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Binks P, Ross C, Gurruwiwi GG, Wurrawilya S, Alley T, Bukulatjpi SM, Vintour-Cesar E, Hosking K, Davis JS, Hefler M, Davies J. Adapting and translating the 'Hep B Story' App the right way: A transferable toolkit to develop health resources with, and for, Aboriginal people. Health Promot J Austr 2024. [PMID: 38566264 DOI: 10.1002/hpja.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/09/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
ISSUE ADDRESSED In 2014 the 'Hep B Story App', the first hepatitis B educational app in an Aboriginal language was released. Subsequently, in 2018, it was assessed and adapted before translation into an additional 10 Aboriginal languages. The translation process developed iteratively into a model that may be applied when creating any health resource in Aboriginal languages. METHODS The adaptation and translation of the 'Hep B Story' followed a tailored participatory action research (PAR) process involving crucial steps such as extensive community consultation, adaptation of the original material, forward and back translation of the script, content accuracy verification, voiceover recording, and thorough review before the publication of the new version. RESULTS Iterative PAR cycles shaped the translation process, leading to a refined model applicable to creating health resources in any Aboriginal language. The community-wide consultation yielded widespread chronic hepatitis B education, prompting participants to share the story within their families, advocating for hepatitis B check-ups. The project offered numerous insights and lessons, such as the significance of allocating sufficient time and resources to undertake the process. Additionally, it highlighted the importance of implementing flexible work arrangements and eliminating barriers to work for the translators. CONCLUSIONS Through our extensive work across the Northern Territory, we produced an educational tool for Aboriginal people in their preferred languages and developed a translation model to create resources for different cultural and linguistic groups. SO WHAT?: This translation model provides a rigorous, transferable method for creating accurate health resources for culturally and linguistically diverse populations.
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Affiliation(s)
- Paula Binks
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Cheryl Ross
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - George Garambaka Gurruwiwi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | - Tiana Alley
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Sarah Mariyalawuy Bukulatjpi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Miwatj Health Aboriginal Corporation, Nhulunbuy, Northern Territory, Australia
| | - Emily Vintour-Cesar
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kelly Hosking
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Northern Territory Health, Darwin, Northern Territory, Australia
| | - Joshua S Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Infectious Diseases and General Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Marita Hefler
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jane Davies
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Northern Territory Health, Darwin, Northern Territory, Australia
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Hosking K, De Santis T, Vintour-Cesar E, Wilson PM, Bunn L, Garambaka Gurruwiwi G, Wurrawilya S, Bukulatjpi SM, Nelson S, Ross C, Stuart-Carter KA, Ngurruwuthun T, Dhagapan A, Binks P, Sullivan R, Ward L, Schroder P, Tate-Baker J, Davis JS, Connors C, Davies J. "Putting the power back into community": A mixed methods evaluation of a chronic hepatitis B training course for the Aboriginal health workforce of Australia's Northern Territory. PLoS One 2024; 19:e0288577. [PMID: 38266007 PMCID: PMC10807824 DOI: 10.1371/journal.pone.0288577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Chronic hepatitis B (CHB) is endemic in the Aboriginal and Torres Strait Islander population of Australia's Northern Territory. Progression to liver disease can be prevented if holistic care is provided. Low health literacy amongst health professionals is a known barrier to caring for people living with CHB. We co-designed and delivered a culturally safe "Managing hepatitis B" training course for the Aboriginal health workforce. Here, we present an evaluation of the course. OBJECTIVES 1. To improve course participants CHB-related knowledge, attitudes, and clinical practice. 2. To evaluate the "Managing hepatitis B" training course. 3. To enable participants to have the skills and confidence to be part of the care team. METHODS We used participatory action research and culturally safe principles. We used purpose-built quantitative and qualitative evaluation tools to evaluate our "Managing hepatitis B" training course. We integrated the two forms of data, deductively analysing codes, grouped into categories, and assessed pedagogical outcomes against Kirkpatrick's training evaluation framework. RESULTS Eight courses were delivered between 2019 and 2023, with 130 participants from 32 communities. Pre- and post-course questionnaires demonstrated statistically significant improvements in all domains, p<0.001 on 93 matched pairs. Thematic network analysis demonstrated high levels of course acceptability and significant knowledge acquisition. Other themes identified include cultural safety, shame, previous misinformation, and misconceptions about transmission. Observations demonstrate improvements in post-course engagement, a deep understanding of CHB as well as increased participation in clinical care teams. CONCLUSIONS The "Managing hepatitis B" training course led to a sustained improvement in the knowledge and attitudes of the Aboriginal health workforce, resulting in improved care and treatment uptake for people living with CHB. Important non-clinical outcomes included strengthening teaching and leadership skills, and empowerment.
