Evaluation of the Cherokee Nation Hepatitis C Virus Elimination Program in the First 22 Months of Implementation.
Evaluation of the Cherokee Nation Hepatitis C Virus Elimination Program in the First 22 Months of Implementation.
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DOI：
10.1001/jamanetworkopen.2020.30427
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发表时间：
2020-12-01
影响因子：
13.8
通讯作者：
Carabin H
中科院分区：
文献类型：
--
作者：
Mera J;Williams MB;Essex W;McGrew KM;Boeckman L;Gahn D;Miller A;Durham D;Fox J;David C;Ritter T;Jones S;Bouse S;Galvani A;Ward JW;Drevets DA;Carabin H
This cohort study evaluates the first 22 months of implementation of the Cherokee Nation Heath Services community-based program designed to eliminate hepatitis C virus (HCV) infection. Can a community-based tribal hepatitis C virus (HCV) elimination program be implemented successfully in a rural setting? In this cohort study, first-time HCV screening coverage increased from 20.9% to 38.2% from 3 years before to 22 months into implementation of the Cherokee Nation Health Services HCV elimination program. Identification, treatment, and cure of newly identified current HCV infections increased. In this study, implementation of a community-based HCV elimination program was associated with an improved cascade of care; this information may serve other organizations planning to implement similar programs in large rural areas. In 2019, hepatitis C virus (HCV) infection contributed to more deaths in the US than 60 other notifiable infectious diseases combined. The incidence of and mortality associated with HCV infection are highest among American Indian and Alaska Native individuals. To evaluate the association of the Cherokee Nation (CN) HCV elimination program with each element of the cascade of care: HCV screening, linkage to care, treatment, and cure. This cohort study used data from the CN Health Services (CNHS), which serves approximately 132 000 American Indian and Alaska Native individuals residing in the 14-county CN reservation in rural northeastern Oklahoma. Data from the first 22 months of implementation (November 1, 2015, to August 31, 2017) of an HCV elimination program were compared with those from the pre–elimination program period (October 1, 2012, to October 31, 2015). The analysis included American Indian and Alaska Native individuals aged 20 to 69 years who accessed care through the CNHS between October 1, 2012, and August 31, 2017. Cure data were recorded through April 15, 2018. The CN HCV elimination program. The main outcomes were the proportions of the population screened for HCV, diagnosed with current HCV infection, linked to care, treated, and cured during the initial 22 months of the elimination program period and the pre–elimination program period. Data from electronic health records and an HCV treatment database were analyzed. The cumulative incidence of HCV infection in this population was estimated using bayesian analyses. Among the 74 039 eligible individuals accessing care during the elimination program period, the mean (SD) age was 36.0 (13.5) years and 55.9% were women. From the pre–elimination program period to the elimination program period, first-time HCV screening coverage increased from 20.9% to 38.2%, and identification of current HCV infection and treatment in newly screened individuals increased from a mean (SD) of 170 (40) per year to 244 (4) per year and a mean of 95 (133) per year to 215 (9) per year, respectively. During the implementation period, of the 793 individuals with current HCV infection accessing the CNHS, 664 were evaluated (83.7%), 394 (59.3%) initiated treatment, and 335 (85.0%) had documented cure. In less than 2 years, the 85% 3-year goal was reached for cure (85.0%), and the goal for linkage to care was nearly reached (83.7%), whereas screening (44.1%) and treatment initiation (59.3%) required more time and resources. This cohort study found that after 22 months of implementation, the CNHS community-based HCV elimination program was associated with an improved cascade of care. The facilitators and lessons learned in this program may be useful to other organizations planning similar programs.
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1975年至2012年，向国家报告癌症状况的年度报告，其发病率不断增加。
影响因子：
6.2
作者：
Ryerson AB;Eheman CR;Altekruse SF;Ward JW;Jemal A;Sherman RL;Henley SJ;Holtzman D;Lake A;Noone AM;Anderson RN;Ma J;Ly KN;Cronin KA;Penberthy L;Kohler BA
通讯作者：
Kohler BA
影响因子：
4.3
作者：
Omran D;Alboraie M;Zayed RA;Wifi MN;Naguib M;Eltabbakh M;Abdellah M;Sherief AF;Maklad S;Eldemellawy HH;Saad OK;Khamiss DM;El Kassas M
通讯作者：
El Kassas M
影响因子：
39.2
作者：
Dore, Gregory J.;Altice, Frederick;Platt, Heather L.
通讯作者：
Platt, Heather L.
影响因子：
33.7
作者：
Schillie, Sarah;Wester, Carolyn;Ryerson, A. Blythe
通讯作者：
Ryerson, A. Blythe
影响因子：
33.9
作者：
Nasrullah, Muazzam;Sergeenko, David;Averhoff, Francisco
通讯作者：
Averhoff, Francisco