Developing and Piloting a Standardized European Protocol for Hepatitis C Prevalence Surveys in the General Population (2016-2019)

Funding Information: This work was funded by the European Center for Disease Prevention and Control (ECDC) through a contract. Publisher Copyright: © Copyright © 2021 Sperle, Nielsen, Bremer, Gassowski, Brummer-Korvenkontio, Bruni, Ciccaglione, Kaneva, Liitsola, Naneva, Perchemlieva, Spada, Toikkanen, Amato-Gauci, Duffell and Zimmermann.Background: A robust estimate of the number of people with chronic hepatitis C virus (HCV) infection is essential for an appropriate public health response and for monitoring progress toward the WHO goal of eliminating viral hepatitis. Existing HCV prevalence studies in the European Union (EU)/European Economic Area (EEA) countries are heterogeneous and often of poor quality due to non-probability based sampling methods, small sample sizes and lack of standardization, leading to poor national representativeness. This project aimed to develop and pilot standardized protocols for undertaking nationally representative HCV prevalence surveys in the general adult population. Methods: From 2016 to 2019 a team from the Robert Koch-Institute contracted by the European Centre for Disease Prevention and Control synthesized evidence on existing HCV prevalence surveys and survey methodology and drafted a protocol. The methodological elements of the protocol were piloted and evaluated in Bulgaria, Finland and Italy, and lessons learnt from the pilots were integrated in the final protocol. An international multidisciplinary expert group was consulted regularly. Results: The protocol includes three alternative study approaches: a stand-alone survey; a "nested" survey within an existing health survey; and a retrospective testing survey approach. A decision algorithm advising which approach to use was developed. The protocol was piloted and finalized covering minimum and gold standards for all steps to be implemented from sampling, data protection and ethical issues, recruitment, specimen collection and laboratory testing options, staff training, data management and analysis and budget considerations. Through piloting, the survey approaches were effectively implemented to produce HCV prevalence estimates and the pilots highlighted the strengths and limitations of each approach and key lessons learnt were used to improve the protocol. Conclusions: An evidence-based protocol for undertaking HCV prevalence serosurveys in the general population reflecting the different needs, resources and epidemiological situations has been developed, effectively implemented and refined through piloting. This technical guidance supports EU/EEA countries in their efforts to estimate their national hepatitis C burden as part of monitoring progress toward the elimination targets.publishersversionPeer reviewe

Hepatiitti C -virusinfektioiden seuranta Suomessa vuosina 1995-2013

Hepatiitti C on yleisin Suomessa esiintyvistä hepatiiteista, ja se saadaan useimmiten suonensisisäisten huumeiden käytön seurauksena. Tartunta saadaan usein nuorena, infektio jää valtaosalla krooniseksi ja altistaa kantajansa vuosikymmenien kuluessa erilaisille maksasairauksille. Hepatiitti C -tartunnan saaneita voidaan kuitenkin hoitaa lääkkeillä ja suurin osa hoidetuista paranee. Tämä raportti on ensimmäinen kokonaisvaltainen selvitys hepatiitti C -virusinfektioista Suomessa. Siihen on koottu tietoa tartuntatautirekisterin hepatiitti C -tapauksista. Lisäksi esitetään arvioita hepatiitti C -tartuntojen esiintyvyydestä eri väestöryhmissä ja käsitellään hoitoa ja ennaltaehkäisyä. Raportti on tarkoitettu hepatiitti C -potilaita hoitaville, tartuntojen ehkäisytyötä tekeville ja muille asiasta kiinnostuneille

Smittsamma sjukdomar i Finland 2013

Rapporten Smittsamma sjukdomar i Finland beskriver de viktigaste fenomenen och epidemierna under året och förekomsten av sjukdomar. I publikationen hittar man information om luftvägs- och tarminfektioner, hepatiter, könssjukdomar och antimikrobiell resistens. År 2013 förmedlades Salmonella Typhimurium-smitta via opastöriserad mjölk. EHEC-bakterien orsakade två omfattande utbrott. Källan till en nordisk hepatit Aepidemi misstänktes vara djupfrysta bär. På ett hotell i Esbo insjuknade närmare 200 personer i magsjuka, och först efter undersökningar i ett expertlaboratorium kunde man konstatera att norovirus var den mikroorganism som låg bakom epidemin. Det förekommer fortfarande stora regionala variationer i incidensen för Clostridium difficile. I Finland konstaterades den första epidemin orsakad av den karbapenemasproducerande bakterien K. pneumoniae. Fem ovaccinerade barn under två år insjuknade i en allvarlig pneumokocksjukdom orsakad av vaccinserotyper. I rapporten jämförs de nyaste uppgifterna med tidigare år, vilket synliggör också långsiktiga förändringar i förekomsten av smittsamma sjukdomar. I rapporten sammanställs uppgifter från registret över smittsamma sjukdomar som förs av Institutet för hälsa och välfärd

