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Shi Q, Herbert C, Ward DV, Simin K, McCormick BA, Ellison Iii RT, Zai AH. COVID-19 Variant Surveillance and Social Determinants in Central Massachusetts: Development Study (Preprint). JMIR Form Res 2022; 6:e37858. [PMID: 35658093 PMCID: PMC9196873 DOI: 10.2196/37858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/08/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background Public health scientists have used spatial tools such as web-based Geographical Information System (GIS) applications to monitor and forecast the progression of the COVID-19 pandemic and track the impact of their interventions. The ability to track SARS-CoV-2 variants and incorporate the social determinants of health with street-level granularity can facilitate the identification of local outbreaks, highlight variant-specific geospatial epidemiology, and inform effective interventions. We developed a novel dashboard, the University of Massachusetts’ Graphical user interface for Geographic Information (MAGGI) variant tracking system that combines GIS, health-associated sociodemographic data, and viral genomic data to visualize the spatiotemporal incidence of SARS-CoV-2 variants with street-level resolution while safeguarding protected health information. The specificity and richness of the dashboard enhance the local understanding of variant introductions and transmissions so that appropriate public health strategies can be devised and evaluated. Objective We developed a web-based dashboard that simultaneously visualizes the geographic distribution of SARS-CoV-2 variants in Central Massachusetts, the social determinants of health, and vaccination data to support public health efforts to locally mitigate the impact of the COVID-19 pandemic. Methods MAGGI uses a server-client model–based system, enabling users to access data and visualizations via an encrypted web browser, thus securing patient health information. We integrated data from electronic medical records, SARS-CoV-2 genomic analysis, and public health resources. We developed the following functionalities into MAGGI: spatial and temporal selection capability by zip codes of interest, the detection of variant clusters, and a tool to display variant distribution by the social determinants of health. MAGGI was built on the Environmental Systems Research Institute ecosystem and is readily adaptable to monitor other infectious diseases and their variants in real-time. Results We created a geo-referenced database and added sociodemographic and viral genomic data to the ArcGIS dashboard that interactively displays Central Massachusetts’ spatiotemporal variants distribution. Genomic epidemiologists and public health officials use MAGGI to show the occurrence of SARS-CoV-2 genomic variants at high geographic resolution and refine the display by selecting a combination of data features such as variant subtype, subject zip codes, or date of COVID-19–positive sample collection. Furthermore, they use it to scale time and space to visualize association patterns between socioeconomics, social vulnerability based on the Centers for Disease Control and Prevention’s social vulnerability index, and vaccination rates. We launched the system at the University of Massachusetts Chan Medical School to support internal research projects starting in March 2021. Conclusions We developed a COVID-19 variant surveillance dashboard to advance our geospatial technologies to study SARS-CoV-2 variants transmission dynamics. This real-time, GIS-based tool exemplifies how spatial informatics can support public health officials, genomics epidemiologists, infectious disease specialists, and other researchers to track and study the spread patterns of SARS-CoV-2 variants in our communities.
