Nationwide Expansion Research Articles

Post-introduction evaluation (PIE) of rotavirus vaccine in India

BackgroundIndia became the first country in the WHO South-East Asia Region (SEAR) to introduce the rotavirus vaccine (RVV) in the Universal immunization programme (UIP) in 2016 with nationwide expansion by 2019. It was a landmark move to reduce the diarrheal disease burden in under-five children. To assess the implementation process of introduction of RVV, Post Introduction Evaluation (PIE) was conducted in March 2022. MethodsThe evaluation was conducted across 14 states, 28 districts and 28 health facilities to obtain a nationwide geographical inclusion. Stakeholders involved in program decision-making, planning, training, vaccine delivery, logistics, and communication from all levels (National, state, district, health facility, health worker, caregiver) were interviewed using standardized data collection tool for PIE (adapted from the standard WHO PIE questionnaire) and scripted on a digital tool. ResultsA total of 260 interviews were conducted. Political willingness, well-planned preparedness activities, securing vaccines timely, strong supply chain monitoring, availability of domestic RVV products, quality trainings and intense communication activities were the key factors identified for the successful RVV introduction. Key activities during the introduction included cold chain space assessment, trainings of healthcare workforce, dissemination of job aids, updation of recording & reporting formats and strengthening of AEFI surveillance. Lack of community awareness for immunization in a few areas, fear of AEFI amongst some caregivers and local issues with Alternate Vaccine Delivery (AVD) were some reported challenges in achieving high coverage for RVV. ConclusionsOverall, the nationwide roll-out of RVV was smooth and the vaccine has been well-accepted in the community. The assessment emphasizes on having a well-strategized operational and communication planning, which is very crucial for any new vaccine introduction.

The rate of return to early childhood education in Japan: estimates from the nationwide expansion

ABSTRACT We present new estimates of the internal rate of return to early childhood education. Utilizing the nationwide expansion of preschool education in Japan between 1960 and 1980, we initially assess the impact of preschool attendance on high school graduation and college enrollment for men. Subsequently, we compute the social rate of return to preschool attendance for men by drawing upon national wage statistics to project expected wage trajectories and referencing government documents to account for the social cost of preschools. Our findings indicate a social rate of return ranging from 5.7% to 8.1%, consistent with previous estimates in the literature.

Rapid expansion and international spread of M1UK in the post-pandemic UK upsurge of Streptococcus pyogenes

The UK observed a marked increase in scarlet fever and invasive group A streptococcal infection in 2022 with severe outcomes in children and similar trends worldwide. Here we report lineage M1UK to be the dominant source of invasive infections in this upsurge. Compared with ancestral M1global strains, invasive M1UK strains exhibit reduced genomic diversity and fewer mutations in two-component regulator genes covRS. The emergence of M1UK is dated to 2008. Following a bottleneck coinciding with the COVID-19 pandemic, three emergent M1UK clades underwent rapid nationwide expansion, despite lack of detection in previous years. All M1UK isolates thus-far sequenced globally have a phylogenetic origin in the UK, with dispersal of the new clades in Europe. While waning immunity may promote streptococcal epidemics, the genetic features of M1UK point to a fitness advantage in pathogenicity, and a striking ability to persist through population bottlenecks.

Reforming private securities litigation in China: Does private enforcement by minority shareholders matter to corporate fraud?

Leveraging the pilot initiative on the diversified resolution mechanism for private securities litigation in China, our study explores the impact of private securities litigation by minority shareholders on corporate fraud. Employing a difference-in-differences analysis over the period 2010–2018, we observe a substantial reduction of 16.4 % in corporate fraud. This effect is particularly pronounced in companies with political connections and those characterized by weaker internal governance structures. Further analysis indicates a diminishing gap in corporate fraud between pilot and non-pilot firms after the nationwide expansion of the pilot program. These findings carry significant policy implications, particularly for emerging markets seeking to enhance protection for minority shareholders.

