The epidemiology of hepatitis B virus (HBV) infection in the general population in Rwanda is not well known. This study examined the prevalence of HBV surface antigen (HBsAg) positivity and associated risk factors among people aged 25 years and over in an organized national screening campaign. This is a cross-sectional study using data from a nationwide HBV screening campaign organized by the Rwanda Biomedical Centre from March to October 2018. This campaign targeted individuals aged > 25 years old from 24 of 30 districts of Rwanda. Sensitization was done through multimedia announcements, community health workers and local church leaders. During the campaign, a structured interview was administered by trained healthcare workers to collect information on socio-demographic, clinical and behavioral characteristics of participants; HBV screening was performed with HBsAg using enzyme-linked immunosorbent assays (ELISA) testing. Bivariate and multivariate logistic regressions were used to assess factors associated with HBsAg positivity in the screened participants. A total of 327,360 individuals were screened during the campaign. Overall 12,865(3.9%) were HBsAg positive. The highest prevalence (4.2%) was found in the 35–44-year-old group, but the difference from other groups was not significant (Odds Ratio [OR = 1.057, 95% Confidence Interval(CI) (0.904–1.235)]. Being male [OR = 1.348, 95% CI (1.30,1.40)]; being single [OR = 1.092, 95% CI (1.10–1.16)] compared to married; a previous positive TB screening test [OR = 2.352, 95% CI (1.63–3.39)]; history of surgical operation [OR = 1.082, 95% CI (1.00,1.17)]; exposure to traditional operational practices and scarification [OR = 1.187, 95% CI (1.13, 1.24)]; and having a person in the family with viral hepatitis [OR = 1.367, 95% CI (1.21, 1.53)] were significantly associated with HBV infection. These data provide the first national estimate of the prevalence of HBsAg seropositivity and its associated factors in Rwanda. The study identified people with the highest risk of HBV infection who should be the priority of future prevention efforts in Rwanda and in similar settings.

This study evaluated the factors influencing patient satisfaction with hospital services and respect for patient rights in outpatient consultation in Rwanda, aiming to provide insights into improving the overall quality of care. This was cross-sectional study design. We recruited participants from all (30) districts in Rwanda using stratified sampling. A structured questionnaire assessed satisfaction across seven hospital areas, including cashier, waiting, triage, doctor consultation, laboratory, pharmacy, and respect for patient rights. We used descriptive statistics, Chi-square, and Multivariate Regression analyses. The study showed that most participants expressed satisfaction with hospital services and respect for their rights: doctor consultations (93.8%), triage (92.0%), dispensing pharmacy (88.2%), laboratory services (87.2%), waiting area (85.3%), patient rights (74.3%), cashier services (73.3%). At bivariate analysis, we observed that satisfaction in waiting areas was associated with location ( p = 0.036), provinces (p < 0.001), and hospital rank (p < 0.001), while satisfaction in triage was associated with age categories (p < 0.001) and visits ( p = 0.02). The association of satisfaction in cashier services with age categories (p < 0.001), visits (p = 0.032), and hospital rank (p = 0.005) was also significant, as well as satisfaction in dispensing pharmacy and provinces (p < 0.001), location (p = 0.002), and visits (p = 0.008). Multiple logistic regression indicated higher satisfaction in waiting areas among patients from Northern (OR = 3.81, 95%CI = 1.85–5.64), Western (OR = 1.95, 95%CI = 1.48–3.60), and Southern provinces (OR = 1.93, 95%CI = 1.17–2.85), while urban patients (OR = 0.65, 95%CI = 0.47–0.91) and those from high-rank hospitals had lower satisfaction (OR = 0.59, 95%CI = 0.43–0.82). High-rank hospital patients were more satisfied with triage (OR = 1.86, 95% CI = 1.14–3.13) while returning patients were less satisfied (OR = 0.51, 95%CI = 0.33–0.90). Lower satisfaction in dispensing pharmacy was observed among the City of Kigali (OR = 0.11, 95%CI = 0.05–0.24), Northern province (OR = 0.43, 95%CI = 0.23–0.80), and returning patients (OR = 0.51, 95%CI = 0.33–0.76). Urban (OR = 2.5, 95%CI = 1.32–5.16) and high-rank hospital patients (OR = 1.96, 95%CI = 1.08–3.77) reported higher laboratory satisfaction. However, cashier services had lower satisfaction among Kigali (OR = 0.37, 95%CI = 0.21–0.64), Northern (OR = 0.44, 95%CI = 0.29–0.65), and Western province patients(OR = 0.63, 95%CI = 0.43–0.91), returning patients (OR = 0.73, 95%CI = 0.55–0.96), and those from high-rank hospitals(OR = 0.70, 95%CI = 0.54–0.92). Our study has revealed disparities in satisfaction with ambulatory care services delivery by provinces, hospital rank and visit status. We recommend hospital to take initiatives aiming at streamlining payments, optimizing waiting area services, and enhancing coordination, staff training, regional equity, and patient-centered policies for continuous service improvement.

Background Medical oxygen therapy is essential for treating hypoxemia, a driver of morbidity and mortality across a number of acute illnesses in children and adults. Healthcare providers must be equipped to detect hypoxemia and provide life-saving oxygen therapy. This study assessed the readiness of Rwandan public hospitals to provide oxygen therapy by evaluating availability of functional equipment, as well as healthcare workers’ self-reported experience with oxygen saturation monitoring and oxygen administration. Methods A cross-sectional study assessed public hospitals in Rwanda, between October to December 2022. The ratio of available oxygen equipment was calculated relative to need, based on patient bed counts within wards, categorized by acuity based on estimated oxygen requirements. Additionally, healthcare workers completed a self-administered survey on their experience with pulse oximetry and oxygen therapy. Results In Rwandan public hospitals, 75.6% (28/37, CI 95% 58.6–87.6%) were found to have sufficient medical oxygen therapy delivery points relative to their inpatient needs. Most, 89.2% (33/37), had piping infrastructure to safely deliver oxygen to the patient bedside. However, only 21.6% (8/37, CI 95% 10.8–38.5%) had sufficient functional pulse oximeter devices, used to detect hypoxemia. Ward specific analyses revealed differences in the distribution of equipment and infrastructures; of high-acute wards, 70.0% (7/10) Intensive Care Units had sufficient pulse oximeter devices, whilst only 40.0% (4/10) had sufficient oxygen delivery points. Whereas in medium-acute wards, 53.1% (17/32) neonatology wards met the recommended number of pulse oximeters, and 87.5% (28/32) had sufficient delivery points. Over half of healthcare workers reported only basic awareness of using pulse oximetry and providing oxygen therapy. Conclusions While Rwanda’s public hospitals demonstrate strong capacity in oxygen delivery, significant gaps in pulse oximetry and healthcare worker experience limit their full readiness to manage hypoxemia. This highlighted critical needs to strengthen capacity through increased equipment availability and healthcare worker experience, in order to deliver excellent hypoxemia management to all patients in need.