The Role of Geographic Mapping of Viral Hepatitis
Transcript of The Role of Geographic Mapping of Viral Hepatitis
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The Role of Geographic Mapping of
Viral Hepatitis -Monitoring the Care Cascade and Driving
Local Responses
Benjamin CowieDirector, WHO Collaborating Centre for Viral Hepatitis, Doherty [email protected] Viral Hepatitis ConferenceAdelaide SAAugust 14th 2018
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Disclosures
I receive no funding or support of any kind from any pharmaceutical or for-profit health care related industry.
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
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Measuring Progress Towards Elimination -
No One Left Behind
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Data for action
1. How can we measure progress towards viral hepatitis elimination?
2. What targets? What’s feasible?
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Data for action
1. How can we measure progress towards viral hepatitis elimination?
2. What targets? What’s feasible?
3. How do we use data to enable ACTION to stop people being left behind?
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
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Hepatitis B Mapping Project: 4th National Report, 2018 Hepatitis C Mapping Project: 1st National Report, 2018
www.ashm.org.au/HBV/hepatitis-b-mapping-reports/ www.ashm.org.au/HCV/hepatitis-c-mapping-reports/
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
National Viral Hepatitis Mapping Project
• Funded by the Australian Government
• Hepatitis B mapping from 2012 in partnership with ASHM
• Expanded to include hepatitis C from 2016
• Provide locally relevant, geographically specific estimates of the burden of disease and of access to treatment and care
• Identifying priority areas, progress, gaps and disparities
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Questions we can answer• Which local areas in my catchment have the
highest burden of hepatitis C?
• Where should we target health workforce development to improve access to care?
• Who are the priority affected communities living with hepatitis B in my region? What languages do they speak?
• What is occurring with uptake of treatment and care over time – and over place?
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
1. Identifying priority populations
Hepatitis B prevalence according to region of birth, 2016
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
1. Identifying priority populationsHepatitis C prevalence according to Primary Health Network, 2016
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2. Assessing disparities in progress Hepatitis B treatment uptake according to Primary Health Network, 2016
2. Assessing disparities in progress Hepatitis B treatment uptake according to SA3, Melbourne, 2016
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2. Assessing disparities in progress
Hepatitis C treatment uptake according to Primary Health Network, 2016
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
3. Identifying drivers of accessSpecialists per 1,000 people living with hepatitis B according to Primary
Health Network, 2016
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
3. Identifying drivers of accessAssociation between hepatitis C treatment uptake
and other health indicators
25.0
27.0
29.0
31.0
33.0
35.0
37.0
39.0
41.0
43.0
45.0
5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
Hepatitis C treatment uptake (%) compared to National Bowel Screening
Program Participation (% of eligible)
72
74
76
78
80
82
84
86
5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
Hepatitis C treatment uptake (%) compared to average life expectancy
(years)
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Mar 2013-Feb 2016Mar 2016-May 2016 Jun 2016-Aug 2016 Sep 2016-Nov 2016 Dec 2016-Feb 2017 Mar 2017-May 2017
Pro
po
rtio
n o
f p
eo
ple
re
ceiv
ing
tre
atm
en
t (%
)
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
AUSTRALIA TOTALNational Viral Hepatitis Mapping Project - Hepatitis C
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3. Identifying drivers of access
Prescribing of hepatitis C treatment by providers other than specialists
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
3. Supporting the design and delivery of programs
• Health workforce education - ASHM
• Australian Government / Hepatitis Australia Hepatitis B Community Education grants
• Victorian Integrated Hepatitis C Nurses
• NT viral hepatitis service
• Priority languages for resources
• Estimates used in many presentations at this conference already!
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
4. Identifying success stories and model programs
• South Australia viral hepatitis nurses– Adelaide HCV treatment uptake
• South Western Sydney B Positive Program– Only PHN to achieve National Hepatitis B Strategy
Treatment target
• NT hepatitis B response – access to care / monitoring among highest in the country by PHN
• Increased focus on chronic hepatitis B in Far North Queensland
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Ongoing work
• CRC-SI work – geospatial analysis, predictors, associations with access to health care
• Health record linkage studies providing individual level of care, maintenance in care, outcomes
• Surveillance for Hepatitis B Indicators mathematical modelling modelling – what will be the future impact of treatment scale up now in your local area?
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
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Surveillance for Hepatitis B Indicators –modelling
Tuesday 14 August 4.00pm – 5.30pmCity Room 2
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The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Making data WORK for elimination
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1.37%
12.8%
29.5%
CHB treatment uptake by SA3
18.5%
18.3%
16.8%
14.0%
10.4%
10.2%
9.9%
6.8%
6.3%
ONLINE INTERACTIVE MAPPING REPORT DATA COMING TO A SCREEN
NEAR YOU SOON !!
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Elimination of viral hepatitis is the goal
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Acknowledgements
WHO Collaborating Centre for Viral Hepatitis
VIDRL, Doherty Institute – Epidemiology Unit
Nicole Allard, Chelsea Brown, Benjamin Cowie,
Jennifer MacLachlan, Karen McCulloch,
Ashleigh Qama, Nicole Romero, Laura Thomas
Research & Programmatic Funding
Department of Health and Ageing, Australian Government
Department of Health and Human Services, Victoria
Melbourne Health Office for Research & RMH Foundation
Cooperative Research Centre for Spatial Information
Peter Doherty Institute for Infection and Immunity
www.doherty.edu.au/whoccvh
The Peter Doherty Institute for Infection and Immunity
A joint venture between The University of Melbourne and The Royal Melbourne Hospital
Download the Mapping Reports:
Hepatitis B
ashm.org.au/products/product/HepB-Mapping-Report-2016
Hepatitis C
ashm.org.au/products/product/HepC-Mapping-Report-2016
Visit us:
doherty.edu.au/whoccvh
For more information, contact: