Hepatology, medicine and policy最新文献

{"title":"Strategies for achieving viral hepatitis C micro-elimination in the Netherlands.","authors":"P A M Kracht,&nbsp;J E Arends,&nbsp;K J van Erpecum,&nbsp;A Urbanus,&nbsp;J A Willemse,&nbsp;A I M Hoepelman,&nbsp;E A Croes","doi":"10.1186/s41124-018-0040-9","DOIUrl":"10.1186/s41124-018-0040-9","url":null,"abstract":"<p><p>The Netherlands is striving to achieve national elimination of the hepatitis C virus (HCV) as one of the first countries worldwide. The favorable HCV epidemiology with both low prevalence and incidence, together with access to care and treatment, present excellent conditions to further build on towards this objective. The Dutch national plan on viral hepatitis, introduced in 2016, defines targets in the HCV healthcare cascade and provides a structural framework for the development of elimination activities. Since many different stakeholders are involved in HCV care in the Netherlands, focus has been placed on micro-elimination initiatives as a pragmatic and efficient approach. These numerous micro-eliminations projects have brought the Netherlands closer to HCV elimination. In the near future, efforts specifically have to be made in order to optimize case-finding strategies and to successfully accomplish the nationwide implementation of the registration and monitoring system of viral hepatitis mono-infections, before this final goal can be reached. The upcoming years will then elucidate if the Dutch' hands on approach has resulted in sufficient progress against HCV and if the Netherlands will lead the way towards nationwide HCV elimination.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2018-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-018-0040-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36600033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of hepatitis B and C in Nepal: a systematic review (1973-2017).","authors":"Marcelo Contardo Moscoso Naveira,&nbsp;Komal Badal,&nbsp;Jagadish Dhakal,&nbsp;Neichu Angami Mayer,&nbsp;Bina Pokharel,&nbsp;Ruben Frank Del Prado","doi":"10.1186/s41124-018-0039-2","DOIUrl":"https://doi.org/10.1186/s41124-018-0039-2","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis B and C represent an important co-infection for people living with HIV worldwide. Nepal wants to be part of the international mobilization for viral hepatitis elimination, and has pursued better understanding of the epidemic in its territory through scientific research.</p><p><strong>Methods: </strong>We performed a systematic review of seroprevalence studies hepatitis B and C in Nepal following the PRISMA 2009 Flow Diagram.</p><p><strong>Results: </strong>Fifty-four scientific publications and reports were selected for this review. Nearly a quarter of these documents have been issued in recent years and many are authored by non-governmental organizations in Nepal. The collective of information displays a wide range of alarming prevalence rates, particularly for girls and women survivors of human trafficking and a progressive participation of civil society in viral hepatitis epidemiology research in the country.</p><p><strong>Conclusion: </strong>This paper presents a most complete review of hepatitis B and C and HIV co-infection prevalence studies in different population groups from 1973 to 2016. A comprehensive analysis of the epidemiology and apparent trends in public health research and policy making in Nepal are also addressed in this document. We expect this to be a most important tool for improvements in future interventions for both epidemics in the country.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2018-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-018-0039-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36600032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis C virus prevention and care for drug injectors: the French approach.","authors":"Jean-Michel Delile, Victor de Ledinghen, Marie Jauffret-Roustide, Perrine Roux, Brigitte Reiller, Juliette Foucher, Daniel Dhumeaux","doi":"10.1186/s41124-018-0033-8","DOIUrl":"10.1186/s41124-018-0033-8","url":null,"abstract":"<p><p>After France removed hepatitis C treatment reimbursement restrictions on 25 May 2016, an expert report presented recommendations, which focused on vulnerable groups including people who inject drugs (PWID). This commentary presents the key points of the chapter with a particular focus on policy. Thanks to the official lifting of restrictions based on disease stage and to the excellent efficacy and tolerance of the new DAA (Direct-Acting Antivirals) among PWID, the main issue is to improve the HCV care cascade. In France, many HCV-infected PWID, especially active/current PWID, remain undiagnosed and unlinked to care. Our challenge is to improve HCV screening by point of care testing (POCT), outreach methods with mobile teams, rapid tests, FibroScan, etc. and to provide PWID with appropriate services in all the settings they attend, such as drug treatment or harm reduction services, social services, prisons, etc. Another important issue is the prevention of reinfection through comprehensive and long-term follow-up. The report recommends a new national policy: testing and treating PWID as a priority, since this is the best way to eliminate HCV infection. It requires a global strategy consisting of combined and long-term interventions: prevention, outreach, screening, DAA, drug treatment programs including opiate substitution treatment (OST) and various harm reduction programs, including needle exchange programs (NEP). Ideally, these services should be delivered in the same place with an integrated approach. This should lead to meeting the national objective set by the government of eliminating hepatitis C by 2025.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2018-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-018-0033-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/ethnic- and county-specific prevalence of chronic hepatitis B and its burden in California.","authors":"Mehlika Toy,&nbsp;Bin Wei,&nbsp;Tejpal S Virdi,&nbsp;An Le,&nbsp;Huy Trinh,&nbsp;Jiayi Li,&nbsp;Jian Zhang,&nbsp;Ann W Hsing,&nbsp;Samuel K So,&nbsp;Mindie H Nguyen","doi":"10.1186/s41124-018-0034-7","DOIUrl":"https://doi.org/10.1186/s41124-018-0034-7","url":null,"abstract":"<p><strong>Background: </strong>In the United States, the highest burden of chronic hepatitis B (CHB) and CHB-related liver cancer is in the state of California, primarily in the San Francisco (SF) Bay and Los Angeles (LA) areas. The aim of this study was to estimate county-specific hepatitis B surface antigen (HBsAg) prevalence and quantify CHB cases by age, race/ethnicity, nativity, and disease activity status.</p><p><strong>Methods: </strong>Twelve counties in SF Bay Area and three large counties in LA area were included for this analysis. Race/ethnicity-specific prevalence of HBsAg for each county and the state of California as a whole, was estimated by including prevalence data from the National Health and Nutrition Examination Survey and various studies that estimated HBsAg prevalence in US and foreign-born Asian Pacific Islanders, Hispanic, and Black populations. In addition, clinical data of 2000 consecutive CHB patients (collected between 2009 and 2014) from a large clinical consortium in the SF Bay area were used to calculate the age-specific disease burden.</p><p><strong>Results: </strong>Of the 15 counties analyzed, SF had the highest HBsAg prevalence (1.78%), followed by Santa Clara (1.63%) and Alameda (1.45%). The majority of CHB cases were estimated to be in LA County (83,770), followed by Santa Clara (31,273), and Alameda (23,764). Among the CHB cases, 12.7% is active HBeAg positive, 24.2% is active HBeAg negative, and 10.6% has cirrhosis.</p><p><strong>Conclusion: </strong>This study confirms and quantifies the current burden of CHB in high endemic counties in the state of California using population-level estimates combined with clinical data including those from the community.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2018-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-018-0034-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluation of chronic hepatitis B and hepatitis C patients lost to follow-up: results of the Northern Holland hepatitis retrieval project.","authors":"N Beekmans, M Klemt-Kropp","doi":"10.1186/s41124-018-0032-9","DOIUrl":"10.1186/s41124-018-0032-9","url":null,"abstract":"<p><strong>Background: </strong>Many persons infected with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) in the past are now lost to follow-up. The aim of the Northern Holland Hepatitis Retrieval Project (NHHRP) is to retrieve and re-evaluate persons previously diagnosed with HBV or HCV and bring them back into care. Chronic HBV infection was defined as two positive Hepatitis B surface antigen (HBsAg) tests within 6 months and chronic HCV infection with 2 positive HCV RNA tests by polymerase chain reaction (PCR).</p><p><strong>Methods: </strong>Data files of the local public health services and microbiology laboratory were explored to identify all registered HBV and HCV cases in the Alkmaar region, the Netherlands, for the past 15 years. Identified cases were compared with patients currently known in our hospital. Patients without follow-up in primary or hospital care were approached via their primary health care physician and invited for evaluation at our hospital.</p><p><strong>Results: </strong>In total, 552 cases of HBV were identified. 356 (64.5%) had no follow-up. Only 113/356 (31.7%) were eligible for retrieval and 44.2% were evaluated in our hospital resulting in a change of management in 22/50 (44%) of patients. Four hundred ninety nine cases of HCV were identified, 150/499 (30.1%) were lost to follow-up. Only 20/150 (13.3%) were eligible for retrieval and 4/20 (20%) were evaluated at our clinic. Resulting in a change of management in 3/4 (75%).