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02.12.2021 | Original Article

Development of an intervention system for linkage-to-care and follow-up for hepatitis B and C virus carriers

verfasst von: Minami Kikuchi, Motoji Sawabe, Haruyo Aoyagi, Kosho Wakae, Koichi Watashi, Satoru Hattori, Naoto Kawabe, Kentaro Yoshioka, Junko Tanaka, Masamichi Muramatsu, Takaji Wakita, Hideki Aizaki

Erschienen in: Hepatology International | Ausgabe 1/2022

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Abstract

Background

Poor connections in the cascade of viral hepatitis care have been discussed around the world. In 2011 in Japan, 500,000 to 1.25 million hepatitis B and C virus carriers needed to consult with hepatologists, so linkage-to-care (LTC) needs to be promoted. Therefore, in this study, to improve LTC and care-seeking behaviors, we attempted to establish a community-based intervention system and evaluate its effectiveness by analyzing behavior modifications.

Methods

In a model city, Okazaki (population: 387,887 as of 2019), LTC was encouraged among HBV and HCV carriers by annually mailed brochures, and their care-seeking behaviors were followed up through questionnaires for 8 years (2012–2019). Their behavior modifications and demographic characteristics were analyzed anonymously in cooperation with community health workers, hepatologists, and researchers.

Results

Through regional HBsAg and anti-HCV screening, 333 HBV and 208 HCV carriers were identified. Before the intervention, only 34.7% (25/72) of HBV- and 34.3% (24/70) of HCV-positive individuals had consulted with hepatologists. However, in 2019, after the intervention, these proportions increased to 79.8% (91/114) and 91.2% (52/57), respectively. Access to outpatient care and treatment uptake also continuously improved. However, individuals over 70 years of age were significantly less likely to engage in care-seeking behaviors (p < 0.05), and significantly fewer HCV-positive females received treatment (p = 0.03).

Conclusions

A paper-based reiterative intervention encouraging LTC and follow-up successfully improved the care-seeking behaviors of hepatitis virus-positive individuals and enabled their behavior modifications to be monitored. Further trials are required to advance the system by age- and gender-specific interventions.

Graphical Abstract

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Titel: Development of an intervention system for linkage-to-care and follow-up for hepatitis B and C virus carriers
verfasst von: Minami Kikuchi
Motoji Sawabe
Haruyo Aoyagi
Kosho Wakae
Koichi Watashi
Satoru Hattori
Naoto Kawabe
Kentaro Yoshioka
Junko Tanaka
Masamichi Muramatsu
Takaji Wakita
Hideki Aizaki
Publikationsdatum: 02.12.2021
Verlag: Springer India
Erschienen in: Hepatology International / Ausgabe 1/2022
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-021-10269-5

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Abstract

Background

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