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Affiliation(s)
- Qiming Shi
- Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, MA, United States
| | - Carly Herbert
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, United States
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Doyle V Ward
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, Worcester, MA, United States
- Center for Microbiome Research, UMass Chan Medical School, Worcester, MA, United States
| | - Karl Simin
- Molecular, Cell, and Cancer Biology, UMass Chan Medical School, Worcester, MA, United States
| | - Beth A McCormick
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, Worcester, MA, United States
- Center for Microbiome Research, UMass Chan Medical School, Worcester, MA, United States
| | - Richard T Ellison Iii
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, Worcester, MA, United States
| | - Adrian H Zai
- Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, United States
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Generaal E, Logtenberg van der Grient H, Schatz E, van Santen DK, Boyd A, Woods SK, Baak BLC, Prins M. A Feasibility Study to Increase Chronic Hepatitis C Virus RNA Testing and Linkage to Care among Clients Attending Homeless Services in Amsterdam, The Netherlands. Diagnostics (Basel) 2021; 11:diagnostics11071197. [PMID: 34209440 PMCID: PMC8306529 DOI: 10.3390/diagnostics11071197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022] Open
Abstract
People who inject drugs (PWID) are disproportionately affected by hepatitis C virus (HCV) infections and are frequently homeless. To improve HCV case finding in these individuals, we examined the feasibility of rapid HCV RNA testing in homeless services in Amsterdam. In 2020, we provided a comprehensive service to homeless facilities, which included workshops on HCV for personnel, a “hepatitis ambassador” at each facility, a rapid, onsite HCV RNA fingerstick test service, and assistance with linkage to care. Risk factors for HCV RNA-positive status were examined using Bayesian logistic regression. Of the 152 participants enrolled, 150 (87% men; median age: 47 years) accepted rapid HCV testing. Seven tested HCV RNA positive (4.7%, 95%CrI = 1.31–8.09; 7/150). Of these, five (71%) were linked to care, of whom four (57%, 4/7) initiated treatment and one (14%, 1/7) delayed treatment due to a drug–drug interaction. Of these four people, two completed treatment (50%), of whom one (25%) achieved sustained virologic response after 12 weeks. HCV RNA-positive individuals were more likely to originate from Eastern Europe (posterior-odds ratio (OR) = 3.59 (95% credible interval (CrI) = 1.27–10.04)) and to inject drugs (ever: posterior-OR = 3.89 (95% CrI = 1.37–11.09); recent: posterior-OR = 3.94 (95% CrI = 1.29–11.71)). We identified HCV RNA-positive individuals and linkage to care was relatively high. Screening in homeless services with rapid testing is feasible and could improve HCV case finding for PWID who do not regularly attend primary care or other harm reduction services for people who use drugs.
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Affiliation(s)
- Ellen Generaal
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands; (D.K.v.S.); (A.B.); (M.P.)
- Correspondence: ; Tel.: +31-(0)20-555-5043
| | | | - Eberhard Schatz
- De Regenboog Groep, 1013 GE Amsterdam, The Netherlands; (H.L.v.d.G.); (E.S.)
| | - Daniela K. van Santen
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands; (D.K.v.S.); (A.B.); (M.P.)
- Disease Elimination Programs, Burnet Institute, Melbourne, VIC 3004, Australia
| | - Anders Boyd
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands; (D.K.v.S.); (A.B.); (M.P.)
- Stichting HIV Monitoring, 1105 BD Amsterdam, The Netherlands
| | | | - Bert L. C. Baak
- Department of Gastroenterology and Hepatology, OLVG Hospital, 1091 AC Amsterdam, The Netherlands;
| | - Maria Prins
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands; (D.K.v.S.); (A.B.); (M.P.)
- Department of Infectious Diseases, Amsterdam UMC, Location AMC, Amsterdam Infection and Immunity (AII), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Clustering of hepatitis C virus antibody positivity within households and communities in Punjab, India. Epidemiol Infect 2019; 147:e283. [PMID: 31587676 PMCID: PMC6805795 DOI: 10.1017/s0950268819001705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
To better understand hepatitis C virus (HCV) epidemiology in Punjab state, India, we estimated the distribution of HCV antibody positivity (anti-HCV+) using a 2013-2014 HCV household seroprevalence survey. Household anti-HCV+ clustering was investigated (a) by individual-level multivariable logistic regression, and (b) comparing the observed frequency of households with multiple anti-HCV+ persons against the expected, simulated frequency assuming anti-HCV+ persons are randomly distributed. Village/ward-level clustering was investigated similarly. We estimated household-level associations between exposures and the number of anti-HCV+ members in a household (N = 1593 households) using multivariable ordered logistic regression. Anti-HCV+ prevalence was 3.6% (95% confidence interval 3.0-4.2%). Individual-level regression (N = 5543 participants) found an odds ratio of 3.19 (2.25-4.50) for someone being anti-HCV+ if another household member was anti-HCV+. Thirty households surveyed had ⩾2 anti-HCV+ members, whereas 0/1000 (P < 0.001) simulations had ⩾30 such households. Excess village-level clustering was evident: 10 villages had ⩾6 anti-HCV+ members, occurring in 31/1000 simulations (P = 0.031). The household-level model indicated the number of household members, living in southern Punjab, lower socio-economic score, and a higher proportion having ever used opium/bhuki were associated with a household's number of anti-HCV+ members. Anti-HCV+ clusters within households and villages in Punjab, India. These data should be used to inform screening efforts.