Effects of time-of-use pricing for residential customers and wholesale market consequences in South Korea

Using a large-scale pilot test on time-of-use (TOU) pricing for residential customers, this study analyzes the effects of TOU pricing on the load patterns of residential customers and on producer surplus in South Korea. We estimate the difference in the electricity demand functions of residential customers across peak, intermediate, and off-peak periods before and after TOU pricing. In addition, we assess the supply curve in the wholesale electricity market and calculate the changes in electricity purchase costs by integrating the supply curve over the range of consumption changes across the periods. This study simulates the effects of TOU pricing on producer surplus that would be obtained if all residential customers in South Korea switch from increasing block pricing to TOU pricing. Our results show that TOU pricing can be an effective measure for load transfer and simultaneously increase producer surplus. We find that although the revenue of electric utility generally decreases, the cost savings are greater and thus producer surplus increases. The results can be a valuable reference for the South Korean government regarding the nationwide expansion of TOU for residential electricity in the future.

From Innovation to Green: Does China’s Innovative City Construction Contribute to Green Development?

ABSTRACT China’s government has launched the innovative city pilot (ICP) policy since 2008 and taken green development as the principle goal of innovative city construction. However, whether or not the ICP policy shapes green development remains largely unknown. Leveraging variation in the timing of the ICP policy implementation across cities, we investigate the causal impact of innovative city construction on green development, as measured by green total-factor productivity (GTFP). Our staggered difference-in-differences (DID) estimator shows that cities which implement the ICP policy experience a 5.3% increase in GTFP. This effect appears one year after the introduction of ICP policy and shows an upward trend over time. Our mechanism analysis further confirms that the ICP policy effect is driven by green innovation effect, which is realized through the support of innovation policy and increased investment in innovation. Finally, substantial heterogeneity is explained by geographic location, environmental constraint, resource endowment, city size and different levels of innovation. Our paper underscores the pivotal role of innovative cities in promoting green development, which warrants nationwide expansion.

Public access defibrillation programs: Progetto Vita, current legal aspects and challenges for the future

Out-of-hospital cardiac arrest (OHCA) represents a significant healthcare issue that is often underestimated. OHCA predominantly affects the general population, with staggering numbers: 400 000 cases annually in Europe and 350 000 in the United States, contributing to 50% of cardiovascular-related deaths. The vast majority of OHCA cases begin with a shockable rhythm, making effective treatment possible through early defibrillation, even by non-medical personnel using automated external defibrillators (AEDs). Despite the availability of such devices, survival from OHCA remains below 10%, with no substantial improvements over the last 25 years. Public access defibrillation programs, which reduce response times with AEDs, have demonstrated a significant increase in survival chances for OHCA victims. Particularly, the "Progetto Vita" in Piacenza is an emblematic example of early defibrillation in Europe, tripling survival rates in OHCA patients treated by laypersons compared to patients treated with the traditional system. This experience contributed to the approval of Law 116, dated August 4, 2021, in Italy, aimed at promoting the distribution and use of AEDs in sports facilities, public venues, transportation, and public services. The law also emphasizes that AEDs can be used without the need for specific training, thus promoting wider usage. In this article, we will briefly examine the epidemiology of OHCA and delve into the organizational model of the "Progetto Vita", which aligns with the principles of Law 116/2021. The goal is to provide some insights into organizational aspects that could facilitate the nationwide expansion of early defibrillation programs in the near future.

Electronic Case Reporting Development, Implementation, and Expansion in the United States.

The COVID-19 pandemic highlighted the need for a nationwide health information technology solution that could improve upon manual case reporting and decrease the clinical and administrative burden on the US health care system. We describe the development, implementation, and nationwide expansion of electronic case reporting (eCR), including its effect on public health surveillance and pandemic readiness. Multidisciplinary teams developed and implemented a standards-based, shared, scalable, and interoperable eCR infrastructure during 2014-2020. From January 27, 2020, to January 7, 2023, the team conducted a nationwide scale-up effort and determined the number of eCR-capable electronic health record (EHR) products, the number of reportable conditions available within the infrastructure, and technical connections of health care organizations (HCOs) and jurisdictional public health agencies (PHAs) to the eCR infrastructure. The team also conducted data quality studies to determine whether HCOs were discontinuing manual case reporting and early results of eCR timeliness. During the study period, the number of eCR-capable EHR products developed or in development increased 11-fold (from 3 to 33), the number of reportable conditions available increased 28-fold (from 6 to 173), the number of HCOs connected to the eCR infrastructure increased 143-fold (from 153 to 22 000), and the number of jurisdictional PHAs connected to the eCR infrastructure increased 2.75-fold (from 24 to 66). Data quality reviews with PHAs resulted in select HCOs discontinuing manual case reporting and using eCR-exclusive case reporting in 13 PHA jurisdictions. The timeliness of eCR was <1 minute. The growth of eCR can revolutionize public health case surveillance by producing data that are more timely and complete than manual case reporting while reducing reporting burden.

