Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study
Background Curative direct-acting antiviral treatment (DAA) has made it plausible to implement hepatitis C elimination interventions. However, poor hepatitis C knowledge among patients could impede the effectiveness of screening and treatment programs. Objective We assessed knowledge on hepatitis C...
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doaj-74abbb73d4284bdd8d2933bcf5816e7c2021-09-20T13:59:59ZengTaylor & Francis GroupGlobal Health Action1654-98802021-01-0114110.1080/16549716.2021.19532501953250Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort studyDale A Barnhart0Innocent Kamali1Francoise Nyirahabihirwe2Carol Mugabo3Jean de la Paix Gakuru4Mariam Uwase5Esdras Nizeyumuremyi6Tumusime Musafiri7Jean de Dieu Gatete8Jean Damascene Makuza9Fredrick Kateera10Bethany Hedt-Gauthier11Jean d’Amour Ndahimana12Harvard Medical SchoolPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaPartners In Health-Rwanda/Inshuti Mu BuzimaUniversity of British ColumbiaPartners In Health-Rwanda/Inshuti Mu BuzimaHarvard Medical SchoolPartners In Health-Rwanda/Inshuti Mu BuzimaBackground Curative direct-acting antiviral treatment (DAA) has made it plausible to implement hepatitis C elimination interventions. However, poor hepatitis C knowledge among patients could impede the effectiveness of screening and treatment programs. Objective We assessed knowledge on hepatitis C among rural Rwandans initiating DAA treatment for hepatitis C in a prospective cohort. Methods We administered 15 true-false statements before treatment initiation and during one follow-up visit occurring either 1 or 2 months after treatment initiation. We assessed the average number of correct responses per patient, the proportion of correct responses to individual statements, pre-treatment predictors of knowledge, and whether post-initiation knowledge was associated with time since treatment initiation, quality of care, or adherence. Results Among 333 patients who answered knowledge questions before treatment initiation, 325 (97.6%) were re-assessed at a post-initiation visit. Pre-initiation, 72.1% knew hepatitis C was curable, 61.9% knew that hepatitis C could cause liver damage or cancer, and 42.3% knew that people with hepatitis C could look and feel fine. The average number of correct responses was 8.1 out of 15 (95% CI: 7.8–8.5), but was significantly lower among those with low educational attainment or with low literacy. Post-initiation, correct responses increased by an average of 2.0 statements (95% CI: 1.6, 2.4, p-value <0.001). Many patients still mistakenly believed that hepatitis C could be transmitted through kissing (66.5%), eating utensils (44.1%), handshakes (34.8%), and hugs (34.8%). Post-initiation knowledge is inversely associated with self-reported quality of care and unassociated with self-reported adherence. Conclusion Although knowledge improved over time, key gaps persisted among patients. Accessible public education campaigns targeted to low-literacy populations emphasizing that hepatitis C can be asymptomatic, has severe consequences, and is curable could promote participation in mass screening campaigns and linkage to care. Visual tools could facilitate clinician-provided patient education.http://dx.doi.org/10.1080/16549716.2021.1953250hepatitis crwandahealth knowledgeattitudespracticedirect acting antiviralstreatment initiation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dale A Barnhart Innocent Kamali Francoise Nyirahabihirwe Carol Mugabo Jean de la Paix Gakuru Mariam Uwase Esdras Nizeyumuremyi Tumusime Musafiri Jean de Dieu Gatete Jean Damascene Makuza Fredrick Kateera Bethany Hedt-Gauthier Jean d’Amour Ndahimana |
spellingShingle |
Dale A Barnhart Innocent Kamali Francoise Nyirahabihirwe Carol Mugabo Jean de la Paix Gakuru Mariam Uwase Esdras Nizeyumuremyi Tumusime Musafiri Jean de Dieu Gatete Jean Damascene Makuza Fredrick Kateera Bethany Hedt-Gauthier Jean d’Amour Ndahimana Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study Global Health Action hepatitis c rwanda health knowledge attitudes practice direct acting antivirals treatment initiation |
author_facet |
Dale A Barnhart Innocent Kamali Francoise Nyirahabihirwe Carol Mugabo Jean de la Paix Gakuru Mariam Uwase Esdras Nizeyumuremyi Tumusime Musafiri Jean de Dieu Gatete Jean Damascene Makuza Fredrick Kateera Bethany Hedt-Gauthier Jean d’Amour Ndahimana |
author_sort |
Dale A Barnhart |
title |
Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study |
title_short |
Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study |
title_full |
Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study |
title_fullStr |
Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study |
title_full_unstemmed |
Knowledge among patients with Hepatitis C initiating on direct-acting antiviral treatment in rural Rwanda: A prospective cohort study |
title_sort |
knowledge among patients with hepatitis c initiating on direct-acting antiviral treatment in rural rwanda: a prospective cohort study |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9880 |
publishDate |
2021-01-01 |
description |
Background Curative direct-acting antiviral treatment (DAA) has made it plausible to implement hepatitis C elimination interventions. However, poor hepatitis C knowledge among patients could impede the effectiveness of screening and treatment programs. Objective We assessed knowledge on hepatitis C among rural Rwandans initiating DAA treatment for hepatitis C in a prospective cohort. Methods We administered 15 true-false statements before treatment initiation and during one follow-up visit occurring either 1 or 2 months after treatment initiation. We assessed the average number of correct responses per patient, the proportion of correct responses to individual statements, pre-treatment predictors of knowledge, and whether post-initiation knowledge was associated with time since treatment initiation, quality of care, or adherence. Results Among 333 patients who answered knowledge questions before treatment initiation, 325 (97.6%) were re-assessed at a post-initiation visit. Pre-initiation, 72.1% knew hepatitis C was curable, 61.9% knew that hepatitis C could cause liver damage or cancer, and 42.3% knew that people with hepatitis C could look and feel fine. The average number of correct responses was 8.1 out of 15 (95% CI: 7.8–8.5), but was significantly lower among those with low educational attainment or with low literacy. Post-initiation, correct responses increased by an average of 2.0 statements (95% CI: 1.6, 2.4, p-value <0.001). Many patients still mistakenly believed that hepatitis C could be transmitted through kissing (66.5%), eating utensils (44.1%), handshakes (34.8%), and hugs (34.8%). Post-initiation knowledge is inversely associated with self-reported quality of care and unassociated with self-reported adherence. Conclusion Although knowledge improved over time, key gaps persisted among patients. Accessible public education campaigns targeted to low-literacy populations emphasizing that hepatitis C can be asymptomatic, has severe consequences, and is curable could promote participation in mass screening campaigns and linkage to care. Visual tools could facilitate clinician-provided patient education. |
topic |
hepatitis c rwanda health knowledge attitudes practice direct acting antivirals treatment initiation |
url |
http://dx.doi.org/10.1080/16549716.2021.1953250 |
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