Values and preferences for hepatitis C self-testing among the general population and healthcare workers in Rwanda

Janvier Serumondo,Guillermo Z Martínez-Pérez,Prosper Karame,Sonjelle Shilton,Ladislas Nshimiyimana,Donatha Dushimiyimana,Emmanuel Fajardo,Eric Remera,Gallican N Rwibasira

doi:10.1186/s12879-021-06773-6

Janvier Serumondo, Guillermo Z Martínez-Pérez + Show 7 more

Open Access

https://doi.org/10.1186/s12879-021-06773-6

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Abstract

BackgroundIn 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030. To improve awareness of HCV status, strategies are needed to ensure easy access to HCV testing by as-yet unreached populations. HCV-self-testing, an innovative strategy, could further increase HCV testing uptake. This assessment explores perceptions around HCV self-testing among members of the public and healthcare workers in Rwanda.MethodsA qualitative study was undertaken in Masaka District Hospital, comprising individual interviews, group interviews and participatory action research (PAR) activities. Purposive and snowball sampling methods guided the selection of informants. Informed consent was obtained from all participants. A thematic analysis approach was used to analyse the findings.ResultsThe participants comprised 36 members of the public and 36 healthcare workers. Informants appreciated HCV self-testing as an innovative means of increasing access to HCV testing, as well as an opportunity to test privately and subsequently autonomously decide whether to seek further HCV care. Informants further highlighted the need to make HCV self-testing services free of charge at the nearest health facility. Disadvantages identified included the lack of pre/post-test counselling, as well as the potential psychosocial harm which may result from the use of HCV self-testing.ConclusionHCV self-testing is perceived to be an acceptable method to increase HCV testing in Rwanda. Further research is needed to assess the impact of HCV self-testing on HCV cascade of care outcomes.

Highlights

In 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030
The findings of this research will help inform the future implementation of HCV self-testing in Rwanda and neighbouring settings with similar socio-cultural characteristics and a high burden of HCV
Public perceptions around HCV and HCV testing Most of the members of the public described HCV as a liver disease that manifested as a distended abdomen

Summary

Introduction

In 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030. HCV-self-testing, an innovative strategy, could further increase HCV testing uptake. Hepatitis C virus (HCV) infection results in more than 290,000 deaths a year, with an estimated 58 million people living with chronic hepatitis C; just 21% of these cases are diagnosed. In December 2018, the Rwandan government launched a 5-year HCV elimination plan that aimed to screen > 4 million individuals and treat all confirmed cases [5]. The plan involved a phased approach, first targeting high-risk groups, followed by mass screening campaigns using RDTs at the community and health facility level to promote the uptake of HCV testing. To enable last-mile service delivery for elimination, innovative testing approaches, such as HCV self-testing, may be needed

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