Introduction: Hepatitis B remains an important public health issue, which management faces several difficulties in countries with limited resources. The aim of this study was to describe the problems encountered by chronic hepatitis B carriers at the University Hospital Center of Kara (CHU). Methods: This was a descriptive cross-sectional study conducted over a period of three years at the Kara University Hospital Center. All chronic hepatitis B virus (HBV) carriers aged over 18 years who had given their consent were included. Results: A total of 652 cases of HBV out of 2014 consultations were recorded, equivalent to 32% frequency. Patients were predominantly male, with a sex ratio of 1.4. The average age was 30 ± 13 years. One third of patients had no monthly source of income. Thirty-two percent of patients had health insurance. Ninety-seven percent of patients considered the cost of the initial pre-therapeutic HBV test to be too expensive, 17% had never been able to undergo the test due to lack of funds, and 35% had undergone it after a minimum delay of 3 months. Around 40% of eligible patients for treatment with nucleotide analogues had started this treatment. There was also a shortage of liver specialists, with only two for the whole Northern Togo. Conclusion: In our context, the difficulties in treating hepatitis B are financial and, above all, there is a shortage of qualified human resources, requiring state subsidies in order to reduce mortality linked to HBV complications.
References
[1]
FMC-HE (2023) Hépatite virale B: Rappel des fondamentaux. https://www.fmcgastro.org/texte-postu/postu-2023/hepatite-virale-b-rappel-des-fondamentaux/
[2]
Liu, J., Zhang, S., Wang, Q., Shen, H., Zhang, M., Zhang, Y., et al. (2016) Seroepidemiology of Hepatitis B Virus Infection in 2 Million Men Aged 21-49 Years in Rural China: A Population-Based, Cross-Sectional Study. The Lancet Infectious Diseases, 16, 80-86. https://doi.org/10.1016/s1473-3099(15)00218-2
[3]
Pita, I., Horta-Vale, A.M., Cardoso, H. and Macedo, G. (2014) Hepatitis B Inactive Carriers: An Overlooked Population? GE Portuguese Journal of Gastroenterology, 21, 241-249. https://doi.org/10.1016/j.jpge.2014.08.003
[4]
Dhumeaux, D. (2014) Prise en charge des personnes infectées par les virus de l’hépatite B ou de l’hépatite C: Rapport de recommandations 2014. EDK, éditions médicales et scientifiques EDP sciences, Paris Les Ulis.
[5]
Kpossou, A.R., Paraiso, M.N., Sokpon, C.N., Alassan, K.S., Vignon, R.K., Keke, R.K., et al. (2020) Hépatite virale B lors d’une campagne de dépistage en population générale au Bénin: Séroprévalence et facteurs associés. Pan African Medical Journal, 37, Article 247. https://doi.org/10.11604/pamj.2020.37.247.26070
[6]
Kra, O., N’Dri, N., Koné, D., Kadiané, N.J., Aba, Y.T., Ouattara, B., et al. (2015) Prevalence of HBs Antigen Carriage in a Population of Recruits of the National Gendarmerie of Ivory Coast in 2010. African Journal of Infectious Diseases Research, 2, 80-83. https://www.internationalscholarsjournals.com/articles/prevalence-of-hbs-antigen-carriage-in-a-population-of-recruits-of-the-national-gendarmerie-of-ivory-coast-in-2010.pdf
[7]
Dossim, S., EL-Hadji Yakoubou, R., Moumouni, A. K., Maba, D., Salou, M., Dagnra, A. Y., et al. (2023) Viral Load B among students at Kara Universityin Togo. African Journal of Virology Research, 17, 1-4.
