Cdn.ymaws.com



National Assessment of Hepatitis C Surveillance CapacityThe Hepatitis C Taskforce of the Council of State and Territorial Epidemiologists (CSTE) created an assessment to better understand Hepatitis C Surveillance Policies and Regulations, Laboratory Reporting, Hepatitis C Case Investigations, and Hepatitis C Data Management. The assessment was distributed to fifty states and eight select local health departments in the United States. Methods:In May 2015, CSTE distributed the web-based (SurveyMonkey?) National Hepatitis C Surveillance Capacity Assessment to the state epidemiologist in all 50 states and Washington, DC, and to the CSTE epidemiology point of contact in six US territories and eight large local health departments in the United States. Fifty-one respondents have completed the assessment at the time of this preliminary analysis. Results:Hepatitis C Virus (HCV) Surveillance Policies and Regulations: Of the 51 responding jurisdictions, 44 (85%) indicated Hepatitis C Virus (HCV) infection is reportable as an acute and/or chronic (defined as past/present, non-acute) condition and five (10%) respondents indicated HCV infection is reportable as an acute condition only; two (3%) jurisdictions specified HCV is not reportable. Of the 49 jurisdictions, where HCV is reportable, a majority (62%) have regulations worded such that any evidence of HCV infection is reportable. The following tests (Figure 1) are reportable in over 85% (n=42) of jurisdictions: standard HCV antibodies, HCV genotype, and HCV RNA (e.g. PCR, NAAT) – positive tests only. Nearly all (98%, n=48) jurisdictions use standard HCV antibodies with high signal-to-cut-off ratio as indicative of infection. 43815010477500 Approximately half (49%) of respondents noted negative RNA tests are not received, while many distinguished that negative results are not currently mandated within the respective jurisdiction (Table 1). 466725635000Electronic Laboratory Reports (ELR): All respondents indicated that they currently have capacity to receive electronic laboratory reports; however, only 27 (55%) indicated that they receive most laboratory tests electronically. Over 90% of jurisdictions receive ELRs for HCV RNA positive results. Table 2: Electronic Lab Reports received for HCV (N=51)????No.%HCV RNA positive results4592%HCV RNA negative results - only as part of a panel2755%HCV RNA negative results - separate results, not part of a panel1122%HCV Ab4184%HCV Ab with signal-to-cut-off ratio4490%Genotype4082%Not applicable36% A majority (86%, n=42) of respondents indicated that they de-duplicate HCV ELR person/cases, of which 37 (88%) append the new laboratory test results to the existing events. The remaining seven respondents cited limited workforce capacity and current surveillance systems as the main barriers to de-duplicating HCV laboratory person/cases. HCV Case Investigations:Nearly all (98%, n=48) of respondents currently use the CSTE/CDC case definitions for classifying hepatitis C, acute infection. The most common HCV cases investigated as suspect acute HCV infection are cases with evidence of jaundice (63%), elevated ALT/AST laboratory test (61%), and provider reported acute disease (80%) (Table 3) (Figure 2). 38100013111900Amongst the 17 jurisdictions that reported investigating age-specific groups for acute infection, the most common was the under 30 year old age group. Of the jurisdictions who reported that they could report specific numbers in 2013, the average number of potential acute HCV infections investigated was 355. Nevertheless, there was only an average of 40 reported cases of confirmed acute hepatitis C infections. When compared to past or present (non-acute) infections, only 90% use the CSTE/CDC case definitions for classification; however, 27 (55%) jurisdictions do not investigate non-acute cases of HCV infection (Table 3) (Figure 3). Some states indicated that there is a variation by county, as some have the resources, while others do not. 77152514097000HCV Data Management:Eight-six percent of respondents have included HCV surveillance as part of an integrated disease surveillance and case management system compared to a stand-along surveillance system. (Table 4) Finally, if the HCV case definitions were changed, 22 (45%) jurisdictions indicated that it would not be possible to retrospectively change previously assigned case classifications to assure longitudinally consistent data.-1333501079500Table 4: Current state of HCV Data Management ??????No.%HCV surveillance is included as part of an integrated disease surveillance and case management systemYes4286%No714%Presence of a backlog of paper-based HCV laboratory test results to be enteredYes, more than 1 year's worth918%Yes, more than 6 month's worth510%Yes, more than 1 month's worth714%Minimal918%No1939%Presence of a backlog of paper-based HCV case report forms to be enteredYes, more than 1 year's worth36%Yes, more than 6 month's worth24%Yes, more than 1 month's worth612%Minimal714%No3265% ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download