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2. Investigating linkage to care following community‐based screening for hepatitis B virus in rural Senegal: A mixed methods study.

Author

Coste, Marion, Diouf, Assane, Ndong, Cilor, Diouf, Aissatou, Périères, Lauren, Nishimwe, Marie Libérée, Bureau, Morgane, Ndiaye, Assane, Maradan, Gwenaëlle, Diallo, Aldiouma, Boyer, Sylvie, Bérenger, Cyril, Bousmah, Marwan‐al‐Qays, Carrieri, Patrizia, de Sèze, Maëlle, Djaogol, Tchadine, Marcellin, Fabienne, Treibich, Carole, Ba, Elhadji, and Dièye, Fambaye

Subjects
CHRONIC hepatitis B, HEPATITIS B virus, AGRICULTURAL resources, CONTINUUM of care, MEDICAL centers
Abstract

This paper investigates linkage to care following community‐based screening for hepatitis B virus (HBV) in rural Senegal. HBV‐positive participants who completed a biological and clinical examination to assess liver disease and treatment eligibility were referred to a regional hospital (if eligible for treatment), invited to join the Sen‐B research cohort study (adults with detectable viral load) or referred to their local health centre (all others). Logistic regressions were conducted to investigate factors associated with (i) uptake of the scheduled post‐screening examination, and (ii) HBV management initiation. Obstacles to HBV management were identified using thematic analysis of in‐depth patient interviews. Of the 206 HBV‐positive participants, 163 (79.1%) underwent the examination; 47 of the 163 (28.8%) initiated HBV management. Women, people not migrating for >6 months/year, individuals living in households with more agricultural and monetary resources, with other HBV‐positive participants, and beneficiaries of the national cash transfer program, were all more likely to undergo the examination. The likelihood of joining the Sen‐B cohort increased with household monetary resources, but decreased with agricultural resources. Initiation of HBV management in local health centre was higher among participants with a non‐agricultural economic activity. Individuals reported wariness and confusion about HBV management content and rationale at various stages of the care continuum, in particular with respect to venous blood sampling and management without treatment. In conclusion, HBV community‐based test‐and‐treat strategies are feasible, but early loss to follow‐up must be addressed through simplified, affordable management and community support and sensitization. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Hepatitis B in Senegal: A Successful Infant Vaccination Program but Urgent Need to Scale Up Screening and Treatment (ANRS 12356 AmBASS survey)

Author

Périères, Lauren, Diallo, Aldiouma, Marcellin, Fabienne, Nishimwe, Marie Libérée, Ba, El Hadji, Coste, Marion, Lo, Gora, Halfon, Philippe, Touré Kane, Coumba, Maradan, Gwenaëlle, Carrieri, Patrizia, Diouf, Assane, Shimakawa, Yusuke, Sokhna, Cheikh, Boyer, Sylvie, Bérenger, Cyril, Bousmah, Marwan al Qays, de Seze, Maëlle, Djaogol, Tchadine, Treibich, Carole, Ba, Elhadji, Dièye, Fambaye, Faye, Elhadji Bilal, Ndiaye, Assane, Sow, Mouhamadou Baba, Ndiaye, Anna Julienne Selbé, Ndiour, Samba, Mohamed, Sofiane, Rouveau, Nicolas, Cortès, Maria‐Camila Calvo, Laborde‐Balen, Gabrièle, Audibert, Martine, Fall, Fatou, Gueye, Ibrahima, Lacombe, Karine, Seydi, Moussa, Tuaillon, Edouard, Vray, Muriel, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Aix-Marseille Sciences Economiques (AMSE), École des hautes études en sciences sociales (EHESS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation [Dakar, Sénégal] (IRESSEF), ALPHABIO - Laboratoire de biologie médicale, Hôpital Européen [Fondation Ambroise Paré - Marseille], Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), ANRS 12356 AmBASS Survey Study Group: Cyril Bérenger, Marwan Al Qays Bousmah, Sylvie Boyer, Patrizia Carrieri, Marion Coste, Maëlle de Seze, Tchadine Djaogol, Gwenaëlle Maradan, Fabienne Marcellin, Carole Treibich, Elhadji Ba, Aldiouma Diallo, Fambaye Dièye, Assane Diouf, Elhadji Bilal Faye, Assane Ndiaye, Lauren Périères, Cheikh Sokhna, Mouhamadou Baba Sow, Coumba Touré Kane, Gora Lo, Anna Julienne Selbé Ndiaye, Samba Ndiour, Philippe Halfon, Sofiane Mohamed, Nicolas Rouveau, Maria-Camila Calvo Cortès, Gabrièle Laborde-Balen, Martine Audibert, Fatou Fall, Ibrahima Gueye, Karine Lacombe, Moussa Seydi, Yusuke Shimakawa, Edouard Tuaillon, Muriel Vray, Lhuillier, Elisabeth, and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA)