Cancer incidence in the vicinity of Finnish nuclear power plants: an emphasis on childhood leukemia

The objective of this paper was to study cancer incidence, especially leukemia in children (<15 years), in the vicinity of Finnish nuclear power plants (NPPs). We used three different approaches: ecological analysis at municipality level, residential cohorts defined from census data, and case–control analysis with individual residential histories. The standardized incidence ratio of childhood leukemia for the seven municipalities in the vicinity of NPPs was 1.0 (95% CI 0.6, 1.6) compared to the rest of Finland. The two cohorts defined by censuses of 1980 and 1990 gave rate ratios of 1.0 (95% CI 0.3, 2.6) and 0.9 (95% CI 0.2, 2.7), respectively, for childhood leukemia in the population residing within 15 km from the NPPs compared to the 15–50 km zone. The case–control analysis with 16 cases of childhood leukemia and 64 matched population-based controls gave an odds ratio for average distance between residence and NPP in the closest 5–9.9 km zone of 0.7 (95% CI 0.1, 10.4) compared to ≥30 km zone. Our results do not indicate an increase in childhood leukemia and other cancers in the vicinity of Finnish NPPs though the small sample size limits the strength of conclusions. The conclusion was the same for adults

Seroprevalence of Antibodies against Measles, Rubella and Varicella among Asylum Seekers Arriving in Lower Saxony, Germany, November 2014–October 2015

The number of asylum seekers arriving in Germany has increased rapidly since 2014 and cases of vaccine-preventable diseases at reception centres were reported. Asylum seekers 12 years and older arriving in Lower Saxony were serologically screened for antibodies against measles, rubella and varicella between November 2014 and October 2015. We calculated the seroprevalence from the screening data by disease, country of origin and age group and compared them to literature-based herd immunity thresholds in order to identify immunisation gaps. In total, 23,647 specimens were included in our study. Although the vast majority of asylum seekers tested positive for antibodies against measles, rubella and varicella, the seroprevalences were not sufficient to ensure herd immunity. The seroprevalences varied substantially between countries of origin and increased with age. Immunisation of asylum seekers against measles, rubella and varicella is needed and the detailed information on seroprevalences among subgroups of asylum seekers can be used for targeted immunisations at reception centres

User Evaluation Indicates High Quality of the Surveillance Outbreak Response Management and Analysis System (SORMAS) After Field Deployment in Nigeria in 2015 and 2018

During the West African Ebola virus disease outbreak in 2014–15, health agencies had severe challenges with case notification and contact tracing. To overcome these, we developed the Surveillance, Outbreak Response Management and Analysis System (SORMAS). The objective of this study was to measure perceived quality of SORMAS and its change over time. We ran a 4-week-pilot and 8-week-implementation of SORMAS among hospital informants in Kano state, Nigeria in 2015 and 2018 respectively. We carried out surveys after the pilot and implementation asking about usefulness and acceptability. We calculated the proportions of users per answer together with their 95% confidence intervals (CI) and compared whether the 2015 response distributions differed from those from 2018. Total of 31 and 74 hospital informants participated in the survey in 2015 and 2018, respectively. In 2018, 94% (CI: 89–100%) of users indicated that the tool was useful, 92% (CI: 86–98%) would recommend SORMAS to colleagues and 18% (CI: 10–28%) had login difficulties. In 2015, the proportions were 74% (CI: 59–90%), 90% (CI: 80–100%), and 87% (CI: 75–99%) respectively. Results indicate high usefulness and acceptability of SORMAS. We recommend mHealth tools to be evaluated to allow repeated measurements and comparisons between different versions and users.Peer Reviewe