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Table 1 Characteristics of 22 viral hepatitis testing programmes

From: Survey of programmatic experiences and challenges in delivery of hepatitis B and C testing in low- and middle-income countries

Programme characteristics Total, n = 22 (%)
Geographic location of testing programmes
 Africa 9 (40.9)
 Europe 3 (13.6)
 South-East Asia 4 (18.2)
 Western Pacific 6 (27.3)
Income categories of countries where programmes conducted a n = 19 countries
 Low-income 7/19 (36.8)
 Lower-middle income 8/19 (42.1)
 Upper-middle 3/19 (15.8)
 High-income 1/19 (5.3)
Programme coverage
 National 7 (31.8)
 Regional 3 (13.6)
 Local 12 (54.5)
Number of testing sites
 More than five 7 (31.8)
 Two to five 6 (27.3)
 One 8 (36.4)
 Not indicated 1 (4.5)
Type of organisation leading programme
 Non-governmental or international organization 10 (45.5)
 Government 3 (13.6)
 Hospital 6 (27.3)
 Research institution 3 (13.6)
Duration of programme
 ≥ 5 years 9 (40.9)
 2 to 4 years 4 (18.2)
 ≤ 1 year 4 (18.2)
 No response 5 (22.7)
Target population and location of testing
 Target population for testing
  Specific target populations only 11 (50)
  General populationb only 2 (9.1)
  General and specific target populations 9 (40.9)
 Details of specific target population (multiple options possible)
  HIV positive 11 (50)
  PWID 10 (45.5)
  Clinical suspicion of hepatitis (Abnormal liver function tests or symptoms/signs) 6 (27.3)
  Sex worker 6 (27.3)
  Pregnant women 6 (27.3)
  Health care worker 6 (27.3)
  Prisoner 4 (18.2)
  Family of HBV/HCV/HIV positive 3 (13.6)
  Children of positive mothers 3 (13.6)
  MSM 3 (13.6)
  Otherc 5 (22.7)
Testing setting (multiple options possible)
  Hospital-based 12 (54.5)
  HIV clinic 10 (45.5)
  Harm reduction service 6 (27.3)
  Primary health care facility 4 (18.2)
  Outreach programme 4 (18.2)
  Antenatal clinic 4 (18.2)
  Private sector 2 (9.1)
  Community 1 (4.5)
  Otherd 4 (18.2)
Approaches to testing
 Who initiates testing? (multiple options possible)
  Provider 19 (86.4)
  Client 8 (36.4)
  Not indicated 2 (9.1)
 Who delivers testing? (multiple options possible)
  Physician 11 (50)
  Laboratory technician 5 (22.7)
  Counsellor 5 (22.7)
  Nurse 4 (18.2)
  Other health care worker 4 (18.2)
  Othere 3 (13.6)
 Testing approach for HCV (20 programmes)f
  RDT standalone 12 (60, n = 20)
  EIA standalone 4 (20, n = 20)
  RDT/EIA + NAT 2 (30, n = 20)
  NAT standalone 1 (5, n = 20)
  Not indicated 1 (5, n = 20)
 Testing approach for HBV (22 programmes)g
  RDT standalone 11 (50)
  EIA standalone 6 (27.3)
  RDT/EIA + NAT 4 (18.2)
  Not indicated 1 (4.5)
 Integrated testing (multiple options possible)
  With HIV 8 (36.4)
  With HIV/HBV/HCV/Syphilis 6 (27.3)
  With HBV/HCV 4 (18.2)
  With HIV/HBV/HCV/TB 1 (4.5)
  No integrated testing 5 (22.7)
 Liver staging in those with positive test
  Not routinely done 6 (27.3)
  Yesh 16 (72.7)
 Counseling
  Pre−/post- counseling 15 (68.2)
  No counseling/or unknown 7 (31.8)
Access to treatment and funding
 Treatment availability
  HBVi 18 (81.8)
  HCV 14 (70, n = 20)
  No treatment for either HBV and HCV 2 (10, n = 20)
 Funding source for HCV testing (multiple options possible, 20 programmes)
  Support from NGO/IO/Government/Other donor 15 (75)
  Patient self-payment 7 (35)
  Private insurance 4 (20)
 Funding source for HBV testing (multiple options possible, 22 programmes)
  Support from NGO/IO/Government/Other donor 19 (86.4)
  Patient self-payment 8 (36.4)
  Private insurance 4 (18.2)
 Financial support for treatment
  For HBV 6 (27.3)
  For HCV 7 (35, n = 20)
  1. PWID people who inject drug, MSM men who have sex with men, RDT rapid diagnosed testing, EIA enzyme immunoassay, NAT nucleic acid testing, HIV human immunodeficiency virus, HBV hepatitis B virus, HCV hepatitis C virus, TB tuberculosis
  2. aBased on the World Bank classification in 2015 [57]; bGeneral population included general population and blood donor; cOther included non-injecting drug users, migrants, military and TB positive persons; dOther included two prisons, one HIV/TB clinic and one sexually transmitted infection clinic; eOther included self-testing; fRDT/EIA + NAT (n = 3) as an optional approach; gRDT/EIA + NAT (n = 2) as an optional approach to evaluate the treatment eligibility. One programme offered RDT standalone for blood donor screening; hFibroscan available (n = 9) and APRI score (n = 7); iHBV treatment only available for HBV-HIV co-infected persons and not for HBV mono-infected persons (n = 9)