Subjects
Adult, Hepatitis B Surface Antigens, Adolescent, Hepatology, Vaccination, Infant, Hepatitis B, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Senegal, 3. Good health, Young Adult, 03 medical and health sciences, Cross-Sectional Studies, 0302 clinical medicine, Humans, Female, Hepatitis B Vaccines, 030211 gastroenterology & hepatology, 030212 general & internal medicine, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, Child
Abstract

International audience; Senegal introduced the infant hepatitis B virus (HBV) vaccination in 2004 and recently committed to eliminating hepatitis B by 2030. Updated epidemiological data are needed to provide information on the progress being made and to develop new interventions. We estimated the prevalence of hepatitis B surface antigen (HBsAg) in children and adults living in rural Senegal and assessed hepatitis B treatment eligibility. A cross-sectional population-based serosurvey of HBsAg was conducted in 2018-2019 in a large sample (n = 3,118) of residents living in the Niakhar area (Fatick region, Senegal). Individuals positive for HBsAg subsequently underwent clinical and biological assessments. Data were weighted for age and sex and calibrated to be representative of the area's population. Among the 3,118 participants, 206 were HBsAg positive (prevalence, 6.9%; 95% confidence interval [CI], 5.6-8.1). Prevalence varied markedly according to age group in individuals aged 0-4, 5-14, 15-34, and >= 35 years as follows: 0.0% (95% CI, 0.00-0.01); 1.5% (95% CI, 0.0-2.3); 12.4% (95% CI, 9.1-15.6); and 8.8% (95% CI, 6.1-11.5), respectively. Of those subsequently assessed, 50.9% (95% CI, 41.8-60.0) had active HBV infection; 4 (2.9%; 95% CI, 0.9-9.4) were eligible for hepatitis B treatment. Conclusion: In this first population-based serosurvey targeting children and adults in rural Senegal, HBsAg prevalence was very low in the former, meeting the World Health Organization's (WHO) < 1% HBsAg 2020 target; however, it was high in young adults (15-34 years old) born before the HBV vaccine was introduced in 2004. To reach national and WHO hepatitis elimination goals, general population testing (particularly for adolescents and young adults), care, and treatment scale-up need to be implemented.

Published
2021

5. Hepatitis B in Senegal: A Successful Infant Vaccination Program but Urgent Need to Scale Up Screening and Treatment (ANRS 12356 AmBASS survey)

Author

Périères, Lauren, primary, Diallo, Aldiouma, additional, Marcellin, Fabienne, additional, Nishimwe, Marie Libérée, additional, Ba, El Hadji, additional, Coste, Marion, additional, Lo, Gora, additional, Halfon, Philippe, additional, Kane, Coumba Touré, additional, Maradan, Gwenaëlle, additional, Carrieri, Patrizia, additional, Diouf, Assane, additional, Shimakawa, Yusuke, additional, Sokhna, Cheikh, additional, and Boyer, Sylvie, additional

Published
2022
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7. Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey)

Author

Périères, Lauren, Marcellin, Fabienne, Lo, Gora, Protopopescu, Camelia, Ba, El, Coste, Marion, Kane, Coumba Touré, Maradan, Gwenaëlle, Diallo, Aldiouma, Sokhna, Cheikh, Boyer, Sylvie, and Group, on behalf of the ANRS 12356 AmBASS Survey Study

Subjects
vaccination timeliness, vaccination coverage, pentavalent vaccination, birth dose vaccination, Medicine, hepatitis B vaccine, Senegal
Abstract

Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination.