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Litzroth A, Suin V, Wyndham-Thomas C, Quoilin S, Muyldermans G, Vanwolleghem T, Kabamba-Mukadi B, Verburgh V, Jacques M, Van Gucht S, Hutse V. Low hepatitis C prevalence in Belgium: implications for treatment reimbursement and scale up. BMC Public Health 2019; 19:39. [PMID: 30621662 PMCID: PMC6325873 DOI: 10.1186/s12889-018-6347-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/19/2018] [Indexed: 01/20/2023] Open
Abstract
Background Prevalence data of chronic hepatitis C virus (HCV) infection are needed to estimate the budgetary impact of reimbursement of direct-acting antivirals (DAAs). In Belgium, the restricted reimbursement criteria are mainly guided by regional seroprevalence estimates of 0.87% from 1993 to 1994. In this first Belgian nationwide HCV prevalence study, we set out to update the seroprevalence and prevalence of chronic HCV infection estimates in the Belgian general population in order to guide decisions on DAA reimbursement. Methods Residual sera were collected through clinical laboratories. We collected data on age, sex and district. HCV antibody status was determined with ELISA and confirmed with a line-immunoassay (LIA). In specimens with undetermined or positive LIA result, HCV viral load was measured. Specimens were classified seronegative, seropositive with resolved infection, indicative of chronic infection and with undetermined HCV status according to the test outcomes. Results were standardized for age, sex and population per district, and adjusted for clustered sampling. Results In total 3209 specimens, collected by 28 laboratories, were tested. HCV seropositivity in the Belgian general population was estimated to be 0.22% (95% CI: 0.09–0.54%), and prevalence of chronic HCV infection 0.12% (95% CI: 0.03–0.41). In individuals of 20 years and older, these estimates were 0.26% (95% CI: 0.10–0.64%) and 0.13% (95% CI: 0.04–0.43), respectively. Of the total estimated number of HCV seropositive individuals in Belgium, 66% were between 50 and 69 years old. Conclusions Prevalence of HCV seropositivity and chronic infection in the Belgian general population were low and comparable to many surrounding countries. These adjusted prevalences can help estimate the cost of reimbursement of DAAs and invite Belgian policy makers to accelerate the scaling up of reimbursement, giving all chronically infected HCV patients a more timely access to treatment.
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Affiliation(s)
- Amber Litzroth
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium.
| | - Vanessa Suin
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Chloé Wyndham-Thomas
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Sophie Quoilin
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Gaëtan Muyldermans
- Scientific directorate Epidemiology and public health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Thomas Vanwolleghem
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken Building S, Universiteitsplein 1, 2610, Wilrijk, Belgium.,Department of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Benoît Kabamba-Mukadi
- Microbiology department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Vera Verburgh
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Marjorie Jacques
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Steven Van Gucht
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
| | - Veronik Hutse
- Scientific directorate Infectious diseases in humans, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium
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Heil J, Hoebe CJPA, Cals JWL, Ter Waarbeek HLG, van Loo IHM, Dukers-Muijrers NHTM. Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing. Ann Fam Med 2018; 16:21-27. [PMID: 29311171 PMCID: PMC5758316 DOI: 10.1370/afm.2166] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/23/2017] [Accepted: 07/12/2017] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Both chronic hepatitis C (HCV) and B virus (HBV) infections are generally asymptomatic, and many remain undetected or are diagnosed at a late stage. Studies that evaluate best practice hepatitis testing strategies are needed to better detect this hidden population. METHODS In this prospective cohort study, we aimed to determine the diagnostic yield (test uptake and rate of positive test results) of a combined public health and primary care birth cohort testing strategy in detecting hidden cases of HCV and HBV infections. We invited all patients aged between 40 and 70 years (n = 6,743) registered with 11 family practices serving 2 higher prevalence areas, or hotspots (ie, estimated HCV prevalence of 1%; national estimated prevalence is 0.1-0.4%), in the south of the Netherlands. RESULTS Test uptake was 50.9% (n = 3,434 patients). No active or chronic HCV infection was detected: 0.00% (95% CI, 0.00%-0.11%). Positive test rates were 0.20% (95% CI, 0.08%-0.42%) for anti-HCV (n = 7), 0.26% (95% CI, 0.12%-0.50%) for hepatitis B surface antigen (n = 9), and 4.14% (95% CI, 3.49%-4.86%) for antihepatitis B core (n = 142). CONCLUSIONS This best practice testing strategy was effective in achieving a high test uptake. It completely failed, however, to detect hidden chronic HCV infections and is not recommended for countries with a low prevalence of the disease.
