Observational studyBMC health services research2025
Decentralization of hepatitis B care in sub-Saharan Africa: study protocol for a prospective cohort assessing three models of care in rural Ethiopia.
Observational study in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06586983 (Decentralization of Hepatitis B Care in Sub-Saharan Africa), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Decentralization of Hepatitis B Care in Sub-Saharan Africa: a Pilot Program in Ethiopia
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0 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproving treatment uptake among people with chronic hepatitis B (CHB) infection who live outside urban centres is crucial to achieving the World Health Organization (WHO) elimination targets. Furthermore, as the number of deaths due to hepatitis B in Africa is rising, there is a need for new models of decentralized care adapted to the local context. The main aim of this study is to compare three different models of decentralized care for CHB treatment in Ethiopia, both from a clinical perspective and an implementation perspective.
methodsThis will be prospective cohort study comparing three models of decentralized care for the management of CHB in Ethiopia. The first model (“standard model”) utilizes the current WHO guidelines for CHB management. The second model (“simplified model”) offers treatment to all individuals with CHB except those with a completely normal baseline assessment, and the third model (“test-and-treat model”) provides treatment to all individuals with CHB. The study will enroll 4,500 individuals with CHB over a one-year period across six study sites in Ethiopia. All patients will be followed up for 3 years, and the primary outcome is death or liver failure. The three models will be compared using a Cox proportional hazards regression model adjusting for potential confounders. Additionally, we will design adequate implementation strategies to address barriers and facilitators to implementation. We will design, implement and evaluate a policy toolbox that will ensure local adoption and implementation, using a co-creation approach, bringing together policymakers, politicians, healthcare personnel and patients, to come up with adequate policy implementation strategies for their contexts. DISCUSSION: From a public health perspective, identifying a simple, feasible and effective model of decentralized CHB care would be a key step to reduce liver-related mortality on the African continent. This study may have important policy implications and is expected to inform national and international hepatitis B elimination efforts in low- and middle income countries (LMICs).
trial registrationClinicalTrials.gov, NCT06586983. Registered on September 4, 2024.
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