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

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 0.05). 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.