Improving the hepatitis cascade: assessing hepatitis testing and its management in primary health care in China

Wong WCW 1 , Lo YR 2 , Jiang S 3 , Peng M 3 , Zhu S 3 , Kidd MR 4 Show all authors , Wang XC 5 , Chan PL 6 , Ong JJ 7

Affiliations 

  • 1 University of Hong Kong-Shenzhen Hospital, Shenzhen, China
  • 2 Head of Mission and WHO Representative to Malaysia, Brunei Darussalam and Singapore
  • 3 Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
  • 4 Department of Family and Community Medicine, University of Toronto, Canada
  • 5 National Center for AIDS/STD Prevention and Control, China Center for Disease Control and Prevention, Beijing, China
  • 6 World Health Organization, Office of the Representative to China
  • 7 Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK
Fam Pract, 2018 12 12;35(6):731-737.
PMID: 29741661 DOI: 10.1093/fampra/cmy032

Abstract

Objective: The study aimed to decentralize hepatitis testing and management services to primary care in China.

Methods: A nationwide representative provider survey amongst community health centres (CHCs) using randomized stratified sampling methods was conducted between September and December 2015. One hundred and eighty CHCs and frontline primary care practitioners from 20 cities across three administrative regions of Western, Central and Eastern China were invited to participate.

Results: One hundred and forty-nine clinicians-in-charge (79%), 1734 doctors and 1846 nurses participated (86%). Majority of CHCs (80%, 95% CI: 74-87) offered hepatitis B testing, but just over half (55%, 95% CI: 46-65) offered hepatitis C testing. The majority of doctors (87%) and nurses (85%) felt that there were benefits for providing hepatitis testing at CHCs. The major barriers for not offering hepatitis testing were lack of training (54%) and financial support (23%). Multivariate analysis showed that the major determinants for CHCs to offer hepatitis B and C testing were the number of nurses (AOR 1.1) and written policies for hepatitis B diagnosis (AOR 12.7-27.1), and for hepatitis B the availability of reproductive health service.

Conclusions: Primary care providers in China could play a pivotal role in screening, diagnosing and treating millions of people with chronic hepatitis B and C in China.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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