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Affiliation(s)
- Jeanne Heil
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service (GGD) South Limburg, Heerlen, The Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service (GGD) South Limburg, Heerlen, The Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jochen W L Cals
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Henriëtte L G Ter Waarbeek
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service (GGD) South Limburg, Heerlen, The Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Inge H M van Loo
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service (GGD) South Limburg, Heerlen, The Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
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Hermetet C, Dubois F, Gaudy-Graffin C, Bacq Y, Royer B, Gaborit C, D’Alteroche L, Desenclos JC, Roingeard P, Grammatico-Guillon L. Continuum of hepatitis C care in France: A 20-year cohort study. PLoS One 2017; 12:e0183232. [PMID: 28850623 PMCID: PMC5574535 DOI: 10.1371/journal.pone.0183232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 08/01/2017] [Indexed: 12/17/2022] Open
Abstract
Background Hepatitis C virus (HCV)-infected patients require a specific continuum of care (CoC) from HCV screening to treatment. We assessed CoC of HCV-infected patients in a longitudinal study. Methods We established a cohort of subjects undergoing HCV screening (high alanine aminotransferase levels or risk factors) during preventive consultations at a French regional medical center from 1993 to 2013. Patients were considered to be HCV-infected if HCV RNA was detected in their serum. CoC was assessed as described by Viner et al. (Hepatology 2015): Stage 1, HCV screening; Stage 2, HCV RNA testing; Stage 3, continuing care; Stage 4, antiviral treatment. Cox multivariate analysis was performed to identify factors favoring CoC, defined as at least one course of antiviral treatment. Results In total, 12,993 HCV tests were performed and 478 outpatients were found to be HCV-seropositive. We included 417 seropositive patients, after excluding false positives and patients lost to follow-up. The baseline characteristics of the patients were: sex ratio (M/F) 1.4; mean age 38.5 years; intravenous drug use (IDU) in 55%; and 28% in unstable social situations, estimated by the EPICES deprivation score. Antiviral treatment was initiated for 179 (42.9%) of the 379 (90.9%) patients attending specialist consultations. CoC was associated with screening after 1997 (HR 2.0, 95%CI 1.4–2.9), age > 45 years (HR 1.5, 95%CI 1.02–2.3), patient acceptance of care (HR 9.3, 95%CI 5.4–16.10), specialist motivation for treatment (HR 10.9, 95%CI 7.4–16.0), and absence of cancer (HR 6.7, 95%CI 1.6–27.9). Other comorbid conditions, such as depression and IDU, were not associated with CoC. Conclusions Our 20-year cohort study reveals the real-life continuum of care for HCV-infected patients in France. The number of patients involved in HCV care after positive testing was substantial due to the organization of healthcare in France. An improved CoC along with new direct-acting antivirals should help to decrease chronic HCV infection.
