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Reference Manager
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-
1.
El-Serag HB , 2012. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 142: 1264–1273.e1.
-
2.
Anna Kramvis MK , 2007. Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes. Hepatol Res 37 (Suppl 1 ):S9–S19.
-
3.
McMahon BJ , 2018. Meeting the WHO and US goals to eliminate hepatitis B infection by 2030: opportunities and challenges. Clin Liver Dis (Hoboken) 12: 29–32.
-
4.
The United Republic of Tanzania, Ministry of Health, Community Development, Elderly and Children , 2023. National Strategic Plan for the Control of Viral Hepatitis: 2018/19–2022/23. Available at: https://www.globalhep.org/sites/default/files/content/resource/files/2020-02/Tanzania%20National%20Strategic%20Plan%20for%20the%20Control%20of%20Viral%20Hepatitis%202018-19-2022-23.pdf. Accessed April 26, 2023.
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5.
Jaka H , Mshana SE , Rambau PF , Masalu N , Chalya PL , Kalluvya SE , 2014. Hepatocellular carcinoma: clinicopathological profile and challenges of management in a resource-limited setting. World J Surg Oncol 12: 246.
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6.
Yang JD et al., 2017. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol Hepatol 2: 103–111.
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7.
Yang JD , Hainaut P , Gores GJ , Amadou A , Plymoth A , Roberts LR , 2019. A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol 16: 589–604.
-
8.
Yang JD et al., 2015. Hepatocellular carcinoma occurs at an earlier age in Africans, particularly in association with chronic hepatitis B. Am J Gastroenterol 110: 1629–1631.
-
9.
McNaughton AL et al., 2020. Hepatitis B virus seroepidemiology data for Africa: modelling intervention strategies based on a systematic review and meta-analysis. PLoS Med 17: e1003068.
-
10.
Ford JS , Marianelli LG , Frassone N , Debes JD , 2020. Hepatitis B screening in an Argentine ED: increasing vaccination in a resource-limited setting. Am J Emerg Med 38: 296–299.
-
11.
Tanaka H , 2020. Current role of ultrasound in the diagnosis of hepatocellular carcinoma. J Med Ultrason (2001) 47: 239–255.
-
12.
Revill PA et al., 2019. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol 4: 545–558.
-
13.
Bonafide CP , Brady PW , Keren R , Conway PH , Marsolo K , Daymont C , 2013. Development of heart and respiratory rate percentile curves for hospitalized children. Pediatrics 131: e1150–e1157.
-
14.
Harris PA , Taylor R , Thielke R , Payne J , Gonzalez N , Conde JG , 2009. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42: 377–381.
-
15.
Kilonzo SB , Gunda DW , Mpondo BCT , Bakshi FA , Jaka H , Hepatitis B , 2018. Virus infection in Tanzania: current status and challenges. J Trop Med 2018: 4239646.
-
16.
Schweitzer A , Horn J , Mikolajczyk RT , Krause G , Ott JJ , 2015. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 386: 1546–1555.
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17.
Miller WC , Shao JF , Weaver DJ , Shimokura GH , Paul DA , Lallinger GJ , 1998. Seroprevalence of viral hepatitis in Tanzanian adults. Trop Med Int Health 3: 757–763.
-
18.
Pellizzer G , Blè C , Zamperetti N , Stroffolini T , Upunda G , Rapicetta M , Chionne P , Villano U , Fabris P , de Lalla F , 1994. Serological survey of hepatitis B infection in Tanzania. Public Health 108: 427–431.
-
19.
Muro FJ , Fiorillo SP , Sakasaka P , Odhiambo C , Reddy EA , Cunningham CK , Buchanan AM , 2013. Seroprevalence of hepatitis B and C viruses among children in Kilimanjaro Region, Tanzania. J Pediatric Infect Dis Soc 2: 320–326.
-
20.
Aaron D , Nagu TJ , Rwegasha J , Komba E , 2017. Hepatitis B vaccination coverage among healthcare workers at national hospital in Tanzania: how much, who and why? BMC Infect Dis 17: 786.
-
21.
