Hepatitis Information and testing and ethnic groups

1. Sheffield Infection Group
Hepatitis B: reaching out to high risk communities
Alicia Vedio1, Fran Rayner1, Ray Poll1, Helena Ellam2, Goura Kudesia2, Mike McKendrick1
1Department of Infection and Tropical Medicine & 2Department of Virology
Sheffield is a city of half a million inhabitants of which 14% belong to black and minority ethnic groups (BME).
National statistics estimate 17,000 Pakistani, 9000 Somali, 6000 Chinese, 3000 Bangladeshi1.
The prevalence of hepatitis B and Barriers to integration studies in
C in countries of origin is high, and these groups have concluded
studies have shown that it is also that factors such as language,
high in immigrants to western cultural differences, failure to
countries and their descendants2. understand the system and lack of
differential provision, contribute to
However, knowledge of these diminished access to health care
conditions, transmission routes, and late presentation of chronic
prevention and complications are conditions4.
low3.
The community program involves: Areas of gathering: Hepatitis B leaflet
Community centre, Saturday school, church, trade centre
1.!Empowering community workers
to develop a strategy of hepatitis
outreach
2.!Providing hepatitis education
3.!Testing using dried blood spot (DBS) Community Health Coordinators
Health Educators
Hepatitis Services Translators
Monitoring + Treatment
Validation of DBS in the laboratory
resulted in a 98% sensitivity and 100%
specificity for combined HBsAg and
HBcAb and 100% sensitivity and
specificity for HCAb compared to Awareness “The initial part of this project was funded by Gilead
serum. Education
UK and Ireland Fellowship Program
Hepatitis Testing (DBS)
Diabetes
Smoking cessation
Results: Cardiovascular Health
231 people from ethnic groups were tested in 12 sessions between September 2009 and September 2011.
Chinese F 113 48 9 8 14 12 0 - 9 1 2 already diag – all F HB eAb+
200
M 87 47 9 10 12 14 0 - 8 1 1 already diag – 1 untreaceable
3 HB eAg+
SEAsian F 16 47 0 - 2 13 0 - - -
231 NAfrican
M.East M 13 51 0 - 3 23 1 1 1 1 Mother Hep C +
29 Patient treated = SVR
F 1 - 0 - 0 - 0 - - -
Other
2 M 1 - 0 - 0 - 0 - - -
Feedback from workers and Conclusion: A strategy of outreach testing using DBS and education with
users showed a 100%
full involvement of community workers is well accepted and enhances
acceptance and request for
liaison with ethnic groups at risk, facilitating diagnosis and treatment.
more sessions. Comments were
very positive and 92% thought References:
1- Office for National Statistics 2008
the test did not cause any 2- Lin SY, Chang ET, So SK. Why we should routinely screen Asian American adults for hepatitis B: a cross-sectional study of Asians in California.
Hepatology 2007
discomfort. 3- Nguyen TT, McPhee SJ, et al. Hepatitis B awareness, knowledge, and screening among Asian Americans. J Cancer Educ. 2007
4- Sczepura A. Access to health care for ethnic minority populations. Postgrad Med J, 2005