Point-of-Care Tests for Hepatitis B Are Associated with A Higher Linkage to Care and Lower Cost Compared to Venepuncture Sampling During Outreach Screenings in an Asian Migrant Population.
Belgium
/ epidemiology
China
/ ethnology
Continuity of Patient Care
/ statistics & numerical data
Emigrants and Immigrants
/ statistics & numerical data
Female
Health Care Costs
Hepatitis B Surface Antigens
/ blood
Hepatitis B, Chronic
/ blood
Humans
Male
Mass Screening
/ economics
Middle Aged
Point-of-Care Testing
/ economics
Seroepidemiologic Studies
Serologic Tests
/ economics
Journal
Annals of global health
ISSN: 2214-9996
Titre abrégé: Ann Glob Health
Pays: United States
ID NLM: 101620864
Informations de publication
Date de publication:
16 07 2020
16 07 2020
Historique:
entrez:
4
8
2020
pubmed:
4
8
2020
medline:
6
7
2021
Statut:
epublish
Résumé
This study compares venepuncture versus point-of-care (POC) HBsAg tests on screening cost and linkage to care in prospective outreach screenings in an Asian population in three major cities in Belgium between 10/2014 and 5/2018. Two community outreach screening programs were organised between 10/2014 and 5/2018. The first screening program used venepuncture and serologic testing for HBsAg. In the second program, HBsAg was tested in finger stick blood POC tests. Positive results were confirmed during outpatient visits with serologic testing. Linkage to care was defined as having received specialist care follow-up with at least one abdominal ultrasound within three months of screening. For 575 participating individuals, 571 valid results were obtained, 456 with venepuncture, and 115 using POC testing. Overall HBsAg seroprevalence was 6.8%. Linkage to care was higher when using POC testing compared to venepuncture (86% or n = 6/7 versus 34% or n = 11/32; p = 0.020). The POC screening program was economically more attractive with a total cost of € 1,461.8 or € 12.7 per person screened compared to € 24,819 or € 54.0 per person screened when using venepuncture testing. Results and an appointment for specialist care follow-up were given onsite with POC testing, while with venepuncture testing; results were sent within 20-45 days. In an Asian migrant population in Belgium with an HBsAg seroprevalence of 6.8%, HBV screening based on POC tests resulted in lower costs per person screened (76.5% lower), and higher linkage to care (2.5 times).
Sections du résumé
Background
This study compares venepuncture versus point-of-care (POC) HBsAg tests on screening cost and linkage to care in prospective outreach screenings in an Asian population in three major cities in Belgium between 10/2014 and 5/2018.
Methods
Two community outreach screening programs were organised between 10/2014 and 5/2018. The first screening program used venepuncture and serologic testing for HBsAg. In the second program, HBsAg was tested in finger stick blood POC tests. Positive results were confirmed during outpatient visits with serologic testing. Linkage to care was defined as having received specialist care follow-up with at least one abdominal ultrasound within three months of screening.
Results
For 575 participating individuals, 571 valid results were obtained, 456 with venepuncture, and 115 using POC testing. Overall HBsAg seroprevalence was 6.8%. Linkage to care was higher when using POC testing compared to venepuncture (86% or n = 6/7 versus 34% or n = 11/32; p = 0.020). The POC screening program was economically more attractive with a total cost of € 1,461.8 or € 12.7 per person screened compared to € 24,819 or € 54.0 per person screened when using venepuncture testing. Results and an appointment for specialist care follow-up were given onsite with POC testing, while with venepuncture testing; results were sent within 20-45 days.
Conclusion
In an Asian migrant population in Belgium with an HBsAg seroprevalence of 6.8%, HBV screening based on POC tests resulted in lower costs per person screened (76.5% lower), and higher linkage to care (2.5 times).
Identifiants
pubmed: 32742939
doi: 10.5334/aogh.2848
pmc: PMC7366862
doi:
Substances chimiques
Hepatitis B Surface Antigens
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
81Informations de copyright
Copyright: © 2020 The Author(s).
Déclaration de conflit d'intérêts
The authors have no competing interests to declare.
Références
BMC Infect Dis. 2016 Aug 15;16(1):415
pubmed: 27526685
J Infect Public Health. 2013 Dec;6(6):448-55
pubmed: 23999342
J Hepatol. 2012 Apr;56(4):908-43
pubmed: 22424438
PLoS One. 2016 Mar 08;11(3):e0150176
pubmed: 26954020
Hepatology. 2015 Jul;62(1):87-100
pubmed: 25808668
J Hepatol. 2012 Dec;57(6):1171-6
pubmed: 22885717
Hepatol Int. 2014 Aug 01;8(4):478-92
pubmed: 25298848
J Epidemiol Glob Health. 2016 Dec;6(4):277-284
pubmed: 27373603
J Hepatol. 2017 Aug;67(2):370-398
pubmed: 28427875
Public Health Rep. 2016 May-Jun;131 Suppl 2:20-8
pubmed: 27168657
BMC Public Health. 2017 Sep 26;17(1):747
pubmed: 28950835
Lancet. 2017 Sep 16;390(10100):1151-1210
pubmed: 28919116
J Hepatol. 2013 Mar;58(3):473-8
pubmed: 23183527
BMC Infect Dis. 2013 Apr 18;13:181
pubmed: 23597411
Theor Biol Med Model. 2017 May 18;14(1):11
pubmed: 28521828
Hepatology. 1994 Jul;20(1 Pt 1):15-20
pubmed: 8020885
J Clin Virol. 2014 Jul;60(3):200-5
pubmed: 24794796
AIDS. 2012 Oct 23;26(16):2059-67
pubmed: 22781227
J Hepatol. 2013 May;58(5):890-7
pubmed: 23333446
J Clin Virol. 2015 Jul;68:79-82
pubmed: 26071342