a population based survey for the prevalence of hepatitis c virus infection in georgia
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A Population-based survey for the prevalence of Hepatitis C Virus Infection in Georgia. Ana Kasradze National Center for Disease Control and Public Health September 6, 2014. Rationale for Survey. Georgia may be among countries with highest HCV burden worldwide

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a population based survey for the prevalence of hepatitis c virus infection in georgia

A Population-based survey for the prevalence of Hepatitis C Virus Infection in Georgia

Ana Kasradze

National Center for Disease Control and Public Health

September 6, 2014

rationale for survey
Rationale for Survey
  • Georgia may be among countries with highest HCV burden worldwide
  • Limited data on national HCV prevalence, risk factors and population at risk

(Tbilisi survey > 10 years prior)

  • Need for high quality serporevalence data

(Disease burden)

  • Need to describe genotypes

(treatment and response)

  • Georgia Ministry of Health priority
hcv genotypes in georgia
HCV Genotypes in Georgia

*Source: Stvilia, et al: J Urban Health; 83(2):2006:289-298;.

†Bouscaillou, J., et al. (2014). : Int J Drug Policy

¶Karchava, et al: Georgia Medical News: 2009 Dec; (177): 51-55

objectives
Objectives
  • Primary Objective: Estimate the prevalence of HCV infection in the general population by age groups, regions, and urban/rural residence
  • Secondary Objectives
    • Assess risk factors for HCV infection in Georgia
    • Describe HCV circulating genotypes
    • Identify knowledge and perceptions towards hepatitis and its prevention and treatment
survey
Survey
  • Design:multistage, cluster, random sampling
  • Population: males and females > 18 years of age, residing in randomly selected households in Georgia.
  • Sample size: total approximately 7,000

(based on 95% confidence interval +/- 1%, design effect of 2,

30% non-response rate)

  • Stratification: 16 Strata (10 regions + 6 cities)
    • Tbilisi (sample of 1000, including 200 IDU)
    • Telavi, Kutaisi, Batumi, Zugdidi , Rustavi (sample of 400*5=2000, including 500 IDU)
idu subsample
IDU Subsample
  • Additional sample of the IDU population within the 6 sampled cities of Georgia
  • Design - Snowball sampling

any self-reporting IDU respondents other IDUs with whom they have contact

  • Will be analyzed independently of the main seroprevalence sample
  • Will give stronger prevalence estimates for this high-risk group
data collection team
Data Collection Team
  • Survey Instrument – Questionnaire
    • Household information
    • Socio-demographic data
    • Medical History
    • Lifestyle information
    • Knowledge, Attitudes, Perceptions
  • Specimen - venous blood
slide8
HCV Testing Algorithm

Anti-HCV

Anti-HCV Positive

Anti-HCV Negative

HCV RNA

HCV RNA Positive

HCV RNA Negative

HCV Genotyping

analysis
Analysis
  • HCV prevalence in Georgia (+/- 1%) and
    • Cities (6)
    • Regions (10)
    • Bivariate analysis assessing association between factors (demographic/risk) and HCV infection
  • Multivariate logistic regression
    • models examining association between independent variables and HCV infection
  • HCV Genotype distribution
benefits
Benefits
  • National/Regional by Urban/Rural Data
    • HCV infection prevalence (burden)
    • Risk factors for transmission (prevention)
    • Genotype distribution (care and treatment)
  • Laboratory capacity building
  • Epidemiology capacity building
  • Additional research/studies (stored sera)
next steps serosurvey
Next Steps (Serosurvey)
  • Protocol (finalize and submit to IRB)
  • Recruitment of Teams
  • Training and Validation of Survey Tool
  • Fieldwork
  • Laboratory Analysis and Capacity Building
  • Data Analysis/Modeling
  • Publication of Results
acknowledgments
Acknowledgments
  • US Centers for Disease Control and Prevention (CDC)
  • Emory University SPH and SOM
  • University of Bristol
  • Division of Viral Hepatitis/NCHHSTP/CDC
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