ABSTRACT
Background:
The
Northern Territory (NT) has the highest
prevalence of
chronic hepatitis B (CHB) in
Australia. The Hep B PAST program aims to improve
health outcomes for people living with CHB.
Methods:
This mixed
methods study involves First Nations peoples living in the NT. We used participatory
action research principles across three
steps:
1.
Foundation step establishing
hepatitis B virus (HBV) status and linkage to care; 2.
Capacity building training the
health workforce; 3. Supported transition to
primary healthcare implementation of the "Hub and Spoke" model and in-
language resources.
Analysis occurred at three
time points 1. Pre-Hep B PAST (2018); 2.
Foundation step (2020); and 3. Completion of Hep B PAST (2023). Evaluation focuses on four key
indicators, the number of people 1) with documented HBV status; 2) diagnosed with CHB; 3) receiving care; and 4) receiving
treatment.
Findings:
Hep B PAST (2018-23) reached 40,555 people. HBV status was documented in 11% (1192/10,853), 79.2% (26,075/32,915) and 90.8% (28,675/31,588) of people at pre-Hep B PAST,
foundation step, and completion respectively. An estimated 99.9% (821/822) of people were diagnosed, 86.3% (709/822) engaged in care, and 24.1% (198/822) on
antiviral treatment at completion. CHB
prevalence in the study
population is 2.6%, decreasing from 6.1% to 0.4% in the pre- and post-
vaccination cohorts.
Interpretation:
Hep B PAST is an effective model of care. Partner
health services are exceeding elimination targets. This model could enable other countries to enhance the cascade of care and
work towards eliminating HBV.
Funding:
National
Health and
Medical Research Council.