0000000000150183
AUTHOR
Nega Berhe
Treatment of chronic hepatitis B in sub-Saharan Africa: 1-year results of a pilot program in Ethiopia
Background The World Health Organization has set an ambitious goal of eliminating viral hepatitis as a major public health threat by 2030. However, in sub-Saharan Africa, antiviral treatment of chronic hepatitis B (CHB) is virtually unavailable. Herein, we present the 1-year results of a pilot CHB treatment program in Ethiopia. Methods At a public hospital in Addis Ababa, CHB patients were treated with tenofovir disoproxil fumarate based on simplified eligibility criteria. Baseline assessment included liver function tests, viral markers, and transient elastography (Fibroscan). Changes in laboratory markers were analyzed using Wilcoxon signed-rank tests. Adherence to therapy was measured by …
Are non-invasive fibrosis markers for chronic hepatitis B reliable in sub-Saharan Africa?
Background In the absence of liver biopsy, the World Health Organization recommends non-invasive tests, such as aspartate aminotransferase to platelet ratio index and FIB-4, to assess liver fibrosis in patients with chronic hepatitis B. However, these tests are not well validated in sub-Saharan Africa. Recently, a new marker, gamma-glutamyl transpeptidase to platelet ratio, was found to be more accurate in an African setting, but this needs confirmation in other cohorts. Methods A treatment program for chronic hepatitis B was initiated in Addis Ababa, Ethiopia, in 2015. Non-invasive tests were compared with transient elastography (Fibroscan 402, Echosense, France) using the following thresh…
Unexplained chronic liver disease in Ethiopia: a cross-sectional study
Background Hepatitis B virus (HBV) infection is assumed to be the major cause of chronic liver disease (CLD) in sub-Saharan Africa. The contribution of other aetiological causes of CLD is less well documented and hence opportunities to modulate other potential risk factors are being lost. The aims of this study were to explore the aetiological spectrum of CLD in eastern Ethiopia and to identify plausible underlying risk factors for its development. Methods A cross-sectional study was undertaken between April 2015 and April 2016 in two public hospitals in Harar, eastern Ethiopia. The study population comprised of consenting adults with clinical and radiological evidence of chronic liver dise…
Additional file 5 of Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Additional file 5: Supplementary file 5 Authors’ information.pdf
High Seroprevalence of Autoantibodies Typical of Autoimmune Liver Disease in Eastern Ethiopia: Is Chewing of Khat (Catha edulis) a Triggering Factor?
Background. Recent studies have identified chewing of khat (Catha edulis) as an independent risk factor for liver injury; however, the pathogenetic mechanism remains poorly understood. Case series have found markers of autoimmune hepatitis in patients with khat-related liver disease, suggesting that khat chewing might trigger an autoimmune response. The aims of the present study were (i) to assess the prevalence of autoantibodies typical for autoimmune liver diseases in a healthy population in Ethiopia and (ii) to explore the hypothesis that khat usage triggers autoimmunity. Methods. Consenting adults (≥18 years) without known autoimmune disease or manifest liver disease were included. One-…
Current status of Schistosoma mansoni infection among previously treated rural communities in the Abbey and Didessa Valleys, Western Ethiopia: Implications for sustainable control.
