4 research outputs found

    Cascade of care among hepatitis B patients in Maastricht, the Netherlands, 1996 to 2018

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    Background &amp; aims: There are approximately 49,000 people (0.34%) in the Netherlands with a chronic hepatitis B virus (HBV) infection. It is unclear how many are linked to care and under follow-up in hepatitis outpatient clinics. This study determined the cascade of care and identified predictors for not being linked to care and loss to follow-up in Maastricht, the Netherlands.Methods: All hepatitis B surface antigen (HBsAg)-positive patients between December 1, 1996 and September 30, 2018 were retrospectively identified.Results: In total, 644 HBsAg-positive patients were identified; of whom 75 had acute HBV infection, 471 chronic HBV infection and 98 unknown. Out of 569 individuals with a chronic/unknown HBV status, 134/569 (23.6%) were not linked to care and 58.7% (195/332 after excluding those who died or achieved HBsAg-seroclearance) were loss to follow-up (LTFU). A predictor for not being linked to care was Caucasian ethnicity (odds ratio (OR) = 2.76 (95% Confidence Interval (CI) = 1.21-6.29); p = .015). Predictors for LTFU were older age (OR = 0.97 (CI = 0.94-0.99); p = .008), HBV DNA &gt;20,000 IU/mL (OR = 0.44 (CI = 0.21 - 0.93); p = .033) and Asian ethnicity (OR = 0.46, (CI = 0.21-1.00); p = .050). Rates of not being linked to care and LTFU decreased over time from 12.7% in 1996 to 4.4% in 2018 and from 79.2% in 1996 to 37.2% in 2018, respectively.Conclusions: A considerable amount of HBsAg-positive individuals were not linked to care or LTFU. This study indicates that ethnicity plays a role in linkage to care and follow-up. Further research is needed to elaborate on those results.</p

    The association between SARS-CoV-2 seroprevalence and cross-border mobility for visiting family or friends among Dutch residents of a Euregional province

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    BACKGROUND: Border measures were implemented in many countries as infection prevention measures to interrupt between-country COVID-19 transmission. Border closings impact border region residents, as their professional and social lives are often intertwined across national borders. We studied whether crossing borders to visit family/friends in neighbouring countries (cross-border mobility) was associated with SARS-CoV-2 seroprevalence in Dutch Euregional residents. METHODS: SARS-CoV-2 serostatus (negative/positive) was assessed (pre-vaccination) using laboratory testing to determine previous infection. Visiting Belgian or German family/friends in February-March 2020 was questioned. The association between cross-border mobility and seroprevalence was tested using logistic regression analysis, adjusted for previously identified exposure factors. RESULTS: In 9,996 participants, 36.8 % (n = 3,677) reported cross-border family/friends. Of these, one-third (n = 1,306) visited their cross-border family/friends in February-March 2020. Multivariable analyses revealed no positive association between cross-border mobility and seropositivity, for both participants living in a border municipality (ORfamily/friends not visited=0.90 [95 % CI:0.78-1.04], ORfamily/friends visited=0.88 [95 % CI:0.73-1.05]), and for participants not living in a border municipality (ORfamily/friends not visited=0.91 [95 % CI:0.72-1.16], ORfamily/friends visited=0.62 [95 % CI:0.41-0.94]). CONCLUSIONS: This study provided no evidence of cross-border mobility as an important exposure factor for SARS-CoV-2. The results of our unique real-world study suggest that cross-border mobility did not substantially contribute to cross-border SARS-CoV-2 transmission in the Netherlands

    Sex and age differences in the proportion of experienced symptoms by SARS-CoV-2 serostatus in a community-based cross-sectional study

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    We examined the possible sex and age differences in the proportion of experienced Coronavirus Disease 2019 (COVID-19) symptoms in unaware (previously) infected adults, and their uninfected counterparts, estimated by serostatus prior to vaccination, at the end of 2020 (Wuhan strain). A cross-sectional community-based study using a convenience sample of 10 001 adult inhabitants of a southern Dutch province, heavily affected by COVID-19, was conducted. Participants donated a blood sample to indicate past infection by serostatus (positive/negative). Experienced symptoms were assessed by questionnaire, before the availability of the serological test result. Only participants without confirmed SARS-CoV-2 infection were included (n = 9715, age range 18-90 years). The seroprevalence was comparable between men (17.3%) and women (18.0%), and participants aged 18-60 years (17.3%) and aged 60 years and older (18.6%). We showed sex and age differences in the proportion experienced symptoms by serostatus in a large cohort of both unaware (untested) seropositive compared with seronegative reference participants. Irritability only differed by serostatus in men (independent of age), while stomach ache, nausea and dizziness only differed by serostatus in women aged 60 years and older. Besides, the proportion of experiencing pain when breathing and headache differed by serostatus in men aged 18-60 years only. Our study highlights the importance of taking possible sex and age differences into account with respect to acute and long-term COVID-19 outcomes. Identifying symptom profiles for sex and age subgroups can contribute to timely identification of infection, gaining importance once governments currently move away from mass testing again.</p
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