Design and Development of a Viral Hepatitis and HIV Infection Screening Program (Hprolipsis) for the General, Greek Roma, and Migrant Populations of Greece: Protocol for Three Cross-Sectional Health Examination Surveys.

Giota Touloumi,Niki Maria Voudouri,Angelos Hatzakis,Theofilos Rosenberg,Maria Kantzanou,Ioanna Petraki,Apostolos Vantarakis,Olga Anagnostou,George Rachiotis,Argiro Karakosta,George Papatheodoridis,Magda Gavana,Agis Terzidis,Vana Sypsa

doi:10.2196/13578

Abstract

BackgroundAlthough infectious diseases are globally on the decline, they remain a major global public health problem. Among them, the hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV infection are of primary interest. Valid prevalence data on these infections are sparse in Greece, especially for vulnerable populations.ObjectiveThis study aimed to present the design and methods of Hprolipsis, an integrated viral hepatitis and HIV screening program administered to adults (≥18 years) from the general, Greek Roma, and migrant populations. Its aims were to estimate the prevalence of HBV, HCV, and HIV; assess infectious disease knowledge level; design, implement, and assess population-specific awareness actions; and offer individual counseling and referral when indicated and HBV vaccination to susceptible Roma and migrants.MethodsMultistage, stratified, random sampling based on the 2011 Census was applied to select the general population sample, and nonprobability multistage quota sampling was used for Roma and migrant sample selection. Trained personnel made home (general population) or community (Roma and migrants) visits. Collected blood samples were tested for Hepatitis B surface Antigen, Hepatitis B core Antibody, Hepatitis B surface Antibody, Hepatitis C Antibody, and HIV 1,2 Antibody. The surveys were conducted during May 2013 and June 2016. To estimate an HCV prevalence of 1.5% with 0.3 precision, the required general population sample size was estimated to be 6000. As migrants constitute 10% of the whole Greek population, the migrant sample size was set to 600. A feasible sample size of 500 Greek Roma was set.ResultsIn total, 6006 individuals from the general population (response rate 72%), 534 Greek Roma, and 612 migrants were recruited. Blood test results are available for 4245 individuals from the general population, 523 Roma, and 537 migrants.ConclusionsHprolipsis is the first nationwide survey on HBV, HCV, and HIV. Its results will enhance our understanding of the health needs and disease burden of these diseases in the 3 studied populations. Its implementation provided useful recommendations for future studies, particularly in vulnerable populations.International Registered Report Identifier (IRRID)DERR1-10.2196/13578

Highlights

Background infectious diseases are on the decline globally, they are still of major public health importance, imposing significant burden on global economies and public health [1]
Hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV infection are of particular interest in developed countries owing to their prevalence and associated disease burden
Compared to the planned sample, settlements with houses and settlements with houses and shacks were slightly underrepresented, and settlements with shacks were slightly overrepresented in the final achieved Greek Roma survey. Albanians and those who originated from Europe were to some degree underrepresented, and those from Africa and Asia were http://www.researchprotocols.org/2020/1/e13578/

Summary

Introduction

Background infectious diseases are on the decline globally, they are still of major public health importance, imposing significant burden on global economies and public health [1]. Hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV infection are of particular interest in developed countries owing to their prevalence and associated disease burden. Highly effective therapies for HCV and long-term therapies for HBV and HIV infections are available. Owing to their usually long asymptomatic period, only a minority of those infected with one of these viruses are aware of their infection, lacking the opportunity to take advantage of new treatments [4]. Infection awareness, treatment uptake and the knowledge for HBV, HCV, and HIV are necessary to plan and implement effective prevention programs. Infectious diseases are globally on the decline, they remain a major global public health problem. Valid prevalence data on these infections are sparse in Greece, especially for vulnerable populations

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