Radical cure for Plasmodium vivax malaria after G6PD qualitative testing in four provinces in Cambodia, results from Phase I implementation

BackgroundCambodia aims to eliminate all forms of malaria by 2025. In 2020, 90% of all malaria cases were Plasmodium vivax. Thus, preventing P. vivax and relapse malaria is a top priority for elimination. 14-day primaquine, a World Health Organization-recommended radical cure treatment regimen, specifically targets dormant hypnozoites in the liver to prevent relapse. Cambodia introduced P. vivax radical cure with primaquine after glucose-6-phosphate dehydrogenase (G6PD) qualitative testing in 2019. This paper presents Cambodia’s radical cure Phase I implementation results and assesses the safety, effectiveness, and feasibility of the programme prior to nationwide scale up.MethodsPhase I implementation was carried out in 88 select health facilities (HFs) across four provinces. Males over 20kgs with confirmed P. vivax or mixed (P. vivax and Plasmodium falciparum) infections were enrolled. A descriptive analysis evaluated the following: successful referral to health facilities, G6PD testing results, and self-reported 14-day treatment adherence. P. vivax incidence was compared before and after radical cure rollout and a controlled interrupted time series analysis compared the estimated relapse rate between implementation and non-implementation provinces before and after radical cure.ResultsIn the 4 provinces from November 2019 to December 2020, 3,239 P. vivax/mixed infections were reported, 1,282 patients underwent G6PD deficiency testing, and 959 patients received radical cure, achieving 29.6% radical cure coverage among all P. vivax/mixed cases and 98.8% coverage among G6PD normal patients. Among those who initiated radical cure, 747 patients (78%) completed treatment. Six patients reported side effects. In implementation provinces, an average 31.8 relapse cases per month were estimated signaling a 90% (286 cases) reduction in relapse compared to what would be expected if radical cure was not implemented.ConclusionsPlasmodium vivax radical cure is a crucial tool for malaria elimination in Cambodia. The high coverage of radical cure initiation and adherence among G6PD normal patients demonstrated the high feasibility of providing radical cure at point of care in Cambodia. Incomplete referral from community to HFs and limited capacity of HF staff to conduct G6PD testing in high burden areas led to lower coverage of G6PD testing. Phase I implementation informed approaches to improve referral completion and patient adherence during the nationwide expansion of radical cure in 2021.

The Rate of Return to Early Childhood Education in Japan: Estimates from the Nationwide Expansion

The Rate of Return to Early Childhood Education in Japan: Estimates from the Nationwide Expansion

한국의 마약중독 치료·재활체계 현황 및 개선방안

Drug-related problems have become very serious social problems in Korea which used to boast as drug-free society. Korean government proclaimed ‘War on Drugs’ and has fortified supply-prevention strategies. However, for ‘War on Drugs’ we should intervene not only on supply side but also on treatment·rehabilitation(TR) for drug abusers. Currently the infrastructure for TR for drug abuse is very poor in Korea. This study analyzed the TR system in Korea and made suggestions for improvement. Specific contents of this paper are as follows. First, the nature of the problems in Korea was analyzed. They are availability of diverse drugs, sharp increase of abusers and young users, and high relapse rate, etc. Second, the ineffective court-ordered treatment policy was analyzed. It was recommended that treatment facilities should be improved and the collaboration system between legal system and treatment system should be developed. Third, the TR systems in public sector such as hospitals, Addiction Rehabilitation Centers(ARCs), Addiction Management Integrative Support Centers(AMISC) were analyzed. Public support to hospital treatment expense, nation-wide expansion of ARCs, and the development of referral system using AMISC were suggested. Fourth, the private sector systems such as DARC, Sonasa, NA were analyzed. It was suggested that government should financially support DARC and Sonasa. Also, it was recommended that NA meetings should be set up across the country. Finally, it was suggested that government should strengthen NIMS, drug-testing kits, prevention education, and develop the control tower to effectively deal with drug addiction issues.

