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. 2006 Jan-Feb;121(1):23-35.
doi: 10.1177/003335490612100108.

Surveillance programs for chronic viral hepatitis in three health departments

Douglas T Fleming  1 , Amy Zambrowski, Felicia Fong, Andrea Lombard, Lynne Mercedes, Claudia Miller, Jan Poujade, Aaron Roome, Amy Sullivan, Lyn Finelli
Affiliations

Surveillance programs for chronic viral hepatitis in three health departments

Douglas T Fleming et al. Public Health Rep. 2006 Jan-Feb.

Abstract

Although chronic hepatitis B and chronic hepatitis C are diseases of public health importance, only a few health departments nationally have chronic viral hepatitis under surveillance; these programs rely primarily on direct reporting by medical laboratories. We conducted an evaluation to determine if lessons from these programs can guide other health departments. Between December 2002 and February 2003, we visited the Connecticut Department of Public Health, the Multnomah County Health Department in Portland, Oregon, and the Minnesota Department of Health to determine the capacity of their chronic hepatitis registries to monitor trends and provide case management. We found that the registries facilitated investigations of potentially acute cases by identifying previously known infections, and aided prevention planning by pinpointing areas where viral hepatitis was being diagnosed. For chronic cases, case management (defined as the process of ensuring that infected individuals and their partners receive medical evaluation, counseling, vaccination, and referral to specialists for treatment when indicated) was provided for hepatitis B in Multnomah County, but was limited in other programs; barriers included resource constraints, difficulties confirming chronic infection, and privacy concerns. Finding innovative ways to overcome these barriers and improve case management is important if chronic hepatitis surveillance is to realize its full potential.

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Figures

Figure 1
Figure 1
Laboratory case definitions for chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, approved by the Council of State and Territorial Epidemiologists
Figure 2
Figure 2
Surveillance for chronic viral hepatitis
Figure 3
Figure 3
Data elements collected during the surveillance system evaluation
Figure 4
Figure 4
Laboratory reporting laws for hepatitis B and C in the jurisdictions of the three health departments
Figure 5
Figure 5
Case management provided at the three health departments for patients with chronic hepatitis B virus infection and chronic hepatitis C virus infection
Figure 6
Figure 6
Distribution of ages at first entry into chronic hepatitis registries at three health departments, for hepatitis B and hepatitis C, since inception
Figure 7
Figure 7
Mean age at first entry into chronic hepatitis registries, and ratio of male entries to female entries, for hepatitis B and hepatitis C, by health department
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