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Type of submission: Oral
Conference track: Practice
Topics: Harm Reduction Services and Service Provision; Viral Hepatitis and Tuberculosis
Presenting author: Jiten Singh Asem
Jiten Singh Asem, Peter Selestino
Issue: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are most commonly transmitted by sharing contaminated injecting equipment among people who inject drugs (PWID). It can cause chronic infection, resulting in cirrhosis of the liver, liver cancer, liver failure, and death. HBV is one of the key component of nine interventions of comprehensive harm reduction package for PWID endorsed by WHO. Although the HBV vaccine is inexpensive, safe and effective, vaccination rates among PWID remains poor in Tanzania due to unavailability of free vaccination, lack of awareness and chaotic lives of PWID.
Setting: National AIDS Control Programme estimate 30,000 PWID in Tanzania. According to some independent studies (ref in footnote? Or directly quote the author) the prevalence of HCV among PWID is reported 35%. Reliable data for HBV prevalence among PWID is unavailable. However, programme data of methadone clinics found HBV prevalence among its attendees as ~ 29.1% (N=1028).
Project: Médecins du Monde implements peer led comprehensive harm reduction programme in Dar E Salaam. The programme sought to improve HBV vaccination among PWID through four steps.
- Trained peer educators provide education on viral hepatitis including importance and benefit of HBV vaccination.
- Outreach team identified PWID who needs vaccination and categorize the priority groups.
- Vaccination was provided at hot-spots at time convenient to the PWID.
- Rapid or accelerated schedule i.e. at 1, 7, and 21 days recommended by WHO for PWID was employed.
These effort improves the knowledge about viral hepatitis and enable PWID to get vaccination in their own setting, which helped increase uptake of HBV vaccination.
Outcome: During April to September 2016, 469 PWID were vaccinated and out of this 301 completed all the doses an increase from baseline of 26. This strategy can be adapted elsewhere to increase HBV vaccination among PWID.