Hepatitis B screening in an argentine ED: Increasing vaccination in a resource-limited setting

James S. Ford, Leonardo G. Marianelli, Natalia Frassone, Jose D. Debes

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is limited data regarding the use of emergency departments (EDs) for infectious disease screening and vaccination in resource-limited regions. In these settings, EDs are often the only contact that patients have with the healthcare system, turning an ED visit into an opportune time to deliver preventative health services. Methods: In this pilot study, patients that met inclusion criteria were prospectively tested for hepatitis B surface antigen test (HBsAg). Previously unvaccinated patients who tested negative for HBsAg were offered HBV vaccination. The study setting was a public infectious disease hospital in Cordoba, Argentina. The primary outcomes were new HBV diagnoses, as well as vaccination completion between screening modalities (Point-of-Care-Testing-POCT vs. laboratory testing) and same vs. different day vaccination. Results: We screened 100 patients for HBV (75 POCT & 25 laboratory). The median age of participants was 35 years (IQR 24-52) and 55% were male. No patients tested positive for HBsAg. All patients who completed first dose vaccination were initially screened with the POCT. No patients screened with laboratory testing returned for vaccination. Patients who were scheduled for vaccination the same day were more likely to complete vaccination compared to those scheduled for another day (75% vs. 14%, p < .001). Conclusion: Our study supports the use of HBV POCTs in the ED in conjunction with vaccination of HBV-negative individuals. In regions with low HBV endemicity, direct vaccination without HBsAg testing may be more cost effective. We believe that this acute-care screening model is applicable to other resource-limited settings.

Original languageEnglish (US)
Pages (from-to)296-299
Number of pages4
JournalAmerican Journal of Emergency Medicine
Volume38
Issue number2
DOIs
StatePublished - Feb 2020

Bibliographical note

Funding Information:
This work was supported in part by the Doris Duke Charitable Foundation through a grant supporting the Doris Duke International Clinical Research Fellowship Program at the University of Minnesota to JL, the Robert Wood Johnson Foundation , AFMDP , University of Minnesota Center for Global Health and Social Responsibility Global Health Seed Award and NIH - NCI R21 CA215883-01A1 to JDD.

Funding Information:
This work was supported in part by the Doris Duke Charitable Foundation through a grant supporting the Doris Duke International Clinical Research Fellowship Program at the University of Minnesota to JL, the Robert Wood Johnson Foundation, AFMDP, University of Minnesota Center for Global Health and Social Responsibility Global Health Seed Award and NIH-NCIR21 CA215883-01A1 to JDD.

Publisher Copyright:
© 2019 Elsevier Inc.

Keywords

  • Hepatitis B vaccination
  • Hepatitis B virus
  • Point-of-care test
  • Rapid diagnostic test

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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