Population Genetic Characterization of the Pear Pest, Cacopsylla jukyungi (Kwon, 1983) (Hemiptera: Psyllidae), Using Novel Microsatellite Markers

The pear pest, Cacopsylla jukyungi (Hemiptera: Psyllidae), is the most damaging insect to commercial pears in South Korea. An assessment of the population genetic characteristics of the species will raise the potential of effective control. In the present study, we developed eight microsatellite markers specific to C. jukyungi and genotyped 132 individuals collected from 11 localities throughout South Korea. Populations showed lower observed heterozygosity than expected heterozygosity and slightly or highly positive values of inbreeding coefficients, suggesting that C. jukyungi is subjected to inbreeding. A strong dependence on commercial pear trees throughout the whole life cycle, even during overwintering, and a nationwide targeting of the overwintered adults are likely contributors to such heterozygosity deficiency. On the other hand, population analyses consistently indicated strong gene flow among populations, implying the presence of persistent factors that have facilitated this process. The nationwide expansion of pear orchards and the replacement with a popular new cultivar during the last 50 years, which may have accompanied the spread of C. jukyungi-bearing pear grafts and scions, are likely causes of such facilitated dispersal. Thus, a management strategy against unintended anthropogenic dispersal of the pear psyllid will be required for better control of C. jukyungi.

Statutory provisions, aims, motives, attitudes and thinking on the outpatient operation profile of general and abdominal surgery

The aim of the manuscript is to discuss and assess the implications and opportunities as well as dangers of "outpatientization" of surgical and inpatient services for general and abdominal surgery. Narrative overview with literature reference based on a PubMed search with the search terms: outpatient operations and inpatient interventions, AOP catalog, hybrid DRG, outpatient hernia surgery, outpatient proctological surgery, selective sector-equal reimbursement and day-care forms of care. RESULTS (KEY POINTS): - In the Anglo-American area, the treatment of inguinal hernias is predominantly carried out on an outpatient clinic basis. In the USA, Sweden and Denmark, for example, over 70% of all hernias are treated in an outpatient clinic setting, in Germany it is only 20%. In Germany, the catalog of operations that can be performed on an outpatient basis and other department-replacing interventions in hospitals defines outpatient interventions in accordance with §115b Social Security Code (SGB)V (Germany). - The conversion from inpatient to outpatient hernia surgery has also failed so far due to an enormous difference in revenues. According to the will of the Federal Ministry of Health, the planned forms of semistationary care are intended to relieve the nursing staff in the hospitals and thus relieve the tense situation of nursing professionals. By the end of March 2023, aspecial industry-specific reimbursement, so-called hybrid DRGs, is to be agreed, which applies regardless of whether apaid service is provided on an outpatient or inpatient basis. - According to §115b SGBV, whether ahernia can be performed under inpatient or outpatient conditions is also decided according to the location of the hernia. In the new AOP catalog, frailty is operationalized in the context factors via the degree of care and the Barthel index. If one compares the number of encryption procedures for the 5‑530 procedure (closure of an inguinal hernia) in 2005 (184,679) with the pre-corona year 2019 (179,851), it can be seen that the proportion of hernias treated in hospital remained approximately the same over aperiod of 14years. - Most elective proctological procedures can be performed on an outpatient basis. For reasons of safety (bleeding) and practicality (pain management, dressing change of large abscesses), inpatient surgery is preferred: extensive hemorrhoidectomy in the case of massive findings, large abscesses, extensive perianal fistula corrections, particularly high transsphincteric or suprasphincteric fistulas. - Guidelines based on the British Guidelines for Ambulant Surgery should be required for comprehensive outpatient treatment in surgery. The introduction of corresponding hybrid DRGs seems to be the right way to cover the costs of outpatient surgery in hospitals. The restructuring of the hospital landscape and the nationwide expansion of outpatient operations is an unavoidable requirement in view of rising costs in the healthcare system and impending financing bottlenecks, which will pose challenges for the surgical disciplines in the years to come. Outpatient surgery is already practiced in many areas but has not become established due to the different remuneration. The flat rates for the same branches can be astarting point here. Furthermore, evidence-based framework conditions must be created along the lines of the British Guidelines for Ambulant Surgery.