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Affiliation(s)
- Kelly Hosking
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Teresa De Santis
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Emily Vintour-Cesar
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Phillip Merrdi Wilson
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Linda Bunn
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - George Garambaka Gurruwiwi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Shiraline Wurrawilya
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | | | - Sandra Nelson
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Cheryl Ross
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kelly-Anne Stuart-Carter
- Centre for Disease Control, Northern Territory Health, Alice Springs, Northern Territory, Australia
| | - Terese Ngurruwuthun
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | - Amanda Dhagapan
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | - Paula Binks
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Richard Sullivan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- UNSW School of Clinical Medicine, St George & Sutherland Campus, Jannali, NSW, Australia
| | - Linda Ward
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Phoebe Schroder
- Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, NSW, Australia
| | - Jaclyn Tate-Baker
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
| | - Joshua S. Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Christine Connors
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Jane Davies
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
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Hosking K, De Santis T, Vintour-Cesar E, Wilson PM, Bunn L, Gurruwiwi GG, Wurrawilya S, Bukulatjpi SM, Nelson S, Ross C, Binks P, Schroder P, Davis JS, Taylor S, Connors C, Davies J. "The most culturally safe training I've ever had": the co-design of a culturally safe Managing hepatitis B training course with and for the Aboriginal health workforce of the Northern Territory of Australia. BMC Health Serv Res 2023; 23:935. [PMID: 37653370 PMCID: PMC10472722 DOI: 10.1186/s12913-023-09902-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The Aboriginal health workforce provide responsive, culturally safe health care. We aimed to co-design a culturally safe course with and for the Aboriginal health workforce. We describe the factors which led to the successful co-design, delivery, and evaluation of the "Managing hepatitis B" course for the Aboriginal health workforce. METHODS A Participatory Action Research approach was used, involving ongoing consultation to iteratively co-design and then develop course content, materials, and evaluation tools. An Aboriginal and Torres Strait Islander research and teaching team received education in chronic hepatitis B and teaching methodologies. Pilot courses were held, in remote communities of the Northern Territory, using two-way learning and teach-back methods to further develop the course and assess acceptability and learnings. Data collection involved focus group discussions, in-class observations, reflective analysis, and use of co-designed and assessed evaluation tools. RESULTS Twenty-six participants attended the pilot courses. Aboriginal and Torres Strait Islander facilitators delivered a high proportion of the course. Evaluations demonstrated high course acceptability, cultural safety, and learnings. Key elements contributing to success and acceptability were acknowledging, respecting, and integrating cultural differences into education, delivering messaging and key concepts through an Aboriginal and Torres Strait Islander lens, using culturally appropriate approaches to learning including storytelling and visual teaching methodologies. Evaluation of culturally safe frameworks and findings from the co-design process led to the creation of a conceptual framework, underpinned by meeting people's basic needs, and offering a safe and comfortable environment to enable productive learning with attention to the following: sustenance, financial security, cultural obligations, and gender and kinship relationships. CONCLUSIONS Co-designed education for the Aboriginal health workforce must embed principles of cultural safety and meaningful community consultation to enable an increase in knowledge and empowerment. The findings of this research can be used to guide the design of future health education for First Nations health professionals and to other non-dominant cultures. The course model has been successfully transferred to other health issues in the Northern Territory.
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Affiliation(s)
- Kelly Hosking
- Northern Territory Health, Darwin, NT, Australia.