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Affiliation(s)
- Coralie Hermetet
- SIMEES, CHRU de Tours, Laboratoire de Santé Publique, Université François Rabelais, Tours, France
| | - Frederic Dubois
- INSERM U966, Université François Rabelais et CHRU de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, CHRU de Tours, Tours, France
- UC-IRSA, Département 37, La Riche, France
| | - Catherine Gaudy-Graffin
- INSERM U966, Université François Rabelais et CHRU de Tours, Tours, France
- Service de Bactériologie-Virologie-Hygiène, CHRU de Tours, Tours, France
| | - Yannick Bacq
- Service de d'Hépato-gastro-entérologie, CHRU de Tours, Tours, France
| | | | - Christophe Gaborit
- SIMEES, CHRU de Tours, Laboratoire de Santé Publique, Université François Rabelais, Tours, France
| | - Louis D’Alteroche
- Service de d'Hépato-gastro-entérologie, CHRU de Tours, Tours, France
| | | | - Philippe Roingeard
- INSERM U966, Université François Rabelais et CHRU de Tours, Tours, France
- Laboratoire de Biologie Cellulaire, CHRU de Tours, Tours, France
| | - Leslie Grammatico-Guillon
- SIMEES, CHRU de Tours, Laboratoire de Santé Publique, Université François Rabelais, Tours, France
- INSERM U966, Université François Rabelais et CHRU de Tours, Tours, France
- * E-mail:
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The Spatial Distribution of Hepatitis C Virus Infections and Associated Determinants--An Application of a Geographically Weighted Poisson Regression for Evidence-Based Screening Interventions in Hotspots. PLoS One 2015; 10:e0135656. [PMID: 26352611 PMCID: PMC4564162 DOI: 10.1371/journal.pone.0135656] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/23/2015] [Indexed: 12/18/2022] Open
Abstract
Background Hepatitis C Virus (HCV) infections are a major cause for liver diseases. A large proportion of these infections remain hidden to care due to its mostly asymptomatic nature. Population-based screening and screening targeted on behavioural risk groups had not proven to be effective in revealing these hidden infections. Therefore, more practically applicable approaches to target screenings are necessary. Geographic Information Systems (GIS) and spatial epidemiological methods may provide a more feasible basis for screening interventions through the identification of hotspots as well as demographic and socio-economic determinants. Methods Analysed data included all HCV tests (n = 23,800) performed in the southern area of the Netherlands between 2002–2008. HCV positivity was defined as a positive immunoblot or polymerase chain reaction test. Population data were matched to the geocoded HCV test data. The spatial scan statistic was applied to detect areas with elevated HCV risk. We applied global regression models to determine associations between population-based determinants and HCV risk. Geographically weighted Poisson regression models were then constructed to determine local differences of the association between HCV risk and population-based determinants. Results HCV prevalence varied geographically and clustered in urban areas. The main population at risk were middle-aged males, non-western immigrants and divorced persons. Socio-economic determinants consisted of one-person households, persons with low income and mean property value. However, the association between HCV risk and demographic as well as socio-economic determinants displayed strong regional and intra-urban differences. Discussion The detection of local hotspots in our study may serve as a basis for prioritization of areas for future targeted interventions. Demographic and socio-economic determinants associated with HCV risk show regional differences underlining that a one-size-fits-all approach even within small geographic areas may not be appropriate. Future screening interventions need to consider the spatially varying association between HCV risk and associated demographic and socio-economic determinants.
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Whitehead NE, Hearn L, Trenz RC, Burrell LE, Latimer WW. Age cohort differences in illicit drug use and hepatitis C among African American substance users. J Addict Dis 2015; 33:314-21. [PMID: 25299749 DOI: 10.1080/10550887.2014.969605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Identifying prognostic indicators for undiagnosed Hepatitis C is crucial to attenuate the negative impact of this disease. This study explored the influence of recent and more distal injection drug use on biologically confirmed Hepatitis C infection among a sample (N = 260) of older and younger African Americans. Data from the baseline assessment of the NEURO-HIV epidemiologic study was analyzed using confounder adjusted regression techniques. Older adults were more likely to test positive for Hepatitis C (OR = 2.80, 95% CI = 1.53-5.11) due to lifetime injection drug use (AOR = 5.37, 95% CI = 3.10-9.28). Clinical implications are discussed.
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Affiliation(s)
- Nicole Ennis Whitehead
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , Florida , USA
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