</p><p><strong>Conclusion: </strong>Only a limited part of HBV and HCV persons lost to follow-up is eligible for retrieval, nonetheless re-evaluation of these persons will lead to a change of management in the majority of persons.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5918904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of the Prospective Real-world Outcomes Study of hepatic encephalopathy Patients' Experience on Rifaximin-α (PROSPER): an observational study among 550 patients.","authors":"Aleksander Krag,&nbsp;Marcus Schuchmann,&nbsp;Hanna Sodatonou,&nbsp;Jeff Pilot,&nbsp;James Whitehouse,&nbsp;Simone I Strasser,&nbsp;Mark Hudson","doi":"10.1186/s41124-017-0029-9","DOIUrl":"https://doi.org/10.1186/s41124-017-0029-9","url":null,"abstract":"<p><strong>Background: </strong>Hepatic encephalopathy (HE) is one of the most important severe complications of liver cirrhosis. Thought to be caused by elevated blood levels of gut-derived neurotoxins (particularly ammonia) entering the brain, HE manifests as a wide range of neurological or psychiatric abnormalities, which increase the risk of mortality, result in substantial morbidity and negatively affect the quality of life (QoL) of both patients and their caregivers. HE is also associated with a substantial economic burden. Rifaximin-α 550 mg is a locally acting oral antibiotic that reduces the effects of ammonia-producing intestinal flora, and which is used to help reduce the recurrence of overt HE. The efficacy of rifaximin-α 550 mg was established in a randomised controlled trial and long-term extension study. However, 'real-world' evidence is also required to assess how this efficacy may translate into effectiveness in clinical practice, including the potential impact of treatment on healthcare resource utilisation.</p><p><strong>Methods: </strong>The Prospective Real-world Outcomes Study of HE Patients' Experience on Rifaximin-α 550 mg (PROSPER) is a multinational, multicentre, observational study that will be conducted under real-world clinical practice conditions. Comprising a retrospective phase (up to 12 months) and a prospective phase (up to 24 months), and employing a robust statistical methodology, PROSPER has been specifically designed to minimise the bias associated with observational studies. The primary endpoint will be the effect of rifaximin-α 550 mg treatment on HE- and liver-related hospitalisation rate and duration of hospitalisation. Secondary endpoints will include comprehensive assessments of the impact of treatment on the QoL and workplace productivity of patients and caregivers, a global assessment of treatment effectiveness and safety/tolerability. Approximately 550 patients will be enrolled.</p><p><strong>Conclusions: </strong>PROSPER will provide valuable real-world information on the effectiveness of rifaximin-α 550 mg in reducing the recurrence of HE, and its impact on the QoL and work productivity of patients and their caregivers. By providing data on both the direct costs (e.g., hospitalisation rate, duration of hospitalisation) and indirect costs (such as work productivity) of HE, PROSPER should help confirm whether rifaximin-α 550 mg treatment represents a good use of economic resources.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT02488993.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-017-0029-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of hepatitis B-HIV co-infection screening and management in a resource limited setting.","authors":"Musomba Rachel,&nbsp;Castelnuovo Barbara,&nbsp;Claire Murphy,&nbsp;Charlene Komujuni,&nbsp;Patience Nyakato,&nbsp;Ponsiano Ocama,&nbsp;Mohammed Lamorde,&nbsp;Philippa Easterbrook,&nbsp;Rosalind Parkes Ratanshi","doi":"10.1186/s41124-017-0030-3","DOIUrl":"https://doi.org/10.1186/s41124-017-0030-3","url":null,"abstract":"<p><strong>Background: </strong>WHO hepatitis B guidelines recommend testing all new HIV patients, treating them accordingly or providing immunization. At the Infectious Diseases Institute (IDI) following an audit done in 2012, only 46% patients had been screened for hepatitis B with variable management plans therefore new internal guidelines were implemented. This study describes the uptake of hepatitis B screening and management of patients with hepatitis B and HIV con-infection after the implementation.</p><p><strong>Methods: </strong>Data included for all HIV positive patients in care at IDI by October 2015. Data are expressed as median with interquartile range (IQR) and percentages were compared using the chi square test. Statistical analysis was performed using STATA version 13. The IDI laboratory upper limit of normal for alanine aminotransferase (ALT) and aspartate aminotransferase (ASTs) was 40 IU/ml.