**Georgia has a high prevalence of hepatitis C and a high prevalence of
injection drug use**, and launched a **hepatitis C elimination programme in
2015.**
It also had something in place since 2006: **needle and syringe programmes
offering HCV antibody testing** to people who inject drugs.
What happened after 2015
| HCV antibody tests performed at needle and syringe programmes | increased fivefold |
| People with a positive result | doubled |
Why the site matters more than the test
Hepatitis C is concentrated among people who inject drugs, and that is the
group least likely to be reached by a clinic-based screening programme —
through cost, through stigma, through prior experience of how they are treated
in health settings, and through having other priorities.
A needle and syringe programme has already solved all of that. People come,
voluntarily, repeatedly, for a service they want, from staff who do not judge
them. Adding a test to that visit costs a fraction of what building a new
outreach service would, and reaches the people the new service would be trying
to find.
Which is the report's conclusion: **hepatitis C testing at needle and syringe
programmes is an effective strategy for identifying people with HCV
infection.**
The pattern is the same one behind WISEWOMAN attaching cardiovascular screening
to a cancer programme, and behind Georgia's own numbers here: **the expensive
part of a screening programme is finding the people, and sometimes somebody has
already found them.**
Why "doubled" rather than "fivefold"
Tests rose fivefold and positives doubled — so the positivity rate fell. That
is the expected shape when a programme expands beyond the people already known
to be at highest risk, and it is a sign of reach rather than of waste.
The programme in Georgia might serve as a model for other countries.
Source: Centers for Disease Control and Prevention, MMWR.
이용 허락: CC0 1.0 (퍼블릭 도메인) · 출처 www.cdc.gov
1
0
0
0
코멘트
