Fitting A Programmatic Response to the HBV Epidemic In Sub-Saharan Africa

This PhD will focus on the analysis of HBV epidemics, and the response that has been made to them, in sub-Saharan Africa. The overall aim is to come to guidance for national governments and international stakeholders about how ambitious targets for HBV elimination can be reached. Following a narrative review of the literature in this field and a review of the state of the epidemic and the programmatic response in a range of countries, the first chapter will compare different sets of modelled HBV prevalence estimates. The second chapter involves a scoping review of parameters of the epidemiology and natural history of HBV in sub-Saharan Africa, and the development of a dynamic transmission model of HBV that can be applied to a West African setting. Building on an existing framework, the model will incorporate all available data in a country in order to make inference on model parameters. The model will be used as the foundation for the analysis in subsequent chapters. The third chapter will assess the case for the scale-up of a screening and treatment programme, and will investigate screening of different segments of the population, initiating treatment against different eligibility criteria, and monitoring patients (prior to treatment) at different frequencies. . The model based analyses will be based on the state-of-the-art understanding of HBV epidemiology, including all attendant sources of uncertainty. A discussion chapter will summarise the findings, collate cross-cutting insights and themes and chart the directions for future work.