</p><p><strong>Results: </strong>Number of hepatitis B screening tests increased from 800 by 2012 to 1400 in 2015. By 2015 8042/8604(93.5%) patients had been screened for hepatitis B. Overall hepatitis B positive were 359 (4.6%). 166 (81.4%) hepatitis B positives were switched to a tenofovir (TDF) containing regimen.</p><p><strong>Conclusion: </strong>Our study confirms the importance of screening for hepatitis B and of using ART regimens containing tenofovir in hepatitis B co-infected patients. Whilst our program has made improvements in care still 18.6% of patients with hepatitis B were not on tenofovir regimens, 98.1% had no hepatitis B viral loads done. Clinicians should recognize the potential for hepatitis B in HIV positive patients and the importance of early diagnosis and treatment to ensure optimal management of cases and follow up.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-017-0030-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-infection viral superinfection technology could treat HBV and HCV patients with unmet needs.","authors":"Tibor Bakacs,&nbsp;Rifaat Safadi,&nbsp;Imre Kovesdi","doi":"10.1186/s41124-017-0028-x","DOIUrl":"https://doi.org/10.1186/s41124-017-0028-x","url":null,"abstract":"<p><strong>Background: </strong>Viral hepatitis deaths from acute infection, cirrhosis, and liver cancer have risen from the tenth to the seventh leading cause of death worldwide between 1990 and 2013. Even in the oral direct acting antiviral (DAA) agent era there are still large numbers of patients with unmet needs. Medications approved for treatment of chronic hepatitis B virus (HBV) infection do not eradicate HBV often requiring treatment for life associated with risks of adverse reactions, drug resistance, nonadherence, and increased cost. Although DAAs increased virologic cure rates well over 90% in all hepatitis C virus (HCV) genotypes, HCV infection still cannot be cured in a small but significant minority of patients. While most of the medical issues of HCV treatment have been solved, the current costs of DAAs are prohibitive.</p><p><strong>Results: </strong>The post-infection viral superinfection treatment (SIT) platform technology has been clinically proven to be safe and effective to resolve acute and persistent viral infections in 42 HBV and HCV patients (20 HBV, 22 HCV), and in 4 decompensated patients (2 HBV, 2 HCV). SIT employs a non-pathogenic avian double stranded RNA (dsRNA) virus, a potent activator of antiviral gene responses. Unexpectedly, SIT is active against unrelated DNA (HBV) and RNA (HCV) viruses. SIT does not require lifelong therapy, which is a major advantage considering present HBV treatments. The new viral drug candidate (R903/78) is homogeneously produced by reverse genetics in Vero cells. R903/78 has exceptional pH and temperature stability and also excellent long-term stability; therefore, it can be orally administered, stored and shipped without freezing. Since R903/78 is easy to stockpile, the post-infection SIT could also alleviate the logistic hurdles of surge capacity in vaccine production during viral pandemics.</p><p><strong>Conclusion: </strong>To help large number of HBV and HCV patients with unmet needs, broad-spectrum antiviral drugs effective against whole classes of viruses are urgently needed. The innovative SIT technological platform will be a great additional armament to conquer viral hepatitis, which is still a major cause of death and disability worldwide.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-017-0028-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"B in IT\" - a community-based model for the management of hepatitis B patients in primary care clinics using a novel web-based clinical tool.","authors":"Debra A O'Leary,&nbsp;Eleanor Cropp,&nbsp;David Isaac,&nbsp;Paul V Desmond,&nbsp;Sally Bell,&nbsp;Tin Nguyen,&nbsp;Darren Wong,&nbsp;Jessica Howell,&nbsp;Jacqui Richmond,&nbsp;Jenny O'Neill,&nbsp;Alexander J Thompson","doi":"10.1186/s41124-017-0031-2","DOIUrl":"https://doi.org/10.1186/s41124-017-0031-2","url":null,"abstract":"<p><strong>Background: </strong>The current model of care for the treatment of chronic hepatitis B (CHB) in Australia is through specialist Hepatology or Infectious Diseases clinics, and limited accredited primary care practices. Capacity is limited, and less than 5% of Australians living with CHB currently access therapy. Increasing treatment uptake is an urgent area of clinical need. Nucleos(t)ide analogue therapy is safe and effective treatment for CHB that is suitable for community prescribing. We have evaluated the success of a community-based model for the management of CHB in primary care clinics using a novel web-based clinical tool.