Show simple item record

dc.contributor.authorKhalid, GG
dc.contributor.authorKyaw, KWY
dc.contributor.authorBousquet, C
dc.contributor.authorAuat, R
dc.contributor.authorDonchuk, D
dc.contributor.authorTrickey, A
dc.contributor.authorHamid, S
dc.contributor.authorQureshi, H
dc.contributor.authorMazzeo, V
dc.contributor.authorAslam, K
dc.contributor.authorKhowaja, S
dc.contributor.authorVan den Bergh, R
dc.date.accessioned2019-02-14T14:36:48Z
dc.date.available2019-02-14T14:36:48Z
dc.date.issued2018-12-28
dc.date.submitted2019-02-01
dc.identifier.citationFrom risk to care: the hepatitis C screening and diagnostic cascade in a primary health care clinic in Karachi, Pakistan—a cohort study 2018 International Healthen
dc.identifier.issn1876-3413
dc.identifier.issn1876-3405
dc.identifier.doi10.1093/inthealth/ihy096
dc.identifier.urihttp://hdl.handle.net/10144/619338
dc.description.abstractBackground In the high-prevalence setting of Pakistan, screening, diagnosis and treatment services for chronic hepatitis C (CHC) patients are commonly offered in specialized facilities. We aimed to describe the cascade of care in a Médecins Sans Frontières primary health care clinic offering CHC care in an informal settlement in Karachi, Pakistan. Methods This was a retrospective cohort analysis using routinely collected data. Three different screening algorithms were assessed among patients with one or more CHC risk factors. Results Among the 87 348 patients attending the outpatient clinic, 5003 (6%) presented with one or more risk factors. Rapid diagnostic test (RDT) positivity was 38% overall. Approximately 60% of the CHC patients across all risk categories were in the early stage of the disease, with an aspartate aminotransferase:platelet ratio index score <1. The sequential delays in the cascade differed between the three groups, with the interval between screening and treatment initiation being the shortest in the cohort tested with GeneXpert onsite. Conclusions Delays between screening and treatment can be reduced by putting in place more patient-centric testing algorithms. New strategies, to better identify and treat the hidden at-risk populations, should be developed and implemented.
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttps://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihy096/5266434en
dc.rightsPublished by Oxford University Pressen
dc.titleFrom Risk to Care: The Hepatitis C Screening and Diagnostic Cascade in a Primary Health Care Clinic in Karachi, Pakistan—a Cohort Studyen
dc.identifier.journalInternational Healthen
dc.contributor.institutionOperational Center Brussels, Médecins Sans Frontières, Islamabad, Pakistan
dc.contributor.institutionDepartment of Operational Research, International Union Against Tuberculosis and Lung Disease, Mandalay, Myanmar
dc.contributor.institutionOperational Center Brussels, Médecins Sans Frontières, Islamabad, Pakistan
dc.contributor.institutionOperational Center Brussels, Brussels, Belgium
dc.contributor.institutionOperational Center Brussels, Brussels, Belgium
dc.contributor.institutionSchool of Social and Population Sciences, University of Bristol, Bristol, UK
dc.contributor.institutionDepartment of Medicine, Agha Khan Medical University, Karachi, Pakistan
dc.contributor.institutionPakistan Health Research Council, Islamabad, Pakistan
dc.contributor.institutionOperational Center Brussels, Médecins Sans Frontières, Islamabad, Pakistan
dc.contributor.institutionOperational Center Brussels, Médecins Sans Frontières, Islamabad, Pakistan
dc.contributor.institutionOperational Center Brussels, Médecins Sans Frontières, Islamabad, Pakistan
dc.contributor.institutionOperational Center Brussels, Brussels, Belgium
refterms.dateFOA2019-03-04T14:18:45Z
html.description.abstractBackground In the high-prevalence setting of Pakistan, screening, diagnosis and treatment services for chronic hepatitis C (CHC) patients are commonly offered in specialized facilities. We aimed to describe the cascade of care in a Médecins Sans Frontières primary health care clinic offering CHC care in an informal settlement in Karachi, Pakistan. Methods This was a retrospective cohort analysis using routinely collected data. Three different screening algorithms were assessed among patients with one or more CHC risk factors. Results Among the 87 348 patients attending the outpatient clinic, 5003 (6%) presented with one or more risk factors. Rapid diagnostic test (RDT) positivity was 38% overall. Approximately 60% of the CHC patients across all risk categories were in the early stage of the disease, with an aspartate aminotransferase:platelet ratio index score <1. The sequential delays in the cascade differed between the three groups, with the interval between screening and treatment initiation being the shortest in the cohort tested with GeneXpert onsite. Conclusions Delays between screening and treatment can be reduced by putting in place more patient-centric testing algorithms. New strategies, to better identify and treat the hidden at-risk populations, should be developed and implemented.


Files in this item

Thumbnail
Name:
Khalid et al - 2018 - From risk ...
Size:
535.0Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record