Practice and improvement plans of the tailored dementia case management in local dementia centers: A qualitative study using focus group

Purpose: With the nationwide expansion of local dementia centers (LDCs) after the National Responsibility for Dementia System, the number of tailored dementia case management (TDCM) programs increased significantly, but qualitative improvement in TDCM is still a remaining task. The purpose of this study was to explore the current practice of the TDCM in LDCs and suggest directions for future program improvement. Methods: A focus group interview was conducted with seven hands-on workers who had experience in TDCM at the LDCs. Participants (mean age=40 years old) were nurses, social workers, and occupational therapists with an average of 9.1 years of working experience in TDCM. Data were analyzed using qualitative content analysis. Results: The results were summarized into three core themes and fourteen sub-themes. The three core themes were ‘Job Characteristics of TDCM’, ‘Barriers to the effective operation of TDCM’, and ‘Improvement plans for successful TDCM’. Conclusion: To establish the function and role of TDCM within the domestic dementia management system, we propose five areas for improvement: 1) Developing a standardized TDCM manual; 2) Quantitative and qualitative expansion of case manager working capacity; 3) Activating a multidisciplinary team approach; 4) Forming a collaborative network between related organizations and local community councils; 5) Active promotion of TDCM.

Estimated number of symptomatic Lyme borreliosis cases in Germany in 2021 after adjusting for under-ascertainment

BackgroundAlthough nine of 16 federal states in Germany conduct public health surveillance for Lyme borreliosis (LB), the extent of under-ascertainment is unknown. ObjectiveAs a model for European countries that conduct LB surveillance, we sought to estimate the population-based incidence of symptomatic LB after adjusting for under-ascertainment. MethodsEstimating seroprevalence-derived under-ascertainment relies on data from seroprevalence studies, public health surveillance, and published literature. The number of symptomatic LB cases in states that conduct LB surveillance was estimated from studies reporting the seroprevalence of antibodies against Borrelia burgdorferi sensu lato, the proportion of LB cases that are asymptomatic, and the duration of antibody detection. The number of estimated incident symptomatic LB cases was compared with the number of surveillance-reported LB cases to derive under-ascertainment multipliers. The multipliers were applied to the number of 2021 surveillance-reported LB cases to estimate the population-based incidence of symptomatic LB in Germany. ResultsAdjusting for seroprevalence-based under-ascertainment multipliers, the estimated number of symptomatic LB cases in states that conducted surveillance was 129,870 (408 per 100,000 population) in 2021. As there were 11,051 surveillance-reported cases in 2021 in these states, these data indicate there were 12 symptomatic LB cases for every surveillance-reported LB case. ConclusionsWe demonstrate that symptomatic LB is underdetected in Germany and that this seroprevalence-based approach can be applied elsewhere in Europe where requisite data are available. Nationwide expansion of LB surveillance would further elucidate the true LB disease burden in Germany and could support targeted disease prevention efforts to address the high LB disease burden.

Research on prediction method of financial stock curve based on BP neural network

In the development of social and economic construction, the stock as an important financial instrument, after the recent decades of regional pilot and nationwide expansion, the stock market supervision mechanism and trading principles have become more and more perfect, the level of our capital market has become more and more rich, the overall scale has expanded rapidly. In order to make investors understand the changes of macro market environment faster and reduce the threshold of investors' investment and trading, stock exchanges and some financial service institutions put forward to use artificial intelligence algorithm to build a prediction system on the basis of integrating the accumulated experience in the past. Based on the research of financial stock curve prediction in recent years, this paper proposes a neural network system for stock market prediction. The final experimental results show that BP neural network can make short-term prediction of the stock market. As long as the appropriate prediction model is selected, it can get more than the average market profit level.

Effects of the community-based health planning and services on anemia and acute malnutrition amongst under-fives in Ghana: A comparative study.

Ghana implemented a community-based health planning and services (CHPS) in 2000 with the aim of bringing health services to the doorsteps of the deprived in the communities. Japan International Cooperation Agency (JICA) supported the implementation of the project with a distinct approach in the Upper West region, employing supportive supervision. To investigate the impact of the JICA CHPS model on anemia and acute malnutrition prevalence amongst children less than five years of age. This is a quasi-experimental study design that compares the upper west region with the two other regions of the North implementing the traditional model of CHPS. We used the Ghana demographic and health survey dataset for 2003 as the baseline and 2014 as the follow-up year and employed the difference-in-difference approach. We find a reduction in the likelihood of anemia and acute malnutrition prevalence among children less than five years by 17 and 8 percentage points respectively. We find the project to be cost-effective, at a cost of $7 per each anemia prevalence averted. The results indicate that the JICA model of CHPS is cost-effective in the reduction of anemia and acute malnutrition prevalence compared to the traditional model. We recommend a nationwide expansion of the JICA model to enhance the reduction of anemia and acute malnutrition in Ghana.

