Improving the Identification of Priority Populations to Increase Hepatitis B Testing Rates, 2012
BACKGROUND:
It
is estimated that over 40 % of the 218,000 people with chronic hepatitis B
(CHB) in Australia in 2011 are undiagnosed. A disproportionate number of those
with undiagnosed infection were born in the Asia-Pacific region. Undiagnosed
CHB can lead to ongoing transmission and late diagnosis limits opportunities to
prevent progression to hepatocellular carcinoma (HCC) and cirrhosis. Strategies
are needed to increase testing for hepatitis B virus (HBV) (including
culturally and linguistically diverse communities, Aboriginal and/or Torres
Strait Islander (Indigenous) people and people who inject drugs). General
practitioners (GPs) have a vital role in increasing HBV testing and the timely
diagnosis CHB. This paper describes the impact of a GP-based screening intervention
to improve CHB diagnosis among priority populations in Melbourne, Australia.
METHODS:
A
non-randomised, pre-post intervention study was conducted between 2012 and 2013
with three general practices in Melbourne, Australia. Using clinic electronic
health records three priority populations known to be at increased CHB risk in
Australia (1: Asian-born patients or patients of Asian ethnicity living in
Australia; 2: Indigenous people; or 3): people with a history of injecting
drugs were identified and their HBV status recorded. A random sample were then
invited to attend their GP for HBV testing and/or vaccination. Baseline and
follow-up electronic data collection identified patients that subsequently had
a consultation and HBV screening test and/or vaccination.
RESULTS:
From a
total of 33,297 active patients, 2674 (8 %) were identified as a priority
population at baseline; 2275 (85.1 %) of these patients had unknown HBV
status from which 338 (14.0 %) were randomly sampled. One-fifth (n = 73,
21.6 %) of sampled patients subsequently had a GP consultation during the
study period; only four people (5.5 %) were subsequently tested for HBV
(CHB detected in n = 1) and none were vaccinated against HBV.
CONCLUSION:
CHB
infection is an important long-term health issue in Australia and strategies to
increase appropriate and timely testing are required. The study was effective
at identifying whether Asian-born patients and patients of Asian had been
tested or vaccinated for HBV; however the intervention was not effective at
increasing HBV testing.
By: van Gemert C1,2, Wang J3, Simmons J4, Cowie B5,6, Boyle D7, Stoove M3,8, Enright C4, Hellard M3,8.
- 1Centre for Population Health, Burnet Institute, Melbourne, Australia. carolinevg@burnet.edu.au.
- 2Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia. carolinevg@burnet.edu.au.
- 3Centre for Population Health, Burnet Institute, Melbourne, Australia.
- 4Cancer Council Victoria, Melbourne, Australia.
- 5WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Melbourne, Australia.
- 6Department of Medicine, University of Melbourne, Melbourne, Australia.
- 7GRHANITE™ Health Informatics Unit, Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Australia.
- 8Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
- BMC Public Health. 2016 Feb 1;16(1):95. doi: 10.1186/s12889-016-2716-7.
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