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Research article

Using a Hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu Provinces to improve data quality and assess program effectiveness, China, 2015

Hui Zheng, Alexander J. Millman, Jeanette J. Rainey, Fuzhen Wang, Rui Zhang, Hong Chen, Zundong Yin, Huaqing Wang, Guomin zhang

Abstract

Background: Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. Methods: We evaluated hepatitis B case-reporting at six hospitals in Fujian, Hainan and Gansu provinces in 2015 to assess the accuracy of case classification. We linked National Notifiable Disease Reporting System (NNDRS) HBV case-reports with hospital information systems and extracted information on age, gender, admission ward and viral hepatitis diagnosis from medical records. To assess accuracy, we compared NNDRS reported case-classifications with the national HBV case definitions. Multivariable logistic regression was used to identify factors associated with misclassification. Results: Of the 1,420 HBV cases reported to NNDRS, 23 (6.5%) of the 352 acute reports and 648 (60.7%) of the 1,068 chronic reports were correctly classified. Of the remaining, 318 (22.4%) were misclassified and 431 (30.4%) could not be classified due to the lack of supporting information. Based on the multivariable analysis, HBV cases reported from Hainan (aOR=1.8; 95% CI: 1.3-2.4) and Gansu (aOR=12.7; 95% CI: 7.7-20.1) along with reports from grade 2 hospitals (aOR=1.6; 95% CI:1.2-2.2) and those from non-HBV related departments (aOR=5.3; 95% CI: 4.1-7.0) were independently associated with being ‘misclassified’ in NNDRS. Conclusions: We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness.

Keywords
Hepatitis B; acute hepatitis infection, chronic hepatitis infection, surveillance, case-reporting

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Preprint: Please note that this article has not completed peer review.
Research article

Using a Hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu Provinces to improve data quality and assess program effectiveness, China, 2015

Hui Zheng, Alexander J. Millman, Jeanette J. Rainey, Fuzhen Wang, Rui Zhang, Hong Chen, Zundong Yin, Huaqing Wang, Guomin zhang

STATUS: In Review

Comments: 0
PDF Downloads: 0
HTML Views: 16

Integrity Check:

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  • Peer Review Timeline

  • Related Articles

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Abstract

Background: Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. Methods: We evaluated hepatitis B case-reporting at six hospitals in Fujian, Hainan and Gansu provinces in 2015 to assess the accuracy of case classification. We linked National Notifiable Disease Reporting System (NNDRS) HBV case-reports with hospital information systems and extracted information on age, gender, admission ward and viral hepatitis diagnosis from medical records. To assess accuracy, we compared NNDRS reported case-classifications with the national HBV case definitions. Multivariable logistic regression was used to identify factors associated with misclassification. Results: Of the 1,420 HBV cases reported to NNDRS, 23 (6.5%) of the 352 acute reports and 648 (60.7%) of the 1,068 chronic reports were correctly classified. Of the remaining, 318 (22.4%) were misclassified and 431 (30.4%) could not be classified due to the lack of supporting information. Based on the multivariable analysis, HBV cases reported from Hainan (aOR=1.8; 95% CI: 1.3-2.4) and Gansu (aOR=12.7; 95% CI: 7.7-20.1) along with reports from grade 2 hospitals (aOR=1.6; 95% CI:1.2-2.2) and those from non-HBV related departments (aOR=5.3; 95% CI: 4.1-7.0) were independently associated with being ‘misclassified’ in NNDRS. Conclusions: We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness.

Figures

Background

Methods

Results

Discussion

Conclusions

Abbreviations

Declarations

References

Tables

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