Construction and Evaluation of the <i>E-clinic</i> Service System in Baoan District, Shenzhen, China

Wei Wang; Weiping Tang; Yali Luo; Naling Zhu; Liling Wang

doi:doi:10.11648/j.ajns.20200904.29

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Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China

Wei Wang, Weiping Tang, Yali Luo, Naling Zhu, Liling Wang

Published in American Journal of Nursing Science (Volume 9, Issue 4)

Received: 14 June 2020 Accepted: 3 July 2020 Published: 23 July 2020

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Abstract

Objective To construct the regional elimination of mother-to-child transmission (EMTCT) clinic (E-clinic) service system and evaluate its effect. Methods Since November 2018, the E-clinic service system has been established in the obstetric clinic of 18 maternal and child health (MCH) providers in Baoan District, Shenzhen, China, forming a regional service system. In E-clinics obstetricians take care of pregnant women with hepatitis B virus (HBV) infection for complete perinatal services and infectious disease management. Before and after the implementation of the E-clinic service system, the changes of HBV screening rate among pregnant women, HBV infected mothers DNA detection rate, mothers with high viral load (> 2 × 10⁶ IU/mL) antiviral therapy (ART) rate and HBV MTCT rate were analyzed. Results From July 2018 to March 2020, there were 162,036 registered pregnant women and 7,358 HBV infected mothers in Baoan District, Shenzhen, including 1,179 mothers with high viral load. The HBV screening rate among pregnant women, HBV infected mothers follow up rate, HBV infected mothers DNA detection rate and ART rate were 97.6% (124,311/127,379), 99.0% (5,742/5,801), 82.8% (4,805/5,801) and 70% (687/982) respectively, which were higher than 95.9% (33,247/34,657), 93.1% (1,449/1,557), 49.3% (767/ 1,557) and 21.3% (42/197) before the implementation of the E-clinic service system. The differences were statistically significant (P < 0.001). The HBV MTCT rate decreased from 0.35% (12/3471) to 0% (0/317) after the implementation of the E-clinic service system, and the difference was no statistically significant (P>0.05). Conclusions The E-clinic service system of Baoan District in Shenzhen integrates antenatal care (ANC) and ART, improves the management of HBV infection during pregnancy, further reduces the HBV MTCT, and provides experience for other regions to manage infectious diseases during pregnancy.

Published in	American Journal of Nursing Science (Volume 9, Issue 4)
DOI	10.11648/j.ajns.20200904.29
Page(s)	276-280
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Hepatitis B., Mother-to-Child Transmission, Antiviral Therapy, E-clinic

