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丙型肝炎病毒即时检验RNA检测:对澳大利亚一个戒备森严的监狱全体人员进行为期3天筛查的经验

Hepatitis C virus point-of-care RNA testing: Experience from screening an entire high-security Australian prison population over 3 days.

作者信息

Wallis Chris, O'Flynn Mim, Fenech Mary, Grimstrup Dorrit

机构信息

Prison and Preventative Health Services, West Moreton Hospital and Health Service, Wacol, QLD Australia.

Kombi Clinic, Inala, QLD, Australia.

出版信息

Aust N Z J Public Health. 2023 Oct;47(5):100083. doi: 10.1016/j.anzjph.2023.100083. Epub 2023 Sep 28.

Abstract

OBJECTIVE

Point-of-care testing for hepatitis C virus (HCV) in high-risk populations is key to diagnosing and eliminating HCV. We aimed to test all occupants for HCV in an entire prison.

METHODS

All consenting participants at the Brisbane Women's Correctional Centre were tested for HCV over 3 days using fingerstick samples. Participants with HCV were linked to care by a Nurse Practitioner experienced in HCV management.

RESULTS

211 of 244 participants of the prison population at the time (86%) consented and were tested. 17 participants (8%) had HCV, of who 14 commenced antiviral therapy ≤1 week of testing, 1 was later approved for antiviral therapy in consultation with a physician, and 2 due for release were followed-up and linked to care in the community. Education and counselling provided before testing was rated as very good or excellent by 47% of participants.

CONCLUSIONS

Testing occupants in a high-security prison of this size is feasible and can provide an overview of HCV infectivity. Testing combined with linkage to care will support the elimination of HCV in this high-risk population.

IMPLICATIONS FOR PUBLIC HEALTH

Point-of-care testing for HCV in prisons with dedicated clinicians, resources, and partnerships, particularly at prison entry, can contribute to eliminating HCV in Australia by 2030.

摘要

目的

对高危人群进行丙型肝炎病毒(HCV)即时检测是诊断和消除HCV的关键。我们旨在对一所监狱中的所有在押人员进行HCV检测。

方法

在3天时间里,使用手指采血样本对布里斯班女子惩教中心所有同意参与的参与者进行HCV检测。HCV感染者由一名有HCV管理经验的执业护士安排接受治疗。

结果

当时监狱中的244名参与者中有211名(86%)同意并接受了检测。17名参与者(8%)感染了HCV,其中14人在检测后≤1周开始接受抗病毒治疗,1人后来经与医生会诊后获批接受抗病毒治疗,2名即将获释的人员接受了随访并被安排在社区接受治疗。47%的参与者对检测前提供的教育和咨询给予了非常好或优秀的评价。

结论

对这种规模的高度戒备监狱中的在押人员进行检测是可行的,并且可以提供HCV感染情况的概述。检测与治疗安排相结合将有助于在这一高危人群中消除HCV。

对公共卫生的启示

在配备专门临床医生、资源和建立伙伴关系的监狱中,特别是在入狱时对HCV进行即时检测,有助于在2030年前在澳大利亚消除HCV。

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