Design and results of a pilot community screening strategy for hepatitis B and hepatitis C to promote early access to treatment among migrant populations from high-prevalence countries residing in Catalonia (MiCatC).

内容摘要

The elimination of hepatitis C virus (HCV) and hepatitis B virus (HBV) requires strategies to overcome barriers associated with access to healthcare among migrants. The objective was to design and implement a community-screening-strategy (MiCat) for HBV and HCV among migrant populations from high-prevalence countries residing in Catalonia. A pilot community-screening was conducted in religious sites, associations or community centres. A multidisciplinary team consisting of peer educators, community health agents, and nurses was established. interventions consisted of workshops pertaining to viral hepatitis, rapid tests featuring onsite results and the collection of dried blood samples for HCV RNA test if anti-HCV-positive result. HBsAg-positive and/or HCV-RNA-positive participants were contacted and referred for hepatology. A total of 1,505 people (71% men; 68% Pakistani) were screened over 10 months. Of the total, 71% were long-term residents in Catalonia (>5 years). The history of exposure was more common among women. A total of individuals tested, 3% (95% CI 2.2-4.0) (n=44) were HBsAg-positive (91% men; 33% new diagnoses), 36.4% (n=16) referred to hepatology (33% women) and 2 treated; and a 3.3% (95% CI 2.42-4.28) (n=49) were anti-HCV-positive (84% men), of these 32.6% (n=16) were HCV-RNA-positive (1.06% viremia prevalence; all new diagnoses), 13 patients completed the treatment. MiCatC project was able to detect, link to care and treat migrant population from countries with high prevalence of HCV and/or HBV based on a multidisciplinary team including community assets. It is essential to include the gender perspective to ensure that migrant women with hepatitis can receive specialised care.