Background Schistosoma constitutes a major public health problem and developmental challenges in the majority of developing and subtropical regions. The World Health Organization has set guidelines for the control and elimination of schistosomiasis. Ethiopia is providing school-based Mass Drug Administration (MDA) at the study areas of the Abbey and Didessa Valleys of western Ethiopian since 2015. Moreover, mass treatment was already done in the same villages 30 years ago. However, the current Schistosoma mansoni infection status among humans and snails in the study areas is not known. Hence, the present study aims to determine the current status. Methods A community-based cross-sectional …
Early experiences from one of the first treatment programs for chronic hepatitis B in sub-Saharan Africa
Treatment for chronic hepatitis B (CHB) is virtually absent in sub-Saharan Africa. Here we present early experiences from a pilot program for treatment of CHB in Ethiopia. Adults (≥18 years) with CHB were included in a cohort study at St. Paul’s Hospital Millennium Medical College, Addis Ababa, from February 2015. The baseline assessment included liver function tests, viral markers and transient elastography (Fibroscan 402, Echosense, France). Logistic regression models were used to identify predictors of fibrosis. Tenofovir disoproxil fumarate (TDF) was initiated based on the European Association for the Study of the Liver (EASL) criteria, with some modifications. The initial 300 patients …
Additional file 6 of Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Additional file 6: Related file 1 Reference lists.pdf
Additional file 1 of Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Additional file 1: Supplementary file 1 In-depth interviews guide.pdf
Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Abstract Background Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. Methods A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group disc…
Additional file 3 of Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Additional file 3: Supplementary file 3 Schistosoma infection risky behaviors observation guide.pdf
Hepatitis delta virus infection in a large cohort of chronic hepatitis B patients in Ethiopia.
Background Hepatitis D Virus (HDV)-infection is associated with a more severe outcome in patients with chronic hepatitis B (CHB); however, little is known about the presence of HDV in sub-Saharan Africa. We aimed to determine the prevalence of HDV-infection, as well as its clinical, biological and virological characteristics, in a large CHB cohort in Ethiopia. Methods In total, 1267 HIV-negative CHB patients at St. Paul's Hospital Millennium Medical College in Addis Ababa were screened for anti-HDV antibodies using ELISA assays. Confirmed positive samples were further tested for HDV RNA using a consensus commercial real-time RT-PCR assay. HDV genotypes were also determined for RNA positive …
Additional file 2 of Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Additional file 2: Supplementary file 2 Focused Group Discussions (FGD) guide.pdf
Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study
Abstract Background Antiviral treatment for chronic hepatitis B (CHB) is largely unavailable in sub-Saharan Africa; hence, little is known about the prognosis after initiating treatment in African CHB patients. In this study we aimed to assess predictors of mortality in one of the largest CHB cohorts in sub-Saharan Africa. Methods Two-hundred-and-seventy-six CHB patients who started treatment with tenofovir disoproxil fumarate at a public hospital in Ethiopia between March 18, 2015, and August 1, 2017, were included in this analysis. Patients were followed up until October 1, 2017, and deaths were ascertained through hospital records and telephone interview with relatives. Decompensated cir…
Gastro-intestinal symptoms associated with intense Schistosoma mansoni infection affect class-attentiveness of schoolchildren in Ethiopia.
Abstract Objective To assess effect of subtle morbidities related to schistosomiasis mansoni on class-attentiveness of schoolchildren. Methods A cross-sectional study was undertaken involving 568 schoolchildren (mean age 13.4 years; 333 from Schistosoma mansoni endemic villages (Sille and Worke-Mado) and 235 from the non-endemic town Sheno. A questionnaire on signs and symptoms of ill-health was administered to all study subjects. In addition, parasitological and nutritional anthropometric data were collected. All study subjects from S. mansoni endemic areas were treated with praziquantel and albendazol while children from the non-endemic town were only treated with albendazol. Findings Pre…
The WHO guidelines for chronic hepatitis B fail to detect half of the patients in need of treatment in Ethiopia
Background & Aims In 2015, the World Health Organization (WHO) issued guidelines for the management of chronic hepatitis B (CHB) in low- and middle-income countries, but little is known about the applicability of the WHO treatment criteria in sub-Saharan Africa. The aim of this study was to evaluate the diagnostic performance of the WHO guidelines in a large CHB cohort in Ethiopia. Methods Treatment-naive adults who attended a public CHB clinic in Addis Ababa were included in this analysis. All patients underwent a standardized evaluation at recruitment, including blood tests and transient elastography (Fibroscan®). A Fibroscan result >7.9 kPa was used to define significant fibrosis and >9.…
Additional file 4 of Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study
Additional file 4: Supplementary file 4 Data.xlsx