HIV and Hepatitis B virus co-infection in Mozambique: Policy review and Health Professionals knowledge and practices

Abstract

Background Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) co-infection is a public health problem affecting 2.7 million worldwide. In Mozambique, the prevalence of this co-infection is 9,1%, calling for specific policies on prevention, diagnosis and adequate management in health facilities caring for HIV patients. This study aimed to review the existing policies and to assess the knowledge and practices of health professionals about HIV/HBV co-infection. Methods A document and literature review to describe the existing policies and guidelines on HIV/HBV co-infection in Mozambique was performed. Key informants were contacted to clarify or add information. Health professionals who care for HIV-positive patients in four health centers in Maputo City, the capital of Mozambique responded to a questionnaire on knowledge and practices about this co-infection. Qualitative analysis was done to identify main themes using content analysis. Descriptive statistics of sociodemographic, knowledge, practices variables was presented using the SPSS Program version 20 and bivariate analysis was applied to describe the association between variables. Results Twenty-one policy documents were found and five key informants were interviewed. Fifty-two participants answered the questionnaire. Only one policy document explicitly referred to HIV/HBV co-infection treatment. Most health professionals (96%) were aware of HIV/HBV co-infection. Although the only existing policy is on the treatment, few (33%) referenced antiretrovirals formulations containing Tenofovir and Lamivudine. Only 29% of health professionals reported screening HIV patients for HBV and 21% practiced HIV/HBV co-infection counseling. No statistically significant differences were found when relating the sociodemographic variables with knowledge and practices. Conclusion Policy documents relating to prevention, diagnosis and clinical management of HIV/HBV co-infection were rare or absent. Health professionals had little knowledge about HIV/HBV co-infection. Defining adequate policies and training of health professionals may help increase awareness, increase counselling of patients for disease prevention, diagnosis and proper management of HIV/HBV co-infected patients.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was funded by a grant from the Swedish International Development Cooperation Agency, Sida to the Eduardo Mondlane University for a research-training program.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Institutional Bioethics Committee for Health of the Faculty of Medicine/Maputo Central Hospital (CIBS FM & HCM/068/2018) and the Scientific Council of the Faculty of Medicine at Eduardo Mondlane University approved the study protocol.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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