</p><p><strong>Methods: </strong>Using guidelines set out by the Gastroenterological Society of Australia, we developed an interactive online clinical management tool for the shared care of patients with CHB in primary care clinics, with remote oversight from tertiary hospital-based hepatologists and a project officer. We call this model of care the \"B in IT\" program. Suitable patients were referred from the specialist liver clinic back to primary care for ongoing management. Compliance with recommended appointments, pathology tests and ultrasounds of patients enrolled in \"B in IT\" was assessed and compared to that of the same patients prior to community discharge, as well as a matched control group of CHB outpatients continuing to attend a specialist clinic.</p><p><strong>Results: </strong>Thirty patients with CHB were enrolled in the \"B in IT\" program. Compliance with attending scheduled appointments within 1 month of the suggested date was 87% across all 115 visits scheduled. Compliance with completing recommended pathology within 1 month of the suggested date was 94% and compliance with completing recommended liver ultrasounds for cancer screening within 1 month of the suggested date was 89%. The compliance rates for visit attendance and ultrasound completion were significantly higher than the control patient group (<i>p</i> < 0.0001) and the \"B in IT\" patients prior to community discharge (<i>p</i> = 0.002 and <i>p</i> = 0.039, respectively).</p><p><strong>Conclusions: </strong>The \"B in IT\" program's novel web-based clinical tool supports primary care physicians to treat and monitor patients with CHB. This program promotes community-based care and increases system capacity for the clinical care of people living with CHB.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"3 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-017-0031-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A school-based intervention of screening a movie to increase hepatitis B vaccination levels among students in Uttar Pradesh, India: impact on knowledge, awareness, attitudes and vaccination levels.","authors":"Gourdas Choudhuri,&nbsp;Rajesh Ojha,&nbsp;T S Negi,&nbsp;Varun Gupta,&nbsp;Shipra Saxena,&nbsp;Arundhati Choudhuri,&nbsp;Sanjoy Pal,&nbsp;Jui Choudhuri,&nbsp;Alok Sangam","doi":"10.1186/s41124-017-0027-y","DOIUrl":"10.1186/s41124-017-0027-y","url":null,"abstract":"<p><strong>Background: </strong>India is home to one in 14 of all chronic hepatitis B virus (HBV) cases, meaning that it is important to develop HBV interventions that are applicable in the Indian context. Vaccination is the foremost tool for interrupting the HBV infection cycle. HBV vaccination was not included in India's government-sponsored expanded immunisation program until 2011, and many children born earlier remain unvaccinated. This study sought to observe the impact of the HOPE Initiative's school-based intervention to increase vaccination coverage by increasing HBV awareness among students in Lucknow, Uttar Pradesh.</p><p><strong>Methods: </strong>At 430 schools in the administrative areas within and surrounding Lucknow, students viewed an educational documentary film on HBV and completed two questionnaires, one immediately before the screening and the other six weeks later. Both questionnaires asked the same 14 questions, which were organized into five domains: knowledge of the magnitude of the problem of HBV; knowledge of modes of HBV transmission; knowledge of consequences of HBV infection; awareness of HBV; and attitudes regarding HBV. The baseline questionnaire also asked students whether they had been vaccinated against HBV. At two-year follow-up, researchers measured vaccination levels at a subset of 30 intervention schools and six non-intervention schools to further assess the impact of the intervention.</p><p><strong>Results: </strong>Baseline questionnaires were completed by 11,250 students, and post-intervention questionnaires, by 9698 students. Scores for knowledge about the magnitude of the HBV problem improved from 41% at baseline to 74% at follow-up, and scores for knowledge about modes of transmission, from 38% to 75% (<i>p</i> < 0.05 for both). The baseline HBV vaccination level among students receiving the intervention was 21%. Two years after the intervention, 45% of students (<i>N</i> = 4284) reported being vaccinated at intervention schools compared to 22% (<i>N</i> = 1264) at non-intervention schools.</p><p><strong>Conclusions: </strong>The observed increases in HBV awareness, knowledge and vaccination levels in this study indicate that school-based interventions can be used to achieve higher vaccination coverage among Indian children. The documentary film was found to be an affordable tool for reaching large audiences. More studies are needed to validate the impact of this intervention and to explore its applicability to other social causes.</p>","PeriodicalId":91692,"journal":{"name":"Hepatology, medicine and policy","volume":"2 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2017-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41124-017-0027-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36558844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}