Barriers to Linkage to Care for Hepatitis B Virus Infection: A Qualitative Analysis in Burkina Faso, West Africa - Institut Pasteur Access content directly
Journal Articles American Journal of Tropical Medicine and Hygiene Year : 2016

Barriers to Linkage to Care for Hepatitis B Virus Infection: A Qualitative Analysis in Burkina Faso, West Africa

Abstract

Hepatitis B virus (HBV) infection is a critical global health problem. The World Health Organization (WHO) has recently developed a global elimination strategy for HBV infection. Increasing access to screening, liver assessment, and antiviral treatment are crucial steps in achieving this goal. Little is known, however, about obstacles to linkage to care in low-and middle-income countries. Using a grounded theory approach, this qualitative study sought to characterize the diagnostic itineraries of people with chronic HBV infection in Burkina Faso, a west African country with high HBV prevalence, to identify barriers to linkage from screening to specialist care with hepatic assessment (alanine transaminase and hepatitis B e antigen or HBV DNA). We conducted 80 semistructured interviews with chronically infected people, their families, medical personnel, and traditional practitioners, and participant observation of HBV diagnostic announcements and consultations. Of 30 individuals diagnosed with chronic viral hepatitis, 18 inadvertently discovered their status through blood screening and 12 actively sought diagnosis for their symptoms. Only a quarter (8/30) were linked to care. Barriers included: 1) patients' ability to pay for testing and treatment; 2) a formal health system lacking trained personnel, diagnostic infrastructures, and other resources; 3) patients' familial and social networks that discouraged access to testing and HBV knowledge; 4) a well-developed demand for and provisioning of traditional medicine for hepatitis; and 5) a weak global politics around HBV. More training for medical personnel would improve linkage to care in sub-Saharan Africa. Developing effective communications between medical workers and patients should be a major priority in this elimination strategy.
Fichier principal
Vignette du fichier
2016 Giles-Vernick T. Barriers to Linkage to Care for Hepatitis B Virus Infection. A Qualitative Analysis in Burkina Faso, West Africa. AmJTropMedHyg.pdf (480.36 Ko) Télécharger le fichier
Origin : Publisher files allowed on an open archive
Loading...

Dates and versions

pasteur-02548814 , version 1 (20-04-2020)

Identifiers

Cite

Tamara Giles-Vernick, Fabienne Hejoaka, Armande Sanou, Yusuke Shimakawa, Issiaka Bamba, et al.. Barriers to Linkage to Care for Hepatitis B Virus Infection: A Qualitative Analysis in Burkina Faso, West Africa. American Journal of Tropical Medicine and Hygiene, 2016, 95, pp.1368 - 1375. ⟨10.4269/ajtmh.16-0398⟩. ⟨pasteur-02548814⟩
124 View
189 Download

Altmetric

Share

Gmail Facebook X LinkedIn More