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Community Engagement and Chronic Viral Hepatitis Public Health Interventions: A Systematic Review, Meta-Analysis, and Complementary Crowdsourcing Open Call
Background: Chronic viral hepatitis causes a high burden of morbidity and mortality, especially in low- and middle-income countries (LMICs). While community engagement shows promise to enhance hepatitis outcomes, evidence on its impact remains limited. To summarize the current state of knowledge on this topic we performed a systematic review and crowdsourcing open call.
Methods: The systematic review included publications that evaluated a community-engaged intervention, reported chronic viral hepatitis outcomes, and included a comparator group. To ensure innovative ideas from LMICs were included, we organized a complementary crowdsourcing open call using the WHO/TDR practical guide. Thematic analysis identified key themes in the crowdsourced submissions.
Findings: Twenty-four studies were included in the systematic review, and twenty-eight crowdsourced submissions were analysed. In both the systematic review and open call, community-engaged interventions included peer-based interventions, community health workers, interactive educational programs, and patient advocacy. The meta-analysis, predominantly from high-income countries, found community-engaged interventions significantly improved HBV vaccine completion (RR 1·95, 95% CI 1·23-3·09), HBV and HCV test uptake (RR 2·83, 95% CI 2·07-3·85), linkage to chronic viral hepatitis care (RR 1·63, 95% CI 1·19-2·21), and HCV sustained virological response (RR 1·27, 95% CI 1·05-1·52). In contrast, open call submissions, largely from LMICs, highlighted community-led interventions where patients led community-based organizations to advocate for improved access to hepatitis care.
Interpretation: Findings underscored the importance of community engagement in chronic viral hepatitis service delivery across the care continuum. Implementing community-engaged interventions can enhance chronic viral hepatitis elimination efforts.
Keywords: Community engagement, Viral hepatitis, Care continuum, Open call
Li, Yifan and Kpokiri, Eneyi E. and Elasi, Dalia and Wang, Keying and Conyers, Hayley and Sheng, Rongrong and Zhang, Ye and Adda, Danjuma K. and Matthews, Philippa C. and Fitzpatrick, Thomas and Tucker, Joseph D. and Wu, Dan, Community Engagement and Chronic Viral Hepatitis Public Health Interventions: A Systematic Review, Meta-Analysis, and Complementary Crowdsourcing Open Call. Available at SSRN: https://ssrn.com/abstract=5122513 or http://dx.doi.org/10.2139/ssrn.5122513
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