Details:

Alternative Title:
PLoS One
Personal Author:
Roberts, Henry ; Boktor, Sameh W. ; Waller, Kirsten ; Daar, Zahra S. ; Boscarino, Joseph A. ; ... More +
Roberts, Henry ; Boktor, Sameh W. ; Waller, Kirsten ; Daar, Zahra S. ; Boscarino, Joseph A. ; Dubin, Perry H. ; Suryaprasad, Anil ; Moorman, Anne C. Less -
Description:
Context

In Pennsylvania, reporting of viral hepatitis B (HBV) and viral hepatitis C (HCV) infections to CDC has been mandated since 2002. Underreporting of HBV and HCV infections has long been identified as a problem. Few reports have described the accuracy of state surveillance case registries for recording clinically-confirmed cases of HBV and HCV infections, or the characteristics of populations associated with lower rates of reporting.

Objective

The primary objective of the current study is to estimate the proportion of HBV and HCV infections that went unreported to the Pennsylvania Department of Health (PDoH), among patients in the Geisinger Health System of Pennsylvania. As a secondary objective, we study the association between underreporting of HBV and HCV infections to PDoH, and the select patient characteristics of interest: sex, age group, race/ethnicity, rural status, and year of initial diagnosis.

Design

Per medical record review, the study population was limited to Geisinger Health System patients, residing in Pennsylvania, who were diagnosed with a chronic HBV and/or HCV infection, between 2001 and 2015. Geisinger Health System patient medical records were matched to surveillance records of confirmed cases reported to the Pennsylvania Department of Health (PDoH). To quantify the extent that underreporting occurred among the Geisinger Health System study participants, we calculated the proportion of study participants that were not reported to PDoH as confirmed cases of HBV or HCV infections. An analysis of adjusted prevalence ratio estimates was conducted to study the association between underreporting of HBV and HCV infections to PDoH, and the select patient characteristics of interest.

Results

Geisinger Health System patients living with HBV were reported to PDoH 88.4% (152 of 172) of the time; patients living with HCV were reported to PDoH 94.6% (2,257 of 2,386) of the time; and patients who were co-infected with both viruses were reported to PDoH 72.0% (18 of 25) of the time. Patients living with HCV had an increased likelihood of being reported if they were: less than or equal to age 30 vs ages 65+ {PR = 1.2, [95%CI, (1.1, 1.3)]}, and if they received their initial diagnosis of HCV during the 2010–2015 time period vs the 1990–1999 time period {PR = 1.08, [95%CI, (1.05, 1.12)]}.

Conclusion

The findings in this study are promising, and suggests that PDoH has largely been successful with tracking and monitoring viral hepatitis B and C infections, among persons that were tested for HBV and/or HCV. Additional efforts should be placed on decreasing underreporting rates of HCV infections among seniors (ages 65 and over), and persons who are co-infected with HBV and HCV.


Subjects:
[+]
Adolescent Adult Aged Child Child, Preschool Epidemiological Monitoring Female Hepatitis B Hepatitis C Humans Infant Infant, Newborn Male Middle Aged Registries
Source:
PLoS One. 14(6)
Pubmed ID:
31170165
Pubmed Central ID:
PMC6553716
Document Type:
Journal Article
Place as Subject:
Pennsylvania
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:bd86103897ff4446c434e2694b83af7540d01601e5eda2c75e7d2afb11f7694e
Download URL:
https://stacks.cdc.gov/view/cdc/79720/cdc_79720_DS1.pdf
File Type:

Supporting Files

• 	pone.0217455.g001.gif	gif
  	pone.0217455.g001.jpg	jpeg
  	pone.0217455.nxml	xml
  	pone.0217455.t001.gif	gif
  	pone.0217455.t001.jpg	jpeg
  	pone.0217455.t002.gif	gif
  	pone.0217455.t002.jpg	jpeg

More +