title: Surveillance programs for chronic viral hepatitis in three health departments.
abstract: Although chronic hepatitis B and chronic hepatitis C are diseases of public health importance, only a few health departments nationally have chronic viral hepatitis under surveillance; these programs rely primarily on direct reporting by medical laboratories. We conducted an evaluation to determine if lessons from these programs can guide other health departments. Between December 2002 and February 2003, we visited the Connecticut Department of Public Health, the Multnomah County Health Department in Portland, Oregon, and the Minnesota Department of Health to determine the capacity of their chronic hepatitis registries to monitor trends and provide case management. We found that the registries facilitated investigations of potentially acute cases by identifying previously known infections, and aided prevention planning by pinpointing areas where viral hepatitis was being diagnosed. For chronic cases, case management (defined as the process of ensuring that infected individuals and their partners receive medical evaluation, counseling, vaccination, and referral to specialists for treatment when indicated) was provided for hepatitis B in Multnomah County, but was limited in other programs; barriers included resource constraints, difficulties confirming chronic infection, and privacy concerns. Finding innovative ways to overcome these barriers and improve case management is important if chronic hepatitis surveillance is to realize its full potential.
authors.affiliation: Mathematica Policy Research Inc., Princeton, NJ, USA.
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Fleming
authors.forename: Amy
authors.initials: A
authors.lastname: Zambrowski
authors.forename: Felicia
authors.initials: F
authors.lastname: Fong
authors.forename: Andrea
authors.initials: A
authors.lastname: Lombard
authors.forename: Lynne
authors.initials: L
authors.lastname: Mercedes
authors.forename: Claudia
authors.initials: C
authors.lastname: Miller
authors.forename: Jan
authors.initials: J
authors.lastname: Poujade
authors.forename: Aaron
authors.initials: A
authors.lastname: Roome
authors.forename: Amy
authors.initials: A
authors.lastname: Sullivan
authors.forename: Lyn
authors.initials: L
authors.lastname: Finelli
mesh_terms: D000328:Adult; D019090:Case Management; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011635:Public Health Administration; D012042:Registries; D018571:Sentinel Surveillance; D014481:United States / Q000453:epidemiology