References

[1]	ZOU H., CHEN Y., DUAN Z., ZHANG H., PAN C. Virologic factors associated with failure to passive-active immunoprophylaxis in infants born to HBsAg-positive mothers. J. VIRAL HEPATITIS. 2012; 19: e18-25.
[2]	LIANG X., BI S., YANG W., et al. Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B. vaccination. VACCINE. 2009; 27: 6550-57.
[3]	WANG FS, FAN JG, ZHANG Z., GAO B., WANG HY. The global burden of liver disease: the major impact of China. HEPATOLOGY. 2014; 60: 2099-108.
[4]	Department of maternal and child health services, national health and Family Planning Commission, Center for Maternal and Child Health, CDC. Interpretation of the Implementation Plan for the Prevention of Mother-to-child Transmission of HIV, Syphilis and HBV (2015 edition) Chinese Journal of Women and Children Health. (Zhonghua Fu You Wei Sheng Za Zhi) 2015; 6 (6): 1-2. (in Chinese).
[5]	TERRAULT NA, LOK A., MCMAHON BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. HEPATOLOGY. 2018; 67: 1560-99.
[6]	SARIN SK, KUMAR M., LAU GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B.: a 2015 update. HEPATOL INT. 2016; 10: 1-98.
[7]	EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J HEPATOL. 2017; 67: 370-98.
[8]	HOU J., CUI F, DING Y., et al. Management Algorithm for Interrupting Mother-to-Child Transmission of Hepatitis B. Virus. CLIN GASTROENTEROL H. 2019; 17: 1929-36.
[9]	YINGREN Z., GUIQIANG W., WENHONG Z., DISEASES CSOI. Chinese Guidelines for prevention and Treatment of Mother-to-child Transmission of hepatitis B. Virus (2019 edition).
[10]	Chin J. Infect Dis (Zhonghua Chuan Ran Bing Za Zhi) 2019; 7 (37): 388-396. (in Chinese).
[11]	TAOYANG C., YAN J., YU Z., et al. Mutations in hepatitis B. virus genome involved inimmunoprophylaxis failure against vertical transmission. Chin J. Microbiol Immunol. (Zhonghua Wei Sheng Wu He Mian Yi Xue Za Zhi) 2009; 6 (29): 538-543. (in Chinese).
[12]	OZARAS R., INANC BI, YEMISEN M., TABAK F. Epidemiology of HBV subgenotypes D. Clin Res Hepatol Gastroenterol. 2015; 39: 28-37.
[13]	WANG A., QIAO Y., DOU L. Challenges of eliminating mother-to-child transmission of HIV, syphilis and hepatitis B in China: a cross-sectional survey. Lancet. 2018; 392.
[14]	HAN GR, CAO MK, ZHAO W., et al. A. prospective sand open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. J. HEPATOL. 2011; 55: 1215-21.
[15]	ZHANG H., PAN CQ, PANG Q., TIAN R., YAN M., LIU X. Telbivudine or lamivudine use in late pregnancy safely reduces perinatal transmission of hepatitis B virus in real-life practice. HEPATOLOGY. 2014.
[16]	XUERU Y., ZHIHUA L., ZHIHONG L., et al. Getting to zero mother-to-child transmission of hepatitis B. virus: dream and challenge. Chin J. Hepatol (Zhonghua Gan Zang Bing Za Zhi) 2018; (4): 262-265. (in Chinese).
[17]	Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. Geneva: World Health Organization, 2015.

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APA Style

Wei Wang, Weiping Tang, Yali Luo, Naling Zhu, Liling Wang. (2020). Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China. American Journal of Nursing Science, 9(4), 276-280. https://doi.org/10.11648/j.ajns.20200904.29

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ACS Style

Wei Wang; Weiping Tang; Yali Luo; Naling Zhu; Liling Wang. Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China. Am. J. Nurs. Sci. 2020, 9(4), 276-280. doi: 10.11648/j.ajns.20200904.29

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AMA Style

Wei Wang, Weiping Tang, Yali Luo, Naling Zhu, Liling Wang. Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China. Am J Nurs Sci. 2020;9(4):276-280. doi: 10.11648/j.ajns.20200904.29

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@article{10.11648/j.ajns.20200904.29,
  author = {Wei Wang and Weiping Tang and Yali Luo and Naling Zhu and Liling Wang},
  title = {Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China},
  journal = {American Journal of Nursing Science},
  volume = {9},
  number = {4},
  pages = {276-280},
  doi = {10.11648/j.ajns.20200904.29},
  url = {https://doi.org/10.11648/j.ajns.20200904.29},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20200904.29},
  abstract = {Objective To construct the regional elimination of mother-to-child transmission (EMTCT) clinic (E-clinic) service system and evaluate its effect. Methods Since November 2018, the E-clinic service system has been established in the obstetric clinic of 18 maternal and child health (MCH) providers in Baoan District, Shenzhen, China, forming a regional service system. In E-clinics obstetricians take care of pregnant women with hepatitis B virus (HBV) infection for complete perinatal services and infectious disease management. Before and after the implementation of the E-clinic service system, the changes of HBV screening rate among pregnant women, HBV infected mothers DNA detection rate, mothers with high viral load (> 2 × 106 IU/mL) antiviral therapy (ART) rate and HBV MTCT rate were analyzed. Results From July 2018 to March 2020, there were 162,036 registered pregnant women and 7,358 HBV infected mothers in Baoan District, Shenzhen, including 1,179 mothers with high viral load. The HBV screening rate among pregnant women, HBV infected mothers follow up rate, HBV infected mothers DNA detection rate and ART rate were 97.6% (124,311/127,379), 99.0% (5,742/5,801), 82.8% (4,805/5,801) and 70% (687/982) respectively, which were higher than 95.9% (33,247/34,657), 93.1% (1,449/1,557), 49.3% (767/ 1,557) and 21.3% (42/197) before the implementation of the E-clinic service system. The differences were statistically significant (P E-clinic service system, and the difference was no statistically significant (P>0.05). Conclusions The E-clinic service system of Baoan District in Shenzhen integrates antenatal care (ANC) and ART, improves the management of HBV infection during pregnancy, further reduces the HBV MTCT, and provides experience for other regions to manage infectious diseases during pregnancy.},
 year = {2020}
}

