Epidemiology of Chronic Hepatitis C and Disease Modelling

Study Overview
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Brief Summary
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Hepatitis C (HCV) is a major health problem amongst people who inject drugs (PWID) and have limited contact with health care services. Halfway houses (HH) serve to reintegrate former drug users into society. Strategies to eliminate HCV must focus on screening for HCV amongst HH. Linkage to care for PWID population is an issue globally. The aim is to determine the sero-prevalence, demographics, disease distribution and factors associated with the risk of HCV transmission amongst former drug users at Halfway Houses. The secondary aim would be to determine the best models of care that can be used to link these individuals to existing healthcare services in a pragmatic, randomised fashion Halfway Houses are invited to participate in a program of HCV education, point-of-care screening using Oraquick test and staging with Fibroscan® by a small mobile team of healthcare workers. A detailed survey regarding illicit drug injecting practices is performed. Those who are tested positive are referred to medical care. It is anticipated that the prevalence of Hepatitis C within the drug injecting population along with the stages of liver disease such that models for disease burden can be determined.

Detailed Description
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This is a pragmatic observational study of point of care HCV screening in the halfway house resident /PWID population. In the secondary aim the HCV positive subjects are randomised to traditional referral pathway (HCV positive cases attend primary care facilities to get referral to specialist clinic in hospital) and 'direct' open access where the HCV positive cases has direct open access to specialist clinic as above (by passing primary care physicians). We observe the no. of subjects being linkage to specialist care, and HCV treatment

Official Title
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Epidemiology of Chronic Hepatitis C and Modelling for Disease Burden Study

Conditions
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Hepatitis C

Intervention / Treatment
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* Other: Screening


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Former Drug Users residing in Halfway Houses Exclusion Criteria: Age below 21 years Residents of Halfway Houses who have never used drugs

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Ex-Drug Users<br>These are ex drug users residing at halfway houses | Other: Screening<br>* Patients tested positive for Hepatitis C will be referred to Hospital through the conventional health care services and by an alternative direct access method to determine if this improves linkage to care<br>* Other names: Models of Care;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HCV Sero-prevalence at Halfway Houses | The number of HCV Sero positive cases at Halfway Houses will be measured | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Linkage to Care | The number of patients linked to care will be compared between the intervention arm and conventional arm | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Community Screening, Halfway house, People who inject drugs, Substance users, Released prisoners