Published
2021

8. Sibling status, home birth, tattoos and stitches are risk factors for chronic hepatitis B virus infection in Senegalese children: A cross‐sectional survey

Author

Périères, Lauren, Protopopescu, Camelia, Lo, Gora, Marcellin, Fabienne, Ba, El Hadji, Coste, Marion, Touré Kane, Coumba, Diallo, Aldiouma, Sokhna, Cheikh, Boyer, Sylvie, Anrs 12356 Ambass Survey Study, Grp, Bérenger, Cyril, Bousmah, Marwân-Al-Qays, Carrieri, Patrizia, de Sèze, Maëlle, Djaogol, Tchadine, Maradan, Gwenaëlle, Treibich, Carole, Ba Ba, El Hadji, Dièye, Fambaye, Diouf, Assane, Faye, Elhadji Bilal, Ndiaye, Assane, Sow, Mouhamadou Baba, Ndiaye, Anna Julienne Selbé, Ndiour, Samba, Halfon, Philippe, Mohamed, Sofiane, Rouveau, Nicolas, Cortès, Maria‐camila Calvo, Laborde‐balen, Gabrièle, Audibert, Martine, Fall, Fatou, Gueye, Ibrahima, Lacombe, Karine, Seydi, Moussa, Shimakawa, Yusuke, Tuaillon, Edouard, Vray, Muriel, Maladies infectieuses persistantes et émergentes en Afrique de l’Ouest [Dakar, Sénégal] (Equipe 3 - VITROME), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation [Dakar, Sénégal] (IRESSEF), Aix-Marseille Sciences Economiques (AMSE), École des hautes études en sciences sociales (EHESS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), The AmBASS research project was funded in full by the French ANRS Emerging Infectious Diseases research agency under the auspices of the French National Institute for Health and Medical Research (INSERM) (INSERM-ANRS), grant number 12356., Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier], Lhuillier, Elisabeth, and École des hautes études en sciences sociales (EHESS)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)

Subjects
HBsAg, Cross-sectional study, medicine.disease_cause, 0302 clinical medicine, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infection control, risk factors, 030212 general & internal medicine, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, Home Childbirth, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, child, Tattooing, virus diseases, Hepatitis B, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Senegal, 3. Good health, Vaccination, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, 030211 gastroenterology & hepatology, Hepatitis B virus, prevalence, 03 medical and health sciences, Hepatitis B, Chronic, Virology, medicine, Humans, Hepatitis B Vaccines, Sibling, Aged, Hepatitis B Surface Antigens, Hepatology, business.industry, Siblings, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Infectious Disease Transmission, Vertical, digestive system diseases, Cross-Sectional Studies, hepatitis B, business, Home birth, Demography
Abstract

International audience; Sub-Saharan Africa's hepatitis B virus (HBV) burden is primarily due to infection in infancy. However, data on chronic HBV infection prevalence and associated risk factors in children born post-HBV vaccination introduction are scarce. We estimated hepatitis B surface antigen (HBsAg) prevalence and risk factors in Senegalese children born during the HBV vaccination era. In 2018-2019, a community-based cross-sectional survey was conducted in Senegal among children born between 2004 and 2015 (ie after the three-dose HBV vaccine series was introduced (2004) but before the birth dose's introduction (2016)). HBsAg-positive children were identified using dried blood spots. A standardized questionnaire collected socioeconomic information. Data were age-sex weighted and calibrated to be representative of children living in the study area. Risk factors associated with HBsAg positivity were identified using negative binomial regression. Among 1,327 children, 17 were HBsAg-positive (prevalence = 1.23% (95% confidence interval [CI] 0.61-1.85)). Older age (adjusted incidence-rate ratio [aIRR] 1.31 per one-year increase, 95% CI 1.10-1.57), home vs healthcare facility delivery (aIRR 3.55, 95% CI 1.39-9.02), stitches (lifetime) (aIRR 4.79; 95% CI 1.84-12.39), tattoos (aIRR 8.97, 95% CI 1.01-79.11) and having an HBsAg-positive sibling with the same mother (aIRR 3.05, 95% CI 1.09-8.57) were all independently associated with HBsAg positivity. The low HBsAg prevalence highlights the success of the Senegalese HBV vaccination program. To further reduce HBV acquisition in children, high-risk groups, including pregnant women and siblings of HBsAg-positive individuals, must be screened. Vital HBV infection prevention measures include promoting delivery in healthcare facilities, and increasing awareness of prevention and control procedures.