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TY  - JOUR
T1  - Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China
AU  - Wei Wang
AU  - Weiping Tang
AU  - Yali Luo
AU  - Naling Zhu
AU  - Liling Wang
Y1  - 2020/07/23
PY  - 2020
N1  - https://doi.org/10.11648/j.ajns.20200904.29
DO  - 10.11648/j.ajns.20200904.29
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 276
EP  - 280
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20200904.29
AB  - Objective To construct the regional elimination of mother-to-child transmission (EMTCT) clinic (E-clinic) service system and evaluate its effect. Methods Since November 2018, the E-clinic service system has been established in the obstetric clinic of 18 maternal and child health (MCH) providers in Baoan District, Shenzhen, China, forming a regional service system. In E-clinics obstetricians take care of pregnant women with hepatitis B virus (HBV) infection for complete perinatal services and infectious disease management. Before and after the implementation of the E-clinic service system, the changes of HBV screening rate among pregnant women, HBV infected mothers DNA detection rate, mothers with high viral load (> 2 × 106 IU/mL) antiviral therapy (ART) rate and HBV MTCT rate were analyzed. Results From July 2018 to March 2020, there were 162,036 registered pregnant women and 7,358 HBV infected mothers in Baoan District, Shenzhen, including 1,179 mothers with high viral load. The HBV screening rate among pregnant women, HBV infected mothers follow up rate, HBV infected mothers DNA detection rate and ART rate were 97.6% (124,311/127,379), 99.0% (5,742/5,801), 82.8% (4,805/5,801) and 70% (687/982) respectively, which were higher than 95.9% (33,247/34,657), 93.1% (1,449/1,557), 49.3% (767/ 1,557) and 21.3% (42/197) before the implementation of the E-clinic service system. The differences were statistically significant (P E-clinic service system, and the difference was no statistically significant (P>0.05). Conclusions The E-clinic service system of Baoan District in Shenzhen integrates antenatal care (ANC) and ART, improves the management of HBV infection during pregnancy, further reduces the HBV MTCT, and provides experience for other regions to manage infectious diseases during pregnancy.
VL  - 9
IS  - 4
ER  -

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Author Information

Wei Wang

Department of Prevention and Health Care, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Weiping Tang

Department of Prevention and Health Care, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Yali Luo

Department of Prevention and Health Care, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Naling Zhu

Department of Prevention and Health Care, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Liling Wang

Department of Hospital Office, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China

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APA Style

Wei Wang, Weiping Tang, Yali Luo, Naling Zhu, Liling Wang. (2020). Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China. American Journal of Nursing Science, 9(4), 276-280. https://doi.org/10.11648/j.ajns.20200904.29

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ACS Style

Wei Wang; Weiping Tang; Yali Luo; Naling Zhu; Liling Wang. Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China. Am. J. Nurs. Sci. 2020, 9(4), 276-280. doi: 10.11648/j.ajns.20200904.29

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AMA Style

Wei Wang, Weiping Tang, Yali Luo, Naling Zhu, Liling Wang. Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China. Am J Nurs Sci. 2020;9(4):276-280. doi: 10.11648/j.ajns.20200904.29

