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Evaluating a novel model of hepatitis B care, Hep B PAST, in the Northern Territory of Australia: results from a prospective, population-based study.
Hosking, Kelly; Binks, Paula; De Santis, Teresa; Wilson, Phillip Merrdi; Gurruwiwi, George Garambaka; Bukulatjpi, Sarah Mariyalawuy; Vintour-Cesar, Emily; McKinnon, Melita; Nihill, Peter; Fernandes, Tammy-Allyn; Greenwood-Smith, Belinda; Batey, Robert; Ross, Cheryl; Tong, Steven Y C; Stewart, Geoffrey; Marshall, Catherine; Gargan, Catherine; Manchikanti, Prashanti; Fuller, Karen; Tate-Baker, Jaclyn; Stewart, Sami; Cowie, Benjamin; Allard, Nicole; MacLachlan, Jennifer H; Qama, Ashleigh; Boettiger, David; Davis, Joshua S; Connors, Christine; Davies, Jane.
Affiliation
  • Hosking K; Northern Territory Health, Northern Territory, Australia.
  • Binks P; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • De Santis T; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Wilson PM; Northern Territory Health, Northern Territory, Australia.
  • Gurruwiwi GG; Northern Territory Health, Northern Territory, Australia.
  • Bukulatjpi SM; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Vintour-Cesar E; Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia.
  • McKinnon M; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Nihill P; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Fernandes TA; Northern Territory Health, Northern Territory, Australia.
  • Greenwood-Smith B; Northern Territory Health, Northern Territory, Australia.
  • Batey R; Northern Territory Health, Northern Territory, Australia.
  • Ross C; Northern Territory Health, Northern Territory, Australia.
  • Tong SYC; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Stewart G; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Marshall C; Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
  • Gargan C; Victorian Infectious Diseases Service, The Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
  • Manchikanti P; Northern Territory Health, Northern Territory, Australia.
  • Fuller K; Northern Territory Health, Northern Territory, Australia.
  • Tate-Baker J; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Stewart S; Northern Territory Health, Northern Territory, Australia.
  • Cowie B; Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia.
  • Allard N; Katherine West Health Board, Katherine, Northern Territory, Australia.
  • MacLachlan JH; Northern Territory Health, Northern Territory, Australia.
  • Qama A; Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, NSW, Australia.
  • Boettiger D; WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Victoria, Australia.
  • Davis JS; Department of Infectious Diseases, University of Melbourne, Parkville, Australia.
  • Connors C; WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Victoria, Australia.
  • Davies J; Department of Infectious Diseases, University of Melbourne, Parkville, Australia.
Lancet Reg Health West Pac ; 48: 101116, 2024 Jul.
Article in En | MEDLINE | ID: mdl-38966601
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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Lancet Reg Health West Pac Year: 2024 Document type: Article Affiliation country: Australia Country of publication: United kingdom
Fulltext
Add to My VHL
Print
XML
PubMed Links
Search on Google

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Lancet Reg Health West Pac Year: 2024 Document type: Article Affiliation country: Australia Country of publication: United kingdom