Assessment of facility performance during mass treatment of chronic hepatitis C in Egypt: Enablers and obstacles

Hend Ibrahim Shousha; Mohamed Said; Wafaa ElAkel; Arwa ElShafei; Gamal Esmat; Emam Waked; Manal Hamdy Elsayed; Wahid Doss; Maysa Elrazky; Mai Mehrez; Mohamed Hassany; Dina Zeyada; Mahmoud Anis; Magdy Alserafy

doi:10.1016/j.jiph.2020.05.008

Assessment of facility performance during mass treatment of chronic hepatitis C in Egypt: Enablers and obstacles

J Infect Public Health. 2020 Sep;13(9):1322-1329. doi: 10.1016/j.jiph.2020.05.008. Epub 2020 May 27.

Authors

Affiliations

¹ Endemic Medicine and Hepato-Gastroenterology Department, Cairo University, Cairo, Egypt. Electronic address: hendshousha@yahoo.com.
² Endemic Medicine and Hepato-Gastroenterology Department, Cairo University, Cairo, Egypt; National Committee for Control of Viral Hepatitis, MOH, Cairo, Egypt.
³ Public Health and Community Medicine Department, Cairo University, Cairo, Egypt.
⁴ National Liver Institute, Menofia University, Menofia, Egypt; National Committee for Control of Viral Hepatitis, MOH, Cairo, Egypt.
⁵ Pediatric Department, Ain Shams University, Cairo, Egypt; National Committee for Control of Viral Hepatitis, MOH, Cairo, Egypt.
⁶ Endemic Medicine and Hepato-Gastroenterology Department, Cairo University, Cairo, Egypt.
⁷ National Tropical Medicine& Hepatology Institute, Cairo, Egypt.
⁸ National Tropical Medicine& Hepatology Institute, Cairo, Egypt; National Committee for Control of Viral Hepatitis, MOH, Cairo, Egypt.
⁹ Tanta University, Tanta, Egypt.

PMID: 32473817
DOI: 10.1016/j.jiph.2020.05.008

Abstract

Background: The national committee for control of viral hepatitis (NCCVH) in Egypt, settled by the Ministry of health, treated over one million patients in around 60 centers with chronological changes in drug combinations. This research aims to study the health care facilities and services provided by NCCVH treatment centers in Egypt and explore hinders faced.

Methods: A cross-sectional operational research study. Multistage random sampling technique was applied for Egyptian governorates. From each stratum one governorate was chosen from which one center was randomly selected. Quality of recorded data for each center in the central server (Data-oriented parameter), newly designed score to assess the overall performance of the centers was retrieved from computer based recording system. A self-administered questionnaire was completed by the centers head.

Results: This study included 24 treatment centers from urban, rural areas, Upper and Lower Egypt. The Upper centers showed the best completeness of follow-up records and the least compliance rates. None of the centers had 100% completeness of follow-up data. Proportion of SVR is minimally less than proportion of patient with known outcome in all treatment centers. A novel indicator standardizing the comparisons of performance of different facilities was introduced: Total number of physicians/total number of SVR patients with completed records. The highest response rate: Monfiya Governorate (Lower Egypt), Aswan (Upper Egypt), Completeness of follow-up records: Kalyoubia (Lower Egypt), Sohag governorate (Upper Egypt). The average administrative score was 64%.

Conclusion: Challenges of NCCVH program: overcrowdings, resistant sociocultural background among rural patients, limited accessibility for internal migrants and incompleteness of data entry are system lacking points. Strengths include, clear patient pathway, well-established database online application, well-trained physicians and treatment availability.

Keywords: Control of viral hepatitis; Facility performance; Hepatitis C virus; Treatment.

MeSH terms

Cross-Sectional Studies
Egypt
Health Facilities / standards*
Health Facilities / statistics & numerical data
Hepacivirus
Hepatitis C, Chronic / prevention & control
Hepatitis C, Chronic / therapy*
Humans
Outcome Assessment, Health Care / methods
Quality Assurance, Health Care / methods
Surveys and Questionnaires