Hepatitis B in West African-Born Persons Living in New York City: Is Linkage to Care Enough?
Notice bibliographique
Résumé
Introduction: Hepatitis B virus (HBV) infection in the US disproportionately affects foreign-born persons. West African nations have among the highest rates of HBV infection worldwide (≥8%) but little is known about West Africans living in the US. Our aims were to test the effectiveness of a community screening and link-to-care program that relies on culturally targeted patient navigators (PNs). Methods: From October 2012 to April 2015, community screenings were conducted targeting persons from countries with a high prevalence of HBV (≥2%). Individuals completed a survey and were tested for HBV (HBsAg, HBcAb, HBsAb). Subjects were identified as having HBV infection (HBsAg+) or as being HBV exposed (HBcAb+). PNs contacted patients with results and linked HBsAg+ persons to care. Data was analyzed using Chi-Square to compare HBV infection, exposure, and factors potentially associated with linkage or retention to care between West Africans and non-West Africans. Follow-up retention data were obtained. Results: In total, 2,455 subjects were screened for HBV, representing 91 high-prevalence countries. The cohort was predominantly from Africa (64%) or Asia (25%). 1,528 (61.6%) individuals were from West African nations: Senegal (42%), Ghana (7.7%), Guinea (7.7%), Ivory Coast (7.5%) and Burkina Faso (6.7%). The overall HBsAg+ rate was 10% (n=243), though higher in West Africans (12%, n=183). West Africans were more likely than non-West Africans to be HBsAg+ (12.0% vs. 6.5%, p < .0001), HBcAb+ (78.6% vs. 39.9%, p < .0001), but less likely to be insured (24.9% vs. 34.4%, p < .0001), or have a primary care physician (26.6% vs. 37.0%, p < .0001). A PN successfully contacted 98% of HBsAg+ individuals. In West African HBsAg+ subjects, 137 (74.9%) have attended an appointment, 35 (19.1%) are actively being linked to care, and 11 (6.0%) refused care or were lost to follow up. In those who attended an initial appointment, 49 (35.8%) were retained in care (one visit in the past 4 months). Conclusion: The high rate of patients who attended an appointment with a hepatitis provider establishes the effectiveness of culturally targeted patient navigation in linking at-risk African persons to access HBV care. Yet, the low rates of insurance, established primary care, and retention in care among West African patients highlight the vulnerability of this population to become lost after initial linkage unless ongoing culturally targeted PN and care coordination programs are enacted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».