A programme to treat chronic hepatitis B in Kiribati: progress and challenges

Area of Science:

• Hepatology
• Public Health
• Infectious Diseases

Background:

• Chronic hepatitis B (CHB) affects over 290 million globally, with high prevalence in Pacific islands.
• Kiribati faces unique challenges including geographic isolation, low immunization rates, and co-infections impacting CHB treatment effectiveness.
• Limited infrastructure hinders effective training, communication, and laboratory services for CHB management.

Purpose of the Study:

• To establish the first national CHB treatment program in the Pacific islands, tailored to Kiribati's specific needs.
• To improve access to direct patient care, diagnostics, and public education for CHB.

Main Methods:

• Implementation of a CHB treatment program aligned with WHO guidelines and local requirements.
• Comprehensive services including patient care, laboratory support, public education, and medical training.
• Screening of thousands, molecular testing for 845 positive patients, and initiation of treatment for 79 patients.

Main Results:

• Development of patient education materials, training programs, and treatment protocols.
• Establishment of regular expert consultations and onsite visits to support the program.
• Successful initiation of a national CHB treatment program in a challenging, remote setting.

Conclusions:

• This program represents a significant step in addressing CHB in the Pacific islands.
• Key success factors include local partnerships, understanding barriers, flexibility, and international support.
• The model provides valuable insights for establishing similar programs in resource-limited, geographically dispersed regions.