자살 위험군 특성 및 관리시스템 구축방안

Suicide can be defined as any act by a person of terminating his or her life through his or her own act with a clear intent of ending the life. Suicide is recognized as a serious social problem, but it has not been successfully prevented for a long time. Suicide prevention has not been successful not only because the causes of suicide are complex and complicated, but also because the prevention system has not been well administered.&#x0D; Suicides can be classified into suicides from social, economic and environmental causes; social disconnection and maladjustment; mental and psychological causes; irreversible health deterioration; and from various interacting causes.&#x0D; In order to effectively control these problems of suicides, it is necessary to establish a control system of suicide prevention at the national level, improve relevant laws, install a police-centered public-private partnership suicide prevention system, and organize and use treatment and response manuals for each type of suicide.&#x0D; The most important measures would be to change public awareness and form a consensus on the environment which prompts suicide. Along with the nationwide expansion of suicide prevention education, it is also essential to remedy a social environment which creates a demand for suicides. Such remedy is needed because it is difficult to achieve an intended effect just by controlling suppliers when there are many people with demand. Therefore, the basic policy of suicide prevention should be to create a social environment which can control the demand for suicides, too.

Enhanced Prediction and Determination of Hydrological Drought at Ungauged River Intake Stations under Changing Climate

Droughts, which are expected to worsen under global climate change, have major impacts on human life and the natural environment. In this study, an analysis system was established for predicting and determining hydrological drought conditions at ungauged water stations and in watersheds connected to municipal river water intake facilities. The aim was to help prevent drought damage or minimize its effects based on an immediate response to severe drought events. A system is presented for the selection of ungauged watersheds that take in river water, and three methodologies are proposed for identifying and forecasting hydrological drought conditions. Two South Korean pilot sites among the numerous ungauged water intake plants that lack local data collection facilities were selected as study areas. In addition, a roadmap for the establishment of standards for the determination of drought conditions in ungauged river basins was proposed. The methodologies introduced in this study assume nationwide expansion and construction. Their utilization can facilitate effective drought responses, based on drought forecasting and restricted water supply criteria for each phase of water intake, at local (and other) waterworks.

Prevalence of blood-borne viral and sexually transmitted infections among homeless people in Berlin

Abstract Background Risk factors associated with precarious living conditions make people experiencing homelessness (PEH) also highly vulnerable for blood-borne viral and sexually transmitted infections (BBVSTI) and tuberculosis (TB). The number of PEH in Germany is rising, yet little data is available on the infectious burden among this population. A pilot study assessed the prevalence of BBVSTI, TB, behaviours and access to medical services among PEH. Methods We recruited PEH from April-June 2021 in five low-threshold medical services in Berlin. Behavioural data was collected via questionnaire-based interviews. Serological/molecular testing from venous blood samples was performed for Hepatitis B (HBV), Hepatitis C (HCV), HIV, syphilis and TB and from urine for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT). Results Of 216 participants, 88% (191/216) were male and 73% (158/215) were born abroad. Mean age was 41 years (range 19-68). No health insurance was reported by 57% (123/216) and previous incarceration by 71% (153/214). Of all, 53% (114/216) injected drugs in the last 30 days, and 41% (89/216) reported unprotected sex in the last 12 months. Prevalence of active HBV was 1.9% (4/212), of active HCV 15.9% (34/213), and of HIV 2.8% (6/213). No active TB was diagnosed, while 14.4% (31/216) tested positive for latent TB infection. Active syphilis was found in 1.4% (3/212), NG in 2.0% (4/197), CT in 3.0% (6/197), and serological evidence of HBV vaccination in 26% (56/212). While 44% (96/216) of participants were ever tested for HCV, 71% (36/51) of those with HCV antibodies knew about their infection, 36% (13/36) of them reported previous/current treatment. Conclusions Burden of HCV and HIV was high among PEH in Berlin, and risk behaviours were frequently reported. There is a need to improve access to regular health care, accompanied by low-threshold prevention offers in cooperation with drug and homeless services. A nationwide expansion of the study is planned. Key messages • High burden of Hepatitis C and HIV among people experiencing homelessness in Berlin, Germany. • Access of people experiencing homelessness to regular health care needs improvement, accompanied by low-threshold prevention offers in cooperation with drug and homeless services.