Evaluating a novel model of hepatitis B care, Hep B PAST, in the Northern Territory of Australia: results from a prospective, population-based studyResearch in context

Kelly Hosking; Paula Binks; Teresa De Santis; Phillip Merrdi Wilson; George Garambaka Gurruwiwi; Sarah Mariyalawuy Bukulatjpi; Emily Vintour-Cesar; Melita McKinnon; Peter Nihill; Tammy-Allyn Fernandes; Belinda Greenwood-Smith; Robert Batey; Cheryl Ross; Steven Y.C. Tong; Geoffrey Stewart; Catherine Marshall; Catherine Gargan; Prashanti Manchikanti; Karen Fuller; Jaclyn Tate-Baker; Sami Stewart; Benjamin Cowie; Nicole Allard; Jennifer H. MacLachlan; Ashleigh Qama; David Boettiger; Joshua S. Davis; Christine Connors; Jane Davies

The Lancet Regional Health. Western Pacific (Jul 2024)

Evaluating a novel model of hepatitis B care, Hep B PAST, in the Northern Territory of Australia: results from a prospective, population-based studyResearch in context

Kelly Hosking,
Paula Binks,
Teresa De Santis,
Phillip Merrdi Wilson,
George Garambaka Gurruwiwi,
Sarah Mariyalawuy Bukulatjpi,
Emily Vintour-Cesar,
Melita McKinnon,
Peter Nihill,
Tammy-Allyn Fernandes,
Belinda Greenwood-Smith,
Robert Batey,
Cheryl Ross,
Steven Y.C. Tong,
Geoffrey Stewart,
Catherine Marshall,
Catherine Gargan,
Prashanti Manchikanti,
Karen Fuller,
Jaclyn Tate-Baker,
Sami Stewart,
Benjamin Cowie,
Nicole Allard,
Jennifer H. MacLachlan,
Ashleigh Qama,
David Boettiger,
Joshua S. Davis,
Christine Connors,
Jane Davies

Affiliations

Kelly Hosking: Northern Territory Health, Northern Territory, Australia; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Corresponding author. Northern Territory Health, Northern Territory, Australia.
Paula Binks: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Teresa De Santis: Northern Territory Health, Northern Territory, Australia
Phillip Merrdi Wilson: Northern Territory Health, Northern Territory, Australia
George Garambaka Gurruwiwi: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Sarah Mariyalawuy Bukulatjpi: Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
Emily Vintour-Cesar: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Melita McKinnon: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Peter Nihill: Northern Territory Health, Northern Territory, Australia
Tammy-Allyn Fernandes: Northern Territory Health, Northern Territory, Australia
Belinda Greenwood-Smith: Northern Territory Health, Northern Territory, Australia
Robert Batey: Northern Territory Health, Northern Territory, Australia
Cheryl Ross: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Steven Y.C. Tong: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; Victorian Infectious Diseases Service, The Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
Geoffrey Stewart: Northern Territory Health, Northern Territory, Australia
Catherine Marshall: Northern Territory Health, Northern Territory, Australia; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Catherine Gargan: Northern Territory Health, Northern Territory, Australia
Prashanti Manchikanti: Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
Karen Fuller: Katherine West Health Board, Katherine, Northern Territory, Australia
Jaclyn Tate-Baker: Northern Territory Health, Northern Territory, Australia
Sami Stewart: Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, NSW, Australia
Benjamin Cowie: WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Parkville, Australia
Nicole Allard: WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Parkville, Australia
Jennifer H. MacLachlan: WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Victoria, Australia; Department of Infectious Diseases, University of Melbourne, Parkville, Australia
Ashleigh Qama: WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Victoria, Australia
David Boettiger: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Kirby Institute, UNSW Sydney, NSW, Australia
Joshua S. Davis: Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; School of Medicine and Public Health, University of Newcastle, NSW, Australia
Christine Connors: Northern Territory Health, Northern Territory, Australia
Jane Davies: Northern Territory Health, Northern Territory, Australia; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia

Journal volume & issue: Vol. 48
p. 101116

Abstract

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Summary: Background: The Northern Territory (NT) has the highest prevalence of chronic hepatitis B (CHB) in Australia. The Hep B PAST program aims to improve health outcomes for people living with CHB. Methods: This mixed methods study involves First Nations peoples living in the NT. We used participatory action research principles across three steps: 1. Foundation step: establishing hepatitis B virus (HBV) status and linkage to care; 2. Capacity building: training the health workforce; 3. Supported transition to primary healthcare: implementation of the “Hub and Spoke” model and in-language resources. Analysis occurred at three time points: 1. Pre-Hep B PAST (2018); 2. Foundation step (2020); and 3. Completion of Hep B PAST (2023). Evaluation focuses on four key indicators, the number of people: 1) with documented HBV status; 2) diagnosed with CHB; 3) receiving care; and 4) receiving treatment. Findings: Hep B PAST (2018–23) reached 40,555 people. HBV status was documented in 11% (1192/10,853), 79.2% (26,075/32,915) and 90.8% (28,675/31,588) of people at pre-Hep B PAST, foundation step, and completion respectively. An estimated 99.9% (821/822) of people were diagnosed, 86.3% (709/822) engaged in care, and 24.1% (198/822) on antiviral treatment at completion. CHB prevalence in the study population is 2.6%, decreasing from 6.1% to 0.4% in the pre- and post-vaccination cohorts. Interpretation: Hep B PAST is an effective model of care. Partner health services are exceeding elimination targets. This model could enable other countries to enhance the cascade of care and work towards eliminating HBV. Funding: National Health and Medical Research Council.

Published in The Lancet Regional Health. Western Pacific

ISSN: 2666-6065 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanwpc/home

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