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BMC Public Health

, 16:95

Infectious Disease Epidemiology

Abstract

BackgroundIt 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.

MethodsA 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.

ResultsFrom 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.

ConclusionCHB 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.

KeywordsHepatitis B Prevention and control Asian continental ancestry group Electronic health records Abbreviationsanti-HBchepatitis B core antibody

anti-HBshepatitis B surface antibody

CHBchronic hepatitis B

HBsAghepatitis B surface antigen

HBVhepatitis B virus

HCChepatocellular carcinoma

HERelectronic health record

IRSDIndex of Relative Socio-economic Disadvantage

PWIDpeople who inject drugs

RACGPRoyal Australian College of General Practitioners

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Autor: Caroline van Gemert - Julie Wang - Jody Simmons - Benjamin Cowie - Douglas Boyle - Mark Stoove - Chris Enright - Margaret 

Fuente: https://link.springer.com/







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