Copy | Download

@article{10.11648/j.ajns.20200904.29,
  author = {Wei Wang and Weiping Tang and Yali Luo and Naling Zhu and Liling Wang},
  title = {Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China},
  journal = {American Journal of Nursing Science},
  volume = {9},
  number = {4},
  pages = {276-280},
  doi = {10.11648/j.ajns.20200904.29},
  url = {https://doi.org/10.11648/j.ajns.20200904.29},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20200904.29},
  abstract = {Objective To construct the regional elimination of mother-to-child transmission (EMTCT) clinic (E-clinic) service system and evaluate its effect. Methods Since November 2018, the E-clinic service system has been established in the obstetric clinic of 18 maternal and child health (MCH) providers in Baoan District, Shenzhen, China, forming a regional service system. In E-clinics obstetricians take care of pregnant women with hepatitis B virus (HBV) infection for complete perinatal services and infectious disease management. Before and after the implementation of the E-clinic service system, the changes of HBV screening rate among pregnant women, HBV infected mothers DNA detection rate, mothers with high viral load (> 2 × 106 IU/mL) antiviral therapy (ART) rate and HBV MTCT rate were analyzed. Results From July 2018 to March 2020, there were 162,036 registered pregnant women and 7,358 HBV infected mothers in Baoan District, Shenzhen, including 1,179 mothers with high viral load. The HBV screening rate among pregnant women, HBV infected mothers follow up rate, HBV infected mothers DNA detection rate and ART rate were 97.6% (124,311/127,379), 99.0% (5,742/5,801), 82.8% (4,805/5,801) and 70% (687/982) respectively, which were higher than 95.9% (33,247/34,657), 93.1% (1,449/1,557), 49.3% (767/ 1,557) and 21.3% (42/197) before the implementation of the E-clinic service system. The differences were statistically significant (P E-clinic service system, and the difference was no statistically significant (P>0.05). Conclusions The E-clinic service system of Baoan District in Shenzhen integrates antenatal care (ANC) and ART, improves the management of HBV infection during pregnancy, further reduces the HBV MTCT, and provides experience for other regions to manage infectious diseases during pregnancy.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Construction and Evaluation of the E-clinic Service System in Baoan District, Shenzhen, China
AU  - Wei Wang
AU  - Weiping Tang
AU  - Yali Luo
AU  - Naling Zhu
AU  - Liling Wang
Y1  - 2020/07/23
PY  - 2020
N1  - https://doi.org/10.11648/j.ajns.20200904.29
DO  - 10.11648/j.ajns.20200904.29
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 276
EP  - 280
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20200904.29
AB  - Objective To construct the regional elimination of mother-to-child transmission (EMTCT) clinic (E-clinic) service system and evaluate its effect. Methods Since November 2018, the E-clinic service system has been established in the obstetric clinic of 18 maternal and child health (MCH) providers in Baoan District, Shenzhen, China, forming a regional service system. In E-clinics obstetricians take care of pregnant women with hepatitis B virus (HBV) infection for complete perinatal services and infectious disease management. Before and after the implementation of the E-clinic service system, the changes of HBV screening rate among pregnant women, HBV infected mothers DNA detection rate, mothers with high viral load (> 2 × 106 IU/mL) antiviral therapy (ART) rate and HBV MTCT rate were analyzed. Results From July 2018 to March 2020, there were 162,036 registered pregnant women and 7,358 HBV infected mothers in Baoan District, Shenzhen, including 1,179 mothers with high viral load. The HBV screening rate among pregnant women, HBV infected mothers follow up rate, HBV infected mothers DNA detection rate and ART rate were 97.6% (124,311/127,379), 99.0% (5,742/5,801), 82.8% (4,805/5,801) and 70% (687/982) respectively, which were higher than 95.9% (33,247/34,657), 93.1% (1,449/1,557), 49.3% (767/ 1,557) and 21.3% (42/197) before the implementation of the E-clinic service system. The differences were statistically significant (P E-clinic service system, and the difference was no statistically significant (P>0.05). Conclusions The E-clinic service system of Baoan District in Shenzhen integrates antenatal care (ANC) and ART, improves the management of HBV infection during pregnancy, further reduces the HBV MTCT, and provides experience for other regions to manage infectious diseases during pregnancy.
VL  - 9
IS  - 4
ER  -

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