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | | | - Emily Vintour-Cesar
- Northern Territory Health, Darwin, NT, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | | | - Linda Bunn
- Northern Territory Health, Darwin, NT, Australia
| | - George Garambaka Gurruwiwi
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | | | | | | | - Cheryl Ross
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Paula Binks
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Phoebe Schroder
- Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, NSW, Australia
| | - Joshua S Davis
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- John Hunter Hospital, Newcastle, NSW, Australia
| | - Sean Taylor
- Northern Territory Health, Darwin, NT, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | | | - Jane Davies
- Northern Territory Health, Darwin, NT, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
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Sullivan RP, Davies J, Binks P, McKinnon M, Dhurrkay RG, Hosking K, Bukulatjpi SM, Locarnini S, Littlejohn M, Jackson K, Tong SYC, Davis JS. Correction: Preventing early childhood transmission of hepatitis B in remote Aboriginal communities in northern Australia. Int J Equity Health 2023; 22:60. [PMID: 37013563 PMCID: PMC10071732 DOI: 10.1186/s12939-023-01844-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Affiliation(s)
- Richard P Sullivan
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
- Department of Infectious Diseases, Immunology and Sexual Health, St George and Sutherland Hospital, School of Clinical Medicine, UNSW Medicine and Health, Sydney, New South Wales, Australia.
| | - Jane Davies
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Paula Binks
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Melita McKinnon
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | - Kelly Hosking
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Population and Primary Health Care, Top End Health Service, Northern Territory Government, Darwin, Northern Territory, Australia
| | | | - Stephen Locarnini
- Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Margaret Littlejohn
- Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Kathy Jackson
- Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Steven Y C Tong
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Victorian Infectious Disease Service, The Royal Melbourne Hospital, and Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Joshua S Davis
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- John Hunter Hospital, Newcastle, New South Wales, Australia
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Sullivan RP, Davies J, Binks P, McKinnon M, Dhurrkay RG, Hosking K, Bukulatjpi SM, Locarnini S, Littlejohn M, Jackson K, Tong SYC, Davis JS. Preventing early childhood transmission of hepatitis B in remote aboriginal communities in Northern Australia. Int J Equity Health 2022; 21:186. [PMID: 36575515 PMCID: PMC9795589 DOI: 10.1186/s12939-022-01808-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic hepatitis B is a public health concern in Aboriginal communities in the Northern Territory of Australia with prevalence almost four times the non-Aboriginal population. Infection is suspected to mainly occur in early life, however, the mode of transmission and vaccine effectiveness is not known in this population. WHO has set a target for hepatitis B elimination by 2030; elimination in this disproportionately affected population in Australia will require understanding of the modes of transmission and vaccine effectiveness. METHODS We conducted the study at four very remote Aboriginal communities. We approached mothers who had chronic hepatitis B and had given birth between 1988 and 2013 for consent. We obtained hepatitis B serology, immunisation and birth details from the medical record. If both mother and child had hepatitis B viral DNA detected, we performed viral whole genome sequencing. RESULTS We approached 45 women for consent, of whom 23 agreed to participate. We included 20 mothers and 38 of their children. Of the 20 included mothers, 5 (25%) had children who were hepatitis B immune by exposure and 3 (15%) had children with evidence of chronic hepatitis B infection at the time of assessment. Hepatitis B immunoglobulin (HBIg) had been given at birth in 29/38 (76.3, 95% CI 59.8-88.6) children, and 26 children (68.4, 95% CI 51.3-82.5) were fully vaccinated. Of the 3 children who had chronic hepatitis B, all had received HBIg at birth and two were fully vaccinated. Of the 5 who were immune by exposure, 4 had received HBIg at birth and one was fully vaccinated. Whole genome sequencing revealed one episode of definite mother to child transmission. There was also one definite case of horizontal transmission. CONCLUSIONS Chronic hepatitis B in this context is a sensitive issue, with a high proportion of women refusing consent. Although uncommon, there is ongoing transmission of hepatitis B to Aboriginal children in remote northern Australia despite vaccination, and this is likely occurring by both vertical and horizontal routes. Prevention will require ongoing investment to overcome the many barriers experienced by this population in accessing care.
