Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/132862 |
Resumo: | OBJECTIVE To investigate the HCV cascade of care and to identify the factors associated with loss or absence to follow-up of patients identified as infected with hepatitis C through blood donation. METHODS Blood donors from 1994 to 2012, identified with positive anti- HCV by enzyme immunoassay and immunoblot tests were invited to participate in the study, through letters or phone calls. Patients who agreed to participate were interviewed and their blood samples were collected for further testing. The following variables were investigated: demographic data, data on comorbidities and history concerning monitoring of hepatitis C. Multiple regression analysis by Poisson regression model was used to investigate the factors associated with non-referral for consultation or loss of follow-up. RESULTS Of the 2,952 HCV-infected blood donors, 22.8% agreed to participate: 394 (58.2%) male, median age 48 years old and 364 (53.8%) Caucasian. Of the 676 participants, 39.7% did not receive proper follow-up or treatment after diagnosis: 45 patients referred not to be aware they were infected, 61 did not seek medical attention and 163 started a follow-up program, but were non-adherent. The main reasons for inadequate follow-up were not understanding the need for medical care (71%) and health care access difficulties (14%). The variables showing a significant association with inadequate follow-up after multiple regression analysis were male gender (PR = 1.40; 95%CI 1.15–1.71), age under or equal to 50 years (PR = 1.36; 95%CI 1.12–1.65) and non-Caucasians (PR = 1.53; 95%CI 1.27–1.84). CONCLUSIONS About 40.0% of patients did not receive appropriate follow-up. These data reinforce the need to establish strong links between primary care and reference centers and the need to improve access to specialists and treatments. |
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oai:revistas.usp.br:article/132862 |
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Revista de Saúde Pública |
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Hepatitis C among blood donors: cascade of care and predictors of loss to follow-upBlood DonorsHepatitis C diagnosisLost to Follow-UpRisk FactorsCascade of Care OBJECTIVE To investigate the HCV cascade of care and to identify the factors associated with loss or absence to follow-up of patients identified as infected with hepatitis C through blood donation. METHODS Blood donors from 1994 to 2012, identified with positive anti- HCV by enzyme immunoassay and immunoblot tests were invited to participate in the study, through letters or phone calls. Patients who agreed to participate were interviewed and their blood samples were collected for further testing. The following variables were investigated: demographic data, data on comorbidities and history concerning monitoring of hepatitis C. Multiple regression analysis by Poisson regression model was used to investigate the factors associated with non-referral for consultation or loss of follow-up. RESULTS Of the 2,952 HCV-infected blood donors, 22.8% agreed to participate: 394 (58.2%) male, median age 48 years old and 364 (53.8%) Caucasian. Of the 676 participants, 39.7% did not receive proper follow-up or treatment after diagnosis: 45 patients referred not to be aware they were infected, 61 did not seek medical attention and 163 started a follow-up program, but were non-adherent. The main reasons for inadequate follow-up were not understanding the need for medical care (71%) and health care access difficulties (14%). The variables showing a significant association with inadequate follow-up after multiple regression analysis were male gender (PR = 1.40; 95%CI 1.15–1.71), age under or equal to 50 years (PR = 1.36; 95%CI 1.12–1.65) and non-Caucasians (PR = 1.53; 95%CI 1.27–1.84). CONCLUSIONS About 40.0% of patients did not receive appropriate follow-up. These data reinforce the need to establish strong links between primary care and reference centers and the need to improve access to specialists and treatments.Universidade de São Paulo. Faculdade de Saúde Pública2017-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/13286210.1590/s1518-8787.2017051006468Revista de Saúde Pública; Vol. 51 (2017); 40Revista de Saúde Pública; Vol. 51 (2017); 40Revista de Saúde Pública; v. 51 (2017); 401518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/rsp/article/view/132862/128915Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessMachado, Soraia MafraAlmeida Neto, Cesar dePinho, João Renato RebelloMalta, Fernanda de MelloCapuani, LigiaCampos, Aléia FaustinaAbreu, Fatima Regina MarquesNastri, Ana Catharina de Seixas SantosSantana, Rúbia Anita FerrazSabino, Ester CerdeiraMendes-Correa, Maria Cássia2017-12-14T10:16:01Zoai:revistas.usp.br:article/132862Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2017-12-14T10:16:01Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
