Screening campaign of hepatitis C among underprivileged people consulting in health centres of Lyon area France
Autor: | François Bailly, F. Sahajian, Philippe Vanhems, M. Sepetjan, C. Trepo, Jacques Fabry |
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Přispěvatelé: | Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS) |
Jazyk: | angličtina |
Rok vydání: | 2007 |
Předmět: |
Adult
Male Pediatrics medicine.medical_specialty [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT] Adolescent Population Hepacivirus Logistic regression Vulnerable Populations Injection drug use Serology Social insurance 03 medical and health sciences 0302 clinical medicine Risk Factors Seroepidemiologic Studies Medicine Humans Mass Screening 030212 general & internal medicine education Substance Abuse Intravenous Poverty education.field_of_study Medically Uninsured High prevalence business.industry Public Health Environmental and Occupational Health Odds ratio Hepatitis C Community Health Centers Middle Aged medicine.disease 3. Good health Multivariate Analysis 030211 gastroenterology & hepatology Female France business Demography |
Zdroj: | European Journal of Public Health European Journal of Public Health, Oxford University Press (OUP): Policy B-Oxford Open Option D, 2007, 17, pp.263-271 European Journal of Public Health, 2007, 17, pp.263-271 |
ISSN: | 1101-1262 1464-360X |
Popis: | Background: A screening campaign for hepatitis C virus (HCV) infection was carried out in eight health centres of Lyon from June 2003 until March 2004. The population targeted for screening was underprivileged individuals without any social insurance, protected by Couverture Mutuelle Universelle or Aide Medicale Etat (AME), to estimate the prevalence of anti-HCV antibodies in this population and to identify associated risk factors. Methods: After training in HCV infection and screening, 43 general practitioners participated in the campaign. Information about patient socio-demographics and risk factors was collected prior to proposing screening serology. Blood samples were often taken in health centres. Follow-up of positive cases was organised via the Reference Centre of HCV Infection in Lyon with possible specialised consultations in health centres. Results: The average age of the 988 individuals in the campaign was 37 years; 51% were women; 54% had a foreign nationality; 21% lived in sheltered accommodation; 19% were lodged in third-party accommodation; 9% were homeless; and 57% possessed less than €562 (Revenu Minimum d'Insertion level). Screening was not proposed to nine patients because of medico-psychological problems. The acceptance rate for screening was 98.8% (967/979), and testing was carried out on 97.6% of these subjects (944/967). The prevalence of anti-HCV antibodies in the sample was 4.7% (44/944) (95% CI = 3.4–6.2). Nearly 80% of positive cases were unknown prior to the campaign. Multivariate logistic regression modelling identified lifetime injection drug use [odds ratios (OR) = 15.99; P < 0.0001], lifetime medical care in a foreign country (OR = 4.46; P = 0.001), and wearing tattoos (OR = 2.75; P = 0.048) as significant risk factors for carrying anti-HCV antibodies. Characteristics independently associated with HCV seropositivity were age between 40 and 49 years, AME benefits, and no social insurance. Conclusion: Wide acceptance of screening, high prevalence of anti-HCV antibodies (much higher than in the French population in general), a high proportion of positive cases unknown beforehand, and satisfactory follow-up of seropositive patients are all factors which support the need for a screening campaign targeting HCV infection in underprivileged persons living in France. |
Databáze: | OpenAIRE |
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