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Affiliation(s)
- Richard P. Sullivan
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia ,grid.240634.70000 0000 8966 2764Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory Australia ,grid.1005.40000 0004 4902 0432Department of Infectious Diseases, Immunology and Sexual Health, St George and Sutherland Hospital, School of Clinical Medicine, UNSW Medicine and Health, Sydney, New South Wales Australia
| | - Jane Davies
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia ,grid.240634.70000 0000 8966 2764Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory Australia
| | - Paula Binks
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia
| | - Melita McKinnon
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia
| | - Roslyn Gundjirryiir Dhurrkay
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia
| | - Kelly Hosking
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia ,grid.483876.60000 0004 0394 3004Population and Primary Health Care, Top End Health Service, Northern Territory Government, Darwin, Northern Territory Australia
| | | | - Stephen Locarnini
- grid.416153.40000 0004 0624 1200Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC Australia
| | - Margaret Littlejohn
- grid.416153.40000 0004 0624 1200Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC Australia
| | - Kathy Jackson
- grid.416153.40000 0004 0624 1200Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC Australia
| | - Steven Y. C. Tong
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia ,grid.416153.40000 0004 0624 1200Victorian Infectious Disease Service, The Royal Melbourne Hospital, and Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria Australia
| | - Joshua S. Davis
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia ,grid.414724.00000 0004 0577 6676John Hunter Hospital, Newcastle, New South Wales Australia
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Sullivan RP, Davies J, Binks P, Dhurrkay RG, Gurruwiwi GG, Bukulatjpi SM, McKinnon M, Hosking K, Littlejohn M, Jackson K, Locarnini S, Davis JS, Tong SYC. Point of care and oral fluid hepatitis B testing in remote Indigenous communities of northern Australia. J Viral Hepat 2020; 27:407-414. [PMID: 31785060 DOI: 10.1111/jvh.13243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 01/17/2023]
Abstract
Many Indigenous Australians in northern Australia living with chronic hepatitis B are unaware of their diagnosis due to low screening rates. A venous blood point of care test (POCT) or oral fluid laboratory test could improve testing uptake in this region. The purpose of this study was to assess the field performance of venous blood POCT and laboratory performance of an oral fluid hepatitis B surface antigen (HBsAg) test in Indigenous individuals living in remote northern Australian communities. The study was conducted with four very remote communities in the tropical north of Australia's Northern Territory. Community research workers collected venous blood and oral fluid samples. We performed the venous blood POCT for HBsAg in the field. We assessed the venous blood and oral fluid specimens for the presence of HBsAg using standard laboratory assays. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the POCT and oral fluid test, using serum laboratory detection of HBsAg as the gold standard. From 215 enrolled participants, 155 POCT and 197 oral fluid tests had corresponding serum HBsAg results. The POCT had a sensitivity of 91.7% and specificity of 100%. Based on a population prevalence of 6%, the PPV was 100% and NPV was 99.5%. The oral fluid test had a sensitivity of 56.8%, specificity of 98.1%, PPV of 97.3% and NPV of 65.9%. The venous blood POCT has excellent test characteristics and could be used to identify individuals with chronic HBV infection in high prevalence communities with limited access to health care. Oral fluid performance was suboptimal.
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Affiliation(s)
- Richard P Sullivan
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Casuarina, NT, Australia.,Department of Infectious Diseases, Immunology and Sexual Health, St George & Sutherland Clinical School, UNSW, Kogarah, NSW, Australia
| | - Jane Davies
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Casuarina, NT, Australia
| | - Paula Binks
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | | | | | | | - Melita McKinnon
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Kelly Hosking
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Top End Health Service, Primary Health Care Branch, Northern Territory Government, Darwin, NT, Australia
| | - Margaret Littlejohn
- Victorian Infectious Diseases Research Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
| | - Kathy Jackson
- Victorian Infectious Diseases Research Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
| | - Stephen Locarnini
- Victorian Infectious Diseases Research Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
| | - Joshua S Davis
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Steven Y C Tong
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Victorian Infectious Disease Service, The Royal Melbourne Hospital, Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
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