Effectiveness of Interventions for Hepatitis B and C: A Systematic Review of Vaccination, Screening, Health Promotion and Linkage to Care Within Higher Income Countries

Abstract

Multiple scales have been developed to measure HIV-related stigma among healthcare providers in lower and middle-income countries. As part of this study to measure HIV stigma in healthcare providers in Australia, we conducted a systematic search to identify and evaluate existing tools designed to measure HIV-related Knowledge, Attitudes and Practices (KAPs) among healthcare providers in higher-income countries. Seven studies were identified that quantitatively assessed perceived HIV stigma among healthcare providers from the patient and/or provider perspectives, including HIV stigma as a primary outcome. These seven studies identified adapted forms of four HIV stigma scales. Assessment of HIV stigma among providers is valuable to better understand how this phenomenon may adversely impact health outcomes, and to inform interventions to reduce stigma and improve healthcare. Developing provider-centred stigma-reduction interventions may also help advance international HIV prevention and care goals.

Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission

“…However, these values are probably underestimates because, among other reasons, the data are obtained from blood donors [2]. Moreover, the situation in Europe may be adversely affected by changing patterns of migration [3,4]. According to a systematic review conducted by the European Centre for Disease Prevention and Control (ECDC) [5] based on articles published from 2005 to 2015, the prevalence in Spain was around 0.8% (0.6-1.1) and according to the latest report available [3] it was 0.66% (0.34-0.97).…”

Early detection of chronic hepatitis B and risk factor assessment in Turkish migrants, Middle Limburg, Belgium

“…Less than one in five susceptible individuals initiated hepatitis B vaccination. This is lower than the reported 52–89% among migrant populations in the USA and might be explained by 1) dissimilar populations, 2) free of charge vaccination or vaccination at a reduced price and 3) the use of a combination of letters, phone calls, e-mail and in-person appointments to contact susceptible individuals for vaccination in these studies [ 11 , 34 – 38 ]. This is in contrast to our study, in which susceptible individuals were invited by a letter to consult their general practitioner for hepatitis B vaccination in accordance with standard practices in Belgium.…”

“…We showed a successful referral of more than 90% newly diagnosed patients with chronic HBV infection. The implementation of a pre-screening phase with awareness activities among general practitioners and delegates of Turkish organizations as well as the impact of educational meetings on the Turkish migrant population to make an informed decision to participate in screening, might explain the good compliance to referral [ 11 ]. Within one year of follow-up, all newly diagnosed patients had HBeAg-negative chronic infection based on normal ALT levels, low HBV DNA levels, HBeAg negative status and no significant fibrosis [ 31 ].…”

“…Most studies concerning hepatitis B testing in FGM involved southeast Asians in the USA, Canada and Australia [11]. A cross-sectional study in Turkish FGM in Germany showed a prevalence of 5% for chronic HBV infection, and this was 3% in a study conducted in the Netherlands [12,13].…”

A qualitative exploration of enablers for hepatitis B clinical management among ethnic Chinese in Australia

“…In addition, hepatitis B‐related stigma and/or fear of being stigmatized, as well as the fear of social implications such as being rejected for jobs or residency applications due to CHB, further impede people from being engaged in CHB clinical management 13,14 . In response, programmes have been developed to engage people with CHB in care including outreach campaigns, community or health facility‐based educational activities and screening programmes 15–17 . However, research to date has primarily focused on increasing hepatitis B testing and treatment uptake, with limited evidence identifying how to support infected individuals attend and stay engaged in regular clinical management, especially those not currently receiving treatment based on clinical guidelines 4,5…”