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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Outcomes of hepatitis C screening programs targeted at risk groups hidden in the general population: a systematic review

Authors: Freke R Zuure, Anouk T Urbanus, Miranda W Langendam, Charles W Helsper, Charlotte HSB van den Berg, Udi Davidovich, Maria Prins

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Effective screening programs are urgently needed to provide undiagnosed hepatitis C virus (HCV)-infected individuals with therapy. This systematic review of characteristics and outcomes of screening programs for HCV focuses on strategies to identify HCV risk groups hidden in the general population.

Methods

We conducted a comprehensive search of MEDLINE and EMBASE databases for articles published between 1991–2010, including studies that screened the general population using either a newly developed (nonintegrated) screening program or one integrated in existing health care facilities. Look-back studies, prevalence studies, and programs targeting high-risk groups in care (e.g., current drug users) were excluded.

Results

After reviewing 7052 studies, we identified 67 screening programs: 24 nonintegrated; 41 programs integrated in a variety of health care facilities (e.g., general practitioner); and 2 programs with both integrated and nonintegrated strategies. Together, these programs identified approximately 25,700 HCV-infected individuals. In general, higher HCV prevalence was found in programs in countries with intermediate to high HCV prevalence, in psychiatric clinics, and in programs that used a prescreening selection based on HCV risk factors. Only 6 programs used a comparison group for evaluation purposes, and 1 program used theory about effective promotion for screening. Comparison of the programs and their effectiveness was hampered by lack of reported data on program characteristics, clinical follow-up, and type of diagnostic test.

Conclusions

A prescreening selection based on risk factors can increase the efficiency of screening in low-prevalence populations, and we need programs with comparison groups to evaluate effectiveness. Also, program characteristics such as type of diagnostic test, screening uptake, and clinical outcomes should be reported systematically.
Appendix
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Metadata
Title
Outcomes of hepatitis C screening programs targeted at risk groups hidden in the general population: a systematic review
Authors
Freke R Zuure
Anouk T Urbanus
Miranda W Langendam
Charles W Helsper
Charlotte HSB van den Berg
Udi Davidovich
Maria Prins
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-66

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