Modelling jurisdictional disparities in the cascade of care for chronic hepatitis B in Australia: impact of treatment uptake on mortality.
Aust N Z J Public Health
; 47(1): 100011, 2023 Feb.
Article
en En
| MEDLINE
| ID: mdl-36638581
ABSTRACT
OBJECTIVE:
Investigate the cascade of care for chronic hepatitis B (CHB) and estimate impacts of increasing treatment uptake on attributable burden, according to jurisdiction.METHODS:
A mathematical model of CHB in Australia was utilised, combined with notifiable disease and Medicare data. We estimated the proportion with CHB who were diagnosed, engaged in care and receiving treatment in each state/territory, and projected future mortality.RESULTS:
The highest uptake of all measures was in New South Wales, however, the largest increase over time occurred in Northern Territory. No jurisdiction is due to meet 2022 targets of treatment uptake or mortality reduction. Previously declining mortality is predicted to plateau or increase in all jurisdictions except Northern Territory. The largest gap in the cascade of care was most commonly diagnosed individuals not engaged in care; however, in Victoria and Tasmania it was lack of diagnosis.CONCLUSIONS:
Measures of the cascade of care varied substantially between jurisdictions; while all require improvements to reduce mortality, the specific gaps vary, as do potential impacts. IMPLICATIONS FOR PUBLIC HEALTH Improving the cascade of care for CHB will require jurisdictionally tailored approaches. If improvements are not made, more deaths will occur due to CHB in most states and territories.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hepatitis B Crónica
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Aspecto:
Implementation_research
Límite:
Aged
/
Humans
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Aust N Z J Public Health
Asunto de la revista:
SAUDE PUBLICA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Australia