Implementation of a unique hepatitis C care continuum model in Rwanda

Area of Science:

• Hepatology and Infectious Diseases
• Global Health Equity
• Task-Shifting in Healthcare

Background:

• Direct-acting antivirals have revolutionized hepatitis C virus (HCV) treatment, but specialist restrictions limit access, especially in resource-limited settings (RLS).
• The ASCEND study demonstrated task-shifting's success in expanding HCV treatment by overcoming provider shortages.
• International application of the ASCEND model in RLS remains underexplored.

Purpose of the Study:

• To translate and implement the ASCEND task-shifting model in Kigali, Rwanda.
• To train general medicine providers in HCV management.
• To ascertain HCV prevalence and identify co-infections.

Main Methods:

• A validated ASCEND model was adapted for an international clinical program in Rwanda.
• General medicine providers received didactic training on HCV management.
• Patient data was collected during the follow-up period.

Main Results:

• The training program significantly improved HCV management knowledge among 11 new providers.
• HCV screening reached 26% of patients during follow-up, with an estimated prevalence of 2%.
• Hepatitis B co-infection was identified in 30% of patients with HCV.

Conclusions:

• The ASCEND paradigm is successfully implementable in RLS to scale up HCV care.
• This approach fosters self-sustaining education for healthcare providers.
• Implementation increases public awareness and access to vital HCV treatment.