William C W Wong1,2, Ying-Ru Lo3, Sunfang Jiang4, Minghui Peng4, Shanzhu Zhu4, Michael R Kidd5,6, Xia-Chun Wang7, Po-Lin Chan8, Jason J Ong9,10. 1. University of Hong Kong-Shenzhen Hospital, Shenzhen, China. 2. Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong. 3. Head of Mission and WHO Representative to Malaysia, Brunei Darussalam and Singapore. 4. Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China. 5. Department of Family and Community Medicine, University of Toronto, Canada. 6. Southgate Institute for Health, Equity and Society, Flinders University, Australia. 7. National Center for AIDS/STD Prevention and Control, China Center for Disease Control and Prevention, Beijing, China. 8. World Health Organization, Office of the Representative to China. 9. Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK. 10. Central Clinical School, Monash University, Melbourne, Australia.
Abstract
Objective: The study aimed to decentralize hepatitis testing and management services to primary care in China. Methods: A 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. Results: One 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. Conclusions: Primary 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.
Objective: The study aimed to decentralize hepatitis testing and management services to primary care in China. Methods: A 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. Results: One 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. Conclusions: Primary 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.
Authors: William C W Wong; Nancy S Yang; Jingjing Li; Hang Li; Eric Y F Wan; Thomas Fitzpatrick; Yuan Xiong; Wai-Kay Seto; Polin Chan; Ruihong Liu; Weiming Tang; Joseph D Tucker Journal: BMC Public Health Date: 2020-07-02 Impact factor: 3.295
Authors: Eva van Oorschot; Özgür M Koc; Astrid Ml Oude Lashof; Inge Hm van Loo; Robin Ackens; Dirk Posthouwer; Ger H Koek Journal: J Virus Erad Date: 2022-06-20
Authors: William C W Wong; Gifty Marley; Jingjing Li; Weihui Yan; Po-Lin Chan; Joseph D Tucker; Weiming Tang; Yuxin Ni; Dan Dan Cheng; Lou Cong; Wai-Kay Seto Journal: NPJ Digit Med Date: 2022-07-19
Authors: Shu Su; William Cw Wong; Zhuoru Zou; Dan Dan Cheng; Jason J Ong; Polin Chan; Fanpu Ji; Man-Fung Yuen; Guihua Zhuang; Wai-Kay Seto; Lei Zhang Journal: Lancet Glob Health Date: 2022-02 Impact factor: 26.763