key: cord-0021022-pl3dr0cu
authors: nan
title: Corrections
date: 2017-06-21
journal: Lancet Infect Dis
DOI: 10.1016/s1473-3099(17)30346-8
sha: 2d77fa7aaf4cefc7b0a568addcde59fee3c6b632
doc_id: 21022
cord_uid: pl3dr0cu

nan

biosocial causes, most notably sorcery, that shape patients' health-seeking practices. 7 Gambian and Burkinabé illness categories referring to abdominal swelling frequently identify sorcery as a cause, requiring traditional healers' interventions. Redressing social transgressions through incantations and other ritual practices, healers also use various herbal and animal substances with emetic and laxative effects to reduce abdominal swelling. These treatments might not only delay access to medical care but also worsen a patient's prognosis.

Finally, African health workers struggle to explain hepatitis B to those who are chronically infected and must navigate lay incomprehension, complex local illness categories, and their own, often insufficient, biomedical knowledge. African health workers frequently rely on other disease categories to explain this illness. Some evoke local terms for severe malaria-eg, sumaya (cold fever) in Djula language, Burkina Faso-or alternatively, describe hepatitis B as "like HIV", suggesting erroneously that both viruses have identical transmission modes, diagnostic tests, and treatments. 6, 8 In regions with a low prevalence of hepatitis B infection (Europe, North America), transmission of both hepatitis B virus and HIV occurs mainly through sexual intercourse or use of intravenous drugs. By contrast, in sub-Saharan Africa, hepatitis B virus was mainly transmitted horizontally during childhood before the introduction of hepatitis B vaccine. 12 The message that hepatitis B is "like HIV" confuses patients and families and increases stigmatisation.

Considerable challenges hamper effective communication between health workers and people with chronic hepatitis. A first step in addressing the burden of chronic hepatitis in sub-Saharan Africa would be to improve training of health workers in understanding viral hepatitis. A second step would be to create more effective, meaningful communication strategies for health workers to use with patients. Development of these measures through anthropological research will set crucial foundations for treatment scale-up in low-income and middle-income countries, which can contribute to the global elimination of viral hepatitis. 

Épidémiologie des Maladies Émergentes

UK (ML) yusuke.shimakawa@pasteur.fr tamara.giles-vernick@pasteur.fr We declare no competing interests

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