Theme: Epidemiology & Public Health Research Year: 2024
Background: To contribute to the elimination targets set by the World Health Organization (WHO) for viral Hepatitis, Community Drug and Alcohol Treatment centres (CDAT’S) were identified as a location which have clients most at risk for blood borne viruses (BBV) (including the Hepatitis C virus (HCV)). HCV has a high prevalence in this patient group and although venepuncture BBV testing is available, refusal rates are high. Point of care testing (POCT) has become more readily available and been identified as a more acceptable testing method for service users. POCT testing provides rapid results which is highly suited to the turnaround time of clients’ care duration to CDAT.
Methods: A team of POCT practitioners set up clinics at 5 CDAT centres offering a two-tiered POCT strategy along with Dried Blood Spot Testing to screen for all BBVs. The strategy utilised Orasure OraQuick POCT swabs to test for Hepatitis C exposure with a follow up PCR test being performed on the Cepheid GeneXpert to detect active HCV infection. A BBV history ‘look back exercise’ was performed to identify past BBV exposure and to select the appropriate POCT. All clients were allocated a BBV screening appointment to offer highly efficient testing to all clients accessing service.
Results: In 32 days at 5 CDAT clinics, 557 clients were screened. 1104 tests were performed in total (465 POCT swabs, 93 HCV PCR’s and 546 DBST’s). 83.11% attendance was linked to the appointment system. 9 active HCV infections were identified. The BBV ‘look back exercise’ revealed that 17.13% of clients had previously been exposure to HCV.
Conclusion: Appointment systems, adverting minimally invasive POCTs proved to be highly effective. High intensity screening sessions are efficient at screening many patients over a short period of time. BBV look back exercises improve patient care and ensures the correct test is selected. BBV screening at CDAT’s is fundamental to achieving the WHO elimination targets.