Hepatitis B knowledge among key stakeholders in Haimen City, China: Implications for addressing chronic HBV infection

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Abstract

Background

This article describes hepatitis B-related knowledge, attitudes and practices after completion of the Gateway to Care campaign, a citywide public health education program that targeted city residents, health care providers and individuals chronically infected with hepatitis B virus in Haimen City, China.

Methods

Pre/post questionnaires assessed hepatitis B knowledge change among health care providers and post-campaign surveys evaluated hepatitis B knowledge, attitudes and behaviors (including stigma-related beliefs and practices) among health care providers, city residents and chronically infected individuals. Focus groups were conducted to gain a more in-depth understanding of the needs of the target communities, and to identify future intervention strategies to improve hepatitis B testing and linkage to care and treatment.

Results

Results indicate high levels of hepatitis B knowledge among multiple stakeholders in Haimen City, with significant knowledge improvement among health care providers. Stigma-related beliefs and myths regarding separation of infected individuals from certain aspects of family life were common among all stakeholder groups, despite high levels of accurate knowledge about hepatitis B transmission and prevention. Self-report of hepatitis B screening was low among city residents, as was awareness of hepatitis B treatment.

Conclusions

More efforts are needed to improve awareness of HBV treatment, decrease HBV-related stigma, improve screening rates, and reduce cost of antiviral treatment. Future interventions in Haimen City should be driven by behavioral change theory, to not only improve knowledge, but to improve screening behaviors and address hepatitis B-related stigma and discrimination.

Electronic supplementary material

The online version of this article (doi:10.1186/s41124-016-0004-x) contains supplementary material, which is available to authorized users.

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Most cited references 19

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Major causes of death among men and women in China.

Jiang He, Dongfeng Gu, Xigui Wu … (2005)

With China's rapid economic development, the disease burden may have changed in the country. We studied the major causes of death and modifiable risk factors in a nationally representative cohort of 169,871 men and women 40 years of age and older in China. Baseline data on the participants' demographic characteristics, medical history, lifestyle-related risk factors, blood pressure, and body weight were obtained in 1991 with the use of a standard protocol. The follow-up evaluation was conducted in 1999 and 2000, with a follow-up rate of 93.4 percent. We documented 20,033 deaths in 1,239,191 person-years of follow-up. The mortality from all causes was 1480.1 per 100,000 person-years among men and 1190.2 per 100,000 person-years among women. The five leading causes of death were malignant neoplasms (mortality, 374.1 per 100,000 person-years), diseases of the heart (319.1), cerebrovascular disease (310.5), accidents (54.0), and infectious diseases (50.5) among men and diseases of the heart (268.5), cerebrovascular disease (242.3), malignant neoplasms (214.1), pneumonia and influenza (45.9), and infectious diseases (35.3) among women. The multivariate-adjusted relative risk of death and the population attributable risk for preventable risk factors were as follows: hypertension, 1.48 (95 percent confidence interval, 1.44 to 1.53) and 11.7 percent, respectively; cigarette smoking, 1.23 (95 percent confidence interval, 1.18 to 1.27) and 7.9 percent; physical inactivity, 1.20 (95 percent confidence interval, 1.16 to 1.24) and 6.8 percent; and underweight (body-mass index [the weight in kilograms divided by the square of the height in meters] below 18.5), 1.47 (95 percent confidence interval, 1.42 to 1.53) and 5.2 percent. Vascular disease and cancer have become the leading causes of death among Chinese adults. Our findings suggest that control of hypertension, smoking cessation, increased physical activity, and improved nutrition should be important strategies for reducing the burden of premature death among adults in China. Copyright 2005 Massachusetts Medical Society.

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To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants. National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA. The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age <15 years compared to that found in the 1992 national serosurvey, and among children age <5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other). China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk.

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Chronic hepatitis B.

, Steven McMahon, Christianne A R Lok (2001)

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Author and article information

Contributors

Chari Cohen: chari.cohen@hepb.org

Journal

Journal ID (nlm-ta): Hepatol Med Policy

Journal ID (iso-abbrev): Hepatol Med Policy

Title: Hepatology, Medicine and Policy

Publisher: BioMed Central (London )

ISSN (Electronic): 2059-5166

Publication date (Electronic): 14 April 2016

Publication date PMC-release: 14 April 2016

Publication date Collection: 2016

Volume: 1

Electronic Location Identifier: 4

Affiliations

[1 ]GRID grid.420690.9, ISNI 0000000404515933, Hepatitis B Foundation, ; Doylestown, PA USA

[2 ]GRID grid.166341.7, ISNI 0000000121813113, Drexel University School of Public Health, ; Philadelphia, PA USA

[3 ]Haimen City Center for Disease Control and Prevention, Haimen City, China

[4 ]GRID grid.412530.1, ISNI 0000000404566466, Fox Chase Cancer Center, ; Philadelphia, PA USA

Article

Publisher ID: 4

DOI: 10.1186/s41124-016-0004-x

PMC ID: 5898514

PubMed ID: 30288308

SO-VID: b2bbd2ea-f4bc-49dd-9d0f-9e21438167d5

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 16 December 2015

Date accepted : 16 March 2016

Funding

Funded by: BMS Foundation

Custom metadata

Keywords: chronic hepatitis b infection,hepatitis b knowledge and behaviors,hepatocellular carcinoma,gateway to care campaign,haimen city,china

Data availability:

Keywords: chronic hepatitis b infection, hepatitis b knowledge and behaviors, hepatocellular carcinoma, gateway to care campaign, haimen city, china

Hepatitis B knowledge among key stakeholders in Haimen City, China: Implications for addressing chronic HBV infection

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Abstract

Background

Methods

Results

Conclusions

Electronic supplementary material

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Karger: Oncology

Most cited references 19

Major causes of death among men and women in China.

Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination.

Chronic hepatitis B.

Author and article information

Contributors

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Affiliations

Article

History

Funding

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