title |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
spellingShingle |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up Machado, Soraia Mafra Blood Donors Hepatitis C diagnosis Lost to Follow-Up Risk Factors Cascade of Care |
title_short |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
title_full |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
title_fullStr |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
title_full_unstemmed |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
title_sort |
Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up |
author |
Machado, Soraia Mafra |
author_facet |
Machado, Soraia Mafra Almeida Neto, Cesar de Pinho, João Renato Rebello Malta, Fernanda de Mello Capuani, Ligia Campos, Aléia Faustina Abreu, Fatima Regina Marques Nastri, Ana Catharina de Seixas Santos Santana, Rúbia Anita Ferraz Sabino, Ester Cerdeira Mendes-Correa, Maria Cássia |
author_role |
author |
author2 |
Almeida Neto, Cesar de Pinho, João Renato Rebello Malta, Fernanda de Mello Capuani, Ligia Campos, Aléia Faustina Abreu, Fatima Regina Marques Nastri, Ana Catharina de Seixas Santos Santana, Rúbia Anita Ferraz Sabino, Ester Cerdeira Mendes-Correa, Maria Cássia |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Machado, Soraia Mafra Almeida Neto, Cesar de Pinho, João Renato Rebello Malta, Fernanda de Mello Capuani, Ligia Campos, Aléia Faustina Abreu, Fatima Regina Marques Nastri, Ana Catharina de Seixas Santos Santana, Rúbia Anita Ferraz Sabino, Ester Cerdeira Mendes-Correa, Maria Cássia |
dc.subject.por.fl_str_mv |
Blood Donors Hepatitis C diagnosis Lost to Follow-Up Risk Factors Cascade of Care |
topic |
Blood Donors Hepatitis C diagnosis Lost to Follow-Up Risk Factors Cascade of Care |
description |
OBJECTIVE To investigate the HCV cascade of care and to identify the factors associated with loss or absence to follow-up of patients identified as infected with hepatitis C through blood donation. METHODS Blood donors from 1994 to 2012, identified with positive anti- HCV by enzyme immunoassay and immunoblot tests were invited to participate in the study, through letters or phone calls. Patients who agreed to participate were interviewed and their blood samples were collected for further testing. The following variables were investigated: demographic data, data on comorbidities and history concerning monitoring of hepatitis C. Multiple regression analysis by Poisson regression model was used to investigate the factors associated with non-referral for consultation or loss of follow-up. RESULTS Of the 2,952 HCV-infected blood donors, 22.8% agreed to participate: 394 (58.2%) male, median age 48 years old and 364 (53.8%) Caucasian. Of the 676 participants, 39.7% did not receive proper follow-up or treatment after diagnosis: 45 patients referred not to be aware they were infected, 61 did not seek medical attention and 163 started a follow-up program, but were non-adherent. The main reasons for inadequate follow-up were not understanding the need for medical care (71%) and health care access difficulties (14%). The variables showing a significant association with inadequate follow-up after multiple regression analysis were male gender (PR = 1.40; 95%CI 1.15–1.71), age under or equal to 50 years (PR = 1.36; 95%CI 1.12–1.65) and non-Caucasians (PR = 1.53; 95%CI 1.27–1.84). CONCLUSIONS About 40.0% of patients did not receive appropriate follow-up. These data reinforce the need to establish strong links between primary care and reference centers and the need to improve access to specialists and treatments. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/132862 10.1590/s1518-8787.2017051006468 |
url |
https://www.revistas.usp.br/rsp/article/view/132862 |
identifier_str_mv |
10.1590/s1518-8787.2017051006468 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/132862/128915 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 51 (2017); 40 Revista de Saúde Pública; Vol. 51 (2017); 40 Revista de Saúde Pública; v. 51 (2017); 40 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221798349930496 |