[8]
Ekouevi, D.K., Larrouy, L., Gbeasor-Komlanvi, F.A., Mackiewicz, V., Tchankoni, M.K., Bitty-Anderson, A.M., et al. (2020) Prevalence of Hepatitis B among Childbearing Women and Infant Born to HBV-Positive Mothers in Togo. BMC Infectious Diseases, 20, Article No. 839. https://doi.org/10.1186/s12879-020-05574-7
[9]
Polaris Observatory Collaborators (2018) Global Prevalence, Treatment, and Prevention of Hepatitis B Virus Infection in 2016: A Modelling Study. The Lancet Gastroenterology and Hepatology, 3, 383-403. https://doi.org/10.1016/S2468-1253(18)30056-6
[10]
Abara, W.E., Qaseem, A., Schillie, S., McMahon, B.J. and Harris, A.M. (2017) Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice from the American College of Physicians and the Centers for Disease Control and Prevention. Annals of Internal Medicine, 167, 794-804. https://doi.org/10.7326/m17-1106
[11]
Valery, P.C., Laversanne, M., Clark, P.J., Petrick, J.L., McGlynn, K.A. and Bray, F. (2017) Projections of Primary Liver Cancer to 2030 in 30 Countries Worldwide. Hepatology, 67, 600-611. https://doi.org/10.1002/hep.29498
[12]
Lok, A.S.F., McMahon, B.J., Brown, R.S., Wong, J.B., Ahmed, A.T., Farah, W., et al. (2015) Antiviral Therapy for Chronic Hepatitis B Viral Infection in Adults: A Systematic Review and Meta‐Analysis. Hepatology, 63, 284-306. https://doi.org/10.1002/hep.28280
[13]
GBD 2019 Hepatitis B Collaborators (2022) Global, Regional, and National Burden of Hepatitis B, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet Gastroenterology and Hepatology, 7, 796-829. https://doi.org/10.1016/S2468-1253(22)00124-8
[14]
Gnatou, G.Y., Diallo, F.B.T., Gbeasor-Komlanvi, F.A., Agoro, S., Sadio, A.J., Adoli, L.K., et al. (2023) Prevalence of Viral Hepatitis B among Women of Childbearing Age in the Kara Region of Togo in 2022. Open Journal of Preventive Medicine, 13, 319-328. https://doi.org/10.4236/ojpm.2023.1312021
[15]
Lawson-Ananissoh, L.M., Bouglouga, O., Bagny, A., Kaaga, L., El Hadj Yakoubou, R. and Redah, D. (2015) Knowledge of Hepatitis B Virus among Outpatients Consulting in the Hepatogastroenterology Department at the Lome Campus University Hospital. Médecine et Santé Tropicales, 25, 319-322. https://doi.org/10.1684/mst.2015.0489
[16]
European Association for the Study of the Liver (2017) EASL 2017 Clinical Practice Guidelines on the Management of Hepatitis B Virus Infection. Journal of Hepatology, 67, 370-398. https://doi.org/10.1016/j.jhep.2017.03.021
[17]
Terrault, N.A., Lok, A.S.F., McMahon, B.J., Chang, K., Hwang, J.P., Jonas, M.M., et al. (2018) Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology, 67, 1560-1599.
[18]
Anzouan-Kacou, H.Y.K., Dehinsala, M., Bangoura, A.D., Kouamé, D.H., Doffou, A.S., Mahassadi, A.K., et al. (2022) Socio-Economic Aspects of the Management of Chronic Viral Hepatitis in Côte-d’Ivoire. Annales Africaines de Medecine, 15, e4770-e4778. https://doi.org/10.4314/aamed.v15i4.3
[19]
Lawson-Ananissoh, L.M., Bouglouga, O., Bagny, A., Kaaga, L., El-Hadj Yakoubou, R. and Redah, D. (2015) Impact de l’assurance maladie sur le coût financier direct de la prise en charge medicale de la cirrhose au centre hospitalier et universitaire campus de Lomé, Togo. Journal Africain d’Hépato-Gastroentérologie, 9, 7-11. https://doi.org/10.1007/s12157-014-0573-9
[20]
Aberra, H., Desalegn, H., Berhe, N., Mekasha, B., Medhin, G., Gundersen, S.G., et al. (2019) The WHO Guidelines for Chronic Hepatitis B Fail to Detect Half of the Patients in Need of Treatment in Ethiopia. Journal of Hepatology, 70, 1065-1071. https://doi.org/10.1016/j.jhep.2019.01.037
[21]
L’OMS tire la sonnette d’alarme sur l’hépatite virale qui tue 3500 personnes chaque jour. https://www.who.int/fr/news/item/09-04-2024-who-sounds-alarm-on-viral-hepatitis-infections-claiming-3500-lives-each-day
[22]
Actualités de l’Urgence—APM/Société Française de Médecine d’Urgence—SFMU. https://www.sfmu.org/fr/actualites/actualites-de-l-urgences/