Mavilia MG , Wu GY , 2017. Mechanisms and prevention of vertical transmission in chronic viral hepatitis. J Clin Transl Hepatol 5: 119–129.
-
22.
Kew MC , 2013. Epidemiology of hepatocellular carcinoma in sub-Saharan Africa. Ann Hepatol 12: 173–182.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 2056 | 2056 | 71 |
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Combined Hepatitis B Virus and Hepatocellular Carcinoma Screening Using Point-of-Care Testing and Ultrasound in a Tanzanian Emergency Department
James S. Ford
James S. Ford
Department of Emergency Medicine, University of California, San Francisco, California;
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Johnstone Kayandabila
Johnstone Kayandabila
Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Joseph C. Morrison
Joseph C. Morrison
University of California Davis School of Medicine, Davis, California;
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Samwel Seth
Samwel Seth
Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Benson Lyimo
Benson Lyimo
Department of Surgery, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Aliasghar Mukhtar
Aliasghar Mukhtar
Department of Emergency Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania;
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Michael Schick
Michael Schick
Department of Emergency Medicine, University of California Davis Health, Sacramento, California;
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Larissa May
Larissa May
Department of Emergency Medicine, University of California Davis Health, Sacramento, California;
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Jose D. Debes
Jose D. Debes
Department of Medicine, University of Minnesota, Minneapolis, Minnesota
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ABSTRACT.
The WHO aims to detect 90% of global cases of hepatitis B virus (HBV) by 2030. Sub-Saharan Africa carries a disproportionate burden of HBV and hepatocellular carcinoma (HCC). In this study, we sought to assess the utility of a combined HBV and HCC screening program in Tanzania. We conducted a prospective, serial cross-sectional study of patients who participated in a combined HBV and HCC screening program at a regional referral hospital emergency department (ED) in Arusha, Tanzania, between April 19, 2022 and June 3, 2022. All patients completed a study questionnaire and were tested for HBV surface antigen. Patients who were HBV positive were screened for HCC via point-of-care ultrasound (POCUS). The primary outcome was the number of new HBV diagnoses. Data were analyzed with descriptive statistics. A total of 846 patients were tested for HBV (primary ED: 761, clinic referral: 85). The median age of patients was 44 ± 15 years, and 66% were female. Only 15% of patients reported having a primary care doctor. Thirteen percent of patients had been previously vaccinated for HBV. There were 17 new HBV diagnoses (primary ED: 16, clinic referral: 1), which corresponds to a seroprevalence of 2.0% (95% CI: 1.2%, 3.2%). No patients had liver masses detected on POCUS. An ED-based, combined HBV and HCC screening protocol can be feasibly implemented. This study could serve as a model for HBV/HCC screening in regions with high HBV endemicity and low rates of community screening.
Author Notes
Authors’ addresses: James S. Ford, Department of Emergency Medicine, University of California, San Francisco, CA, E-mail: james.ford@ucsf.edu. Johnstone Kayandabila and Samwel Seth, Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania, E-mails: johnskay3@hotmail.com and samwelseth@gmail.com. Joseph C. Morrison, University of California Davis School of Medicine, Davis, CA, E-mail: jcmorrison@ucdavis.edu. Benson Lyimo, Department of Surgery, Arusha Lutheran Medical Center, Arusha, Tanzania, E-mail: ben2harris@yahoo.com. Aliasghar Mukhtar, Department of Emergency Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania, E-mail: aliasghar.mukhtar52@gmail.com. Michael Schick and Larissa May, Department of Emergency Medicine, University of California Davis Health, Sacramento, CA, E-mails: mschick@ucdavis.edu and lsmay@ucdavis.edu. Jose D. Debes, Department of Medicine, University of Minnesota, Minneapolis, MN, E-mail: debes003@umn.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
El-Serag HB , 2012. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 142: 1264–1273.e1.
-
2.
Anna Kramvis MK , 2007. Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes. Hepatol Res 37 (Suppl 1 ):S9–S19.
-
3.
McMahon BJ , 2018. Meeting the WHO and US goals to eliminate hepatitis B infection by 2030: opportunities and challenges. Clin Liver Dis (Hoboken) 12: 29–32.
