rapid Test. Available at: https://www.healgen.com/products_197_112.html. Accessed July 6, 2024.
-
29.
Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ, 2015. Estimations of worldwide prevalence of chronic hepatitis B virus infection: A systematic review of data published between 1965 and 2013. Lancet 386: 1546–1555.
-
30.
Miller WC, Shao JF, Weaver DJ, Shimokura GH, Paul DA, Lallinger GJ, 1998. Seroprevalence of viral hepatitis in Tanzanian adults. Trop Med Int Health 3: 757–763.
-
31.
Pellizzer G, Blé C, Zamperetti N, Stroffolini T, Upunda G, Rapicetta M, Chionne P, Villano U, Fabris P, de Lalla F, 1994. Serological survey of hepatitis B infection in Tanzania. Public Health 108: 427–431.
-
32.
Muro FJ, Fiorillo SP, Sakasaka P, Odhiambo C, Reddy EA, Cunningham CK, Buchanan AM, 2013. Seroprevalence of hepatitis B and C viruses among children in Kilimanjaro Region, Tanzania. J Pediatric Infect Dis Soc 2: 320–326.
-
33.
Debes JD, Stauffer WM, Jacobson M, Boulware DR, 2015. Low rates of hepatitis B and human immunodeficiency virus coinfection in rural northern Tanzania. J Glob Infect Dis 7: 47.
-
34.
United States Agency for International Development. Tanzania Immunization, 2023. Available at: https://www.usaid.gov/tanzania/fact-sheet/jul-19-2023-immunization-factsheet. Accessed July 29, 2024.
-
35.
Ministry of Health [Tanzania Mainland], Ministry of Health [Zanzibar], National Bureau of Statistics, Office of the Chief Government Statistician, and ICF, 2023. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022. Dodoma, Tanzania and Rockville, MD: MoH, NBS, OCGS, and ICF.
-
36.
Shah SM, et al., 2020. Hepatitis B awareness and vaccination patterns among healthcare workers in Africa. Am J Trop Med Hyg 103: 2460–2468.
-
37.
Martin S, 2017. Word-of-mouth in the health care sector: A literature analysis of the current state of research and future perspectives. Int Rev Public Nonprofit Mark 14: 35–56.
-
38.
Shen YC, Hsu C, Cheng CC, Hu FC, Cheng AL, 2012. A critical evaluation of the preventive effect of antiviral therapy on the development of hepatocellular carcinoma in patients with chronic hepatitis C or B: A novel approach by using meta-regression. Oncology 82: 275–289.
-
39.
Kew MC, 2013. Epidemiology of hepatocellular carcinoma in sub-Saharan Africa. Ann Hepatol 12: 173–182.
-
40.
Wallace J, Pitts M, Locarnini S, Ellard J, Carman M, Chen DS, 2016. Essential components in developing public policy to control viral hepatitis: Lessons from Taiwan. Hepatol Int 10: 355–362.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 538 | 538 | 466 |
| Full Text Views | 22 | 22 | 4 |
| PDF Downloads | 22 | 22 | 5 |