TY - JOUR
T1 - Evaluating a novel model of hepatitis B care, Hep B PAST, in the Northern Territory of Australia
T2 - Results from a prospective, population-based study
AU - Hep B PAST partnership
AU - Hosking, Kelly
AU - Binks, Paula
AU - De Santis, Teresa
AU - Wilson, Phillip Merrdi
AU - Gurruwiwi, George Garambaka
AU - Bukulatjpi, Sarah Mariyalawuy
AU - Vintour-Cesar, Emily
AU - McKinnon, Melita
AU - Nihill, Peter
AU - Fernandes, Tammy Allyn
AU - Greenwood-Smith, Belinda
AU - Batey, Robert
AU - Ross, Cheryl
AU - Tong, Steven Y.C.
AU - Stewart, Geoffrey
AU - Marshall, Catherine
AU - Gargan, Catherine
AU - Manchikanti, Prashanti
AU - Fuller, Karen
AU - Tate-Baker, Jaclyn
AU - Stewart, Sami
AU - Cowie, Benjamin
AU - Allard, Nicole
AU - MacLachlan, Jennifer H.
AU - Qama, Ashleigh
AU - Boettiger, David
AU - Davis, Joshua S.
AU - Connors, Christine
AU - Davies, Jane
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/7
Y1 - 2024/7
N2 - 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.
AB - 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.
KW - Chronic hepatitis B
KW - First Nations peoples
KW - Global public health
KW - Hepatitis B virus
KW - Primary healthcare
UR - http://www.scopus.com/inward/record.url?scp=85195557871&partnerID=8YFLogxK
U2 - 10.1016/j.lanwpc.2024.101116
DO - 10.1016/j.lanwpc.2024.101116
M3 - Article
AN - SCOPUS:85195557871
SN - 2666-6065
VL - 48
SP - 1
EP - 11
JO - The Lancet Regional Health - Western Pacific
JF - The Lancet Regional Health - Western Pacific
M1 - 101116
ER -