Published
2021

9. Hepatitis Delta virus in migrants: The challenge of elimination (ANRS CO22 HEPATHER cohort).

Author

Lotto, Marta, Fontaine, Hélène, Marcellin, Fabienne, Périères, Lauren, Bureau‐Stoltmann, Morgane, Carrat, Fabrice, Pol, Stanislas, Zoulim, Fabien, and Carrieri, Patrizia

Subjects
HEPATITIS D virus, HEPATITIS B virus, SOCIAL science research, IMMIGRANTS, VIRAL hepatitis, INFECTION, CHRONIC hepatitis B
Abstract

Novel treatments for hepatitis Delta virus (HDV) infection provide promising opportunities to treat patients with hepatitis B virus (HBV) and HDV co‐infection. However, current clinical trials on HDV treatment rarely explore patients' barriers to treatments. In Europe, HDV infection mostly affects young migrants from HDV‐endemic areas who experience early liver‐related mortality. Migrants are more likely to face multiple situations of statutory and socioeconomic insecurity and structural barriers than non‐migrants. These obstacles may impact their quality of life and can (i) lead them to give secondary importance to certain HDV care options, (ii) delay treatment initiation and (iii) affect their adherence and commitment to care. Preliminary results from the ANRS CO22 HEPATHER cohort show that the majority (61.6%) of HBV‐HDV co‐infected migrants live in poverty. Moreover, half were diagnosed and a quarter of those who initiated HBV treatment had been in France for no more than two years, a period when language skills are often still poor and when knowledge of the health and administrative system may be lacking. We advocate for increased social science research, in particular qualitative studies, to investigate the effects that multiple forms of precarity (weak access to social rights, language barriers, housing insecurity, unexpected expenditures and other difficulties) may have on HDV screening opportunities, follow‐up, and treatment pathways in migrants. This will help adapt communication and care around viral hepatitis, as well as inform and orient medical services and public health actors about the difficulties that migrants encounter. [ABSTRACT FROM AUTHOR]

Published
2022
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10. Sibling status, home birth, tattoos and stitches are risk factors for chronic hepatitis B virus infection in Senegalese children: A cross-sectional survey.

Author

Périères L, Protopopescu C, Lo G, Marcellin F, Ba EH, Coste M, Touré Kane C, Diallo A, Sokhna C, and Boyer S

Subjects
Aged, Child, Cross-Sectional Studies, Female, Hepatitis B Surface Antigens, Hepatitis B Vaccines, Hepatitis B virus, Humans, Infectious Disease Transmission, Vertical, Pregnancy, Prevalence, Risk Factors, Siblings, Hepatitis B, Hepatitis B, Chronic epidemiology, Hepatitis B, Chronic prevention & control, Home Childbirth, Tattooing
Abstract

Sub-Saharan Africa's hepatitis B virus (HBV) burden is primarily due to infection in infancy. However, data on chronic HBV infection prevalence and associated risk factors in children born post-HBV vaccination introduction are scarce. We estimated hepatitis B surface antigen (HBsAg) prevalence and risk factors in Senegalese children born during the HBV vaccination era. In 2018-2019, a community-based cross-sectional survey was conducted in Senegal among children born between 2004 and 2015 (ie after the three-dose HBV vaccine series was introduced (2004) but before the birth dose's introduction (2016)). HBsAg-positive children were identified using dried blood spots. A standardized questionnaire collected socioeconomic information. Data were age-sex weighted and calibrated to be representative of children living in the study area. Risk factors associated with HBsAg positivity were identified using negative binomial regression. Among 1,327 children, 17 were HBsAg-positive (prevalence = 1.23% (95% confidence interval [CI] 0.61-1.85)). Older age (adjusted incidence-rate ratio [aIRR] 1.31 per one-year increase, 95% CI 1.10-1.57), home vs healthcare facility delivery (aIRR 3.55, 95% CI 1.39-9.02), stitches (lifetime) (aIRR 4.79; 95% CI 1.84-12.39), tattoos (aIRR 8.97, 95% CI 1.01-79.11) and having an HBsAg-positive sibling with the same mother (aIRR 3.05, 95% CI 1.09-8.57) were all independently associated with HBsAg positivity. The low HBsAg prevalence highlights the success of the Senegalese HBV vaccination program. To further reduce HBV acquisition in children, high-risk groups, including pregnant women and siblings of HBsAg-positive individuals, must be screened. Vital HBV infection prevention measures include promoting delivery in healthcare facilities, and increasing awareness of prevention and control procedures., (© 2021 John Wiley & Sons Ltd.)

Published
2021
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