Journal des maladies infectieuses et de la médecine

Hepatitis B Prevention and Care Pathway in Kuwait: Assessing the Current Situation, Identifying Gaps and Recommending Actions

Abstract

Fuad Hasan, Ali Bahbahani, Haifa Askar, Eid Mansour, Snehanshu Snehanshu, Nathalie Bassil, Sam Kozma and Saqr Al Suraya

Introduction: Hepatitis B virus (HBV) infection remains a worldwide public health problem. The last major review of the epidemiology and management of HBV in the Middle East was published in 2011. This paper aims to assess the current situation of the HBV care pathway in Kuwait, identify gaps and barriers therein and recommend initiatives to improve patient management.
Materials and Methods: A literature search was conducted in PubMed as well as free internet searches. To provide context to the results and to collect information on areas for which limited evidence was found, interviews and group discussions were held with HBV experts.
Results: There is limited evidence on the national prevalence of HBV; however, prevalence is expected to be higher in those >30 years of age born before the introduction of the HBV vaccination program. There is also limited data on the burden of HBV-related hepatocellular carcinoma in the country. Public and health-care provider awareness of various aspects of the disease is perceived to be low. There are several mandated national screening structures; however, there are no country-specific HBV guidelines regarding diagnosis, linkage-to-care, treatment
and follow-up.
Conclusion: Although significant improvements have been made in the past 30 years in Kuwait in terms of a decline in prevalence, both the burden due to HBV complications and the coverage of screening and treatment remain unclear. Efforts must be made in all areas of the HBV care pathway to improve morbidity and reduce mortality in Kuwait, and the interventions should be supported by research evidence.