Community-based hbv screening increases linkage to care among west african migrants in greater barcelona, spain: Preliminary data from the hbvcomsava model of care

ABSTRACT

Background: African migrant populations living in Europe are disproportionately affected by HBV infection. Chronic HBV infection is a major public health threat for African migrant populations living in Spain who use health services at lower rates due to structural and/or cultural/linguistic barriers. Efforts to scale up prevention, testing and treatment are needed to reach the 2030 hepatitis elimination targets set by the WHO. TheHBV-COMSAVA study aims to use pointof-care testing and simplified diagnostic tools in community settings to identify and link to care or vaccinate west African migrants in the greater Barcelona area during the ongoing COVID-19 pandemic. Methods: 280 study participants were offered HBV screening in a pop-up clinic in a community setting from 21/11/20- 6/6/21 Rapid tests to screen for the presence of HBsAg were used and a blood sample was collected using plasma separation cards and analyzed in a laboratory. Patients received their results during a second visit and were offered a) linkage to specialist care);b) posttest counselling;or c) vaccination of the first dose of the HBV vaccine in situ. Sociodemographic and clinical history were collected and basic standard descriptive statistics were utilized using STATA software. Participants who did not already have Catalonia's CatSalut health card were offered an expedited processing system to acquire one. Results: Five participants were excluded and 275 were included for analysis. The overall HBsAg prevalence was 12.7% (n=35). Of those included, laboratory results are available for 229 (83.3%). Of these, anti-HBc positivity was detected in 31.9% (n=73). The majority (44.4%, n=122) required vaccination against HBV followed by post-test counselling (30.9%, n=85) and referral to a specialist (12.7%, n=35). Of those who received their results (n=243), 75.7% returned and either received post-test counselling, linkage to specialist care, or the first dose of the HBV vaccine (figure 1). The HBV vaccination acceptance rate was 86.4%. Eight participants did not have access to the public health system and requested CatSalut cards and all were provided with one Conclusion: Despite the COVID-19 pandemic, by employing a community-based model of care utilizing novel simplified diagnostic tools the HBV-COMSAVA study demonstrated the possibility to screen, diagnose, link to care, and vaccinate African migrants who may otherwise not have received care.