Difficulties Associated with the Management of Viral Hepatitis B in a Country with Limited Resources: The Case of Togo

Abstract

Introduction : Hepatitis B remains an important public health issue, which management faces several difficulties in countries with limited resources. The aim of this study was to describe the problems encountered by chronic hepatitis B carriers at the University Hospital Center of Kara (CHU). Methods : This was a descriptive cross-sectional study conducted over a period of three years at the Kara University Hospital Center. All chronic hepatitis B virus (HBV) carriers aged over 18 years who had given their consent were included. Results : A total of 652 cases of HBV out of 2014 consultations were recorded, equivalent to 32% frequency. Patients were predominantly male, with a sex ratio of 1.4. The average age was 30 ± 13 years. One third of patients had no monthly source of income. Thirty-two percent of patients had health insurance. Ninety-seven percent of patients considered the cost of the initial pre-therapeutic HBV test to be too expensive, 17% had never been able to undergo the test due to lack of funds, and 35% had undergone it after a minimum delay of 3 months. Around 40% of eligible patients for treatment with nucleotide analogues had started this treatment. There was also a shortage of liver specialists, with only two for the whole Northern Togo. Conclusion : In our context, the difficulties in treating hepatitis B are financial and, above all, there is a shortage of qualified human resources, requiring state subsidies in order to reduce mortality linked to HBV complications.