-
4.
The United Republic of Tanzania, Ministry of Health, Community Development, Elderly and Children , 2023. National Strategic Plan for the Control of Viral Hepatitis: 2018/19–2022/23. Available at: https://www.globalhep.org/sites/default/files/content/resource/files/2020-02/Tanzania%20National%20Strategic%20Plan%20for%20the%20Control%20of%20Viral%20Hepatitis%202018-19-2022-23.pdf. Accessed April 26, 2023.
-
5.
Jaka H , Mshana SE , Rambau PF , Masalu N , Chalya PL , Kalluvya SE , 2014. Hepatocellular carcinoma: clinicopathological profile and challenges of management in a resource-limited setting. World J Surg Oncol 12: 246.
-
6.
Yang JD et al., 2017. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol Hepatol 2: 103–111.
-
7.
Yang JD , Hainaut P , Gores GJ , Amadou A , Plymoth A , Roberts LR , 2019. A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol 16: 589–604.
-
8.
Yang JD et al., 2015. Hepatocellular carcinoma occurs at an earlier age in Africans, particularly in association with chronic hepatitis B. Am J Gastroenterol 110: 1629–1631.
-
9.
McNaughton AL et al., 2020. Hepatitis B virus seroepidemiology data for Africa: modelling intervention strategies based on a systematic review and meta-analysis. PLoS Med 17: e1003068.
-
10.
Ford JS , Marianelli LG , Frassone N , Debes JD , 2020. Hepatitis B screening in an Argentine ED: increasing vaccination in a resource-limited setting. Am J Emerg Med 38: 296–299.
-
11.
Tanaka H , 2020. Current role of ultrasound in the diagnosis of hepatocellular carcinoma. J Med Ultrason (2001) 47: 239–255.
-
12.
Revill PA et al., 2019. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol 4: 545–558.
-
13.
Bonafide CP , Brady PW , Keren R , Conway PH , Marsolo K , Daymont C , 2013. Development of heart and respiratory rate percentile curves for hospitalized children. Pediatrics 131: e1150–e1157.
-
14.
Harris PA , Taylor R , Thielke R , Payne J , Gonzalez N , Conde JG , 2009. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42: 377–381.
-
15.
Kilonzo SB , Gunda DW , Mpondo BCT , Bakshi FA , Jaka H , Hepatitis B , 2018. Virus infection in Tanzania: current status and challenges. J Trop Med 2018: 4239646.
-
16.
Schweitzer A , Horn J , Mikolajczyk RT , Krause G , Ott JJ , 2015. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 386: 1546–1555.
-
17.
Miller WC , Shao JF , Weaver DJ , Shimokura GH , Paul DA , Lallinger GJ , 1998. Seroprevalence of viral hepatitis in Tanzanian adults. Trop Med Int Health 3: 757–763.
-
18.
Pellizzer G , Blè C , Zamperetti N , Stroffolini T , Upunda G , Rapicetta M , Chionne P , Villano U , Fabris P , de Lalla F , 1994. Serological survey of hepatitis B infection in Tanzania. Public Health 108: 427–431.
-
19.
Muro FJ , Fiorillo SP , Sakasaka P , Odhiambo C , Reddy EA , Cunningham CK , Buchanan AM , 2013. Seroprevalence of hepatitis B and C viruses among children in Kilimanjaro Region, Tanzania. J Pediatric Infect Dis Soc 2: 320–326.
-
20.
Aaron D , Nagu TJ , Rwegasha J , Komba E , 2017. Hepatitis B vaccination coverage among healthcare workers at national hospital in Tanzania: how much, who and why? BMC Infect Dis 17: 786.
-
21.
Mavilia MG , Wu GY , 2017. Mechanisms and prevention of vertical transmission in chronic viral hepatitis. J Clin Transl Hepatol 5: 119–129.
-
22.
Kew MC , 2013. Epidemiology of hepatocellular carcinoma in sub-Saharan Africa. Ann Hepatol 12: 173–182.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2056 | 2056 | 71 |
| Full Text Views | 77 | 77 | 1 |
| PDF Downloads | 95 | 95 | 1 |