• Family practice · Dec 2018

    Improving the hepatitis cascade: assessing hepatitis testing and its management in primary health care in China.

    • WongWilliam C WWCWUniversity of Hong Kong-Shenzhen Hospital, Shenzhen, China.Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong., Ying-Ru Lo, Sunfang Jiang, Minghui Peng, Shanzhu Zhu, Michael R Kidd, Xia-Chun Wang, Po-Lin Chan, and Jason J Ong.
    • University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
    • Fam Pract. 2018 Dec 12; 35 (6): 731-737.

    ObjectiveThe study aimed to decentralize hepatitis testing and management services to primary care in China.MethodsA nationwide representative provider survey amongst community health centres (CHCs) using randomized stratified sampling methods was conducted between September and December 2015. One hundred and eighty CHCs and frontline primary care practitioners from 20 cities across three administrative regions of Western, Central and Eastern China were invited to participate.ResultsOne hundred and forty-nine clinicians-in-charge (79%), 1734 doctors and 1846 nurses participated (86%). Majority of CHCs (80%, 95% CI: 74-87) offered hepatitis B testing, but just over half (55%, 95% CI: 46-65) offered hepatitis C testing. The majority of doctors (87%) and nurses (85%) felt that there were benefits for providing hepatitis testing at CHCs. The major barriers for not offering hepatitis testing were lack of training (54%) and financial support (23%). Multivariate analysis showed that the major determinants for CHCs to offer hepatitis B and C testing were the number of nurses (AOR 1.1) and written policies for hepatitis B diagnosis (AOR 12.7-27.1), and for hepatitis B the availability of reproductive health service.ConclusionsPrimary care providers in China could play a pivotal role in screening, diagnosing and treating millions of people with chronic hepatitis B and C in China.

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