Transcript PowerPoint-presentatie
HCV infections among non-Western migrants living in Amsterdam, the Netherlands
Anouk Urbanus, MSc Cluster of Infectious diseases Public Health Service Amsterdam
29 april 2020
29 april 2020 HCV among non-western migrants living in Amsterdam
Introduction
HCV is a severe infection of the liver Estimation of prevalence in the Netherlands: 0.1-0.4% Large groups of (non-Western) migrants are living in Amsterdam (Morocco, Turkey, Surinam) Limited information about the HCV prevalence in country of origin little is known about HCV prevalence among migrants living in NL 2
29 april 2020 HCV among non-western migrants living in Amsterdam
Introduction Objective
To examine the HCV prevalence and determinants among individuals of non-Western ethnicity living in Amsterdam, the Netherlands 3
29 april 2020 HCV among non-western migrants living in Amsterdam
Methods
Data obtained from three different surveys: 1) 2) 3) Random sample of pregnant women HIV-survey among heterosexual visitors STI clinic Amsterdam Random sample general population of Amsterdam All HCV RNA positives were sequenced 4
29 april 2020 HCV among non-western migrants living in Amsterdam
Methods
1) Random sample of pregnant women 10-12 th week of pregnancy screened for infectious diseases 5146/12,676 in 2003 anonymous retrospectively tested for HCV Demographic data collected (no data on risk factors) N=5146 5
29 april 2020 HCV among non-western migrants living in Amsterdam
Methods
2) Heterosexual visitors STI clinic Amsterdam Bi-annual anonymous survey STI clinic Amsterdam 2007-2009 Demographic and data about risk factors collected MSM excluded N=3985 6
29 april 2020 HCV among non-western migrants living in Amsterdam
Methods
3) Random sample general population of Amsterdam Random sample of ≥18 years in 2004 living in Amsterdam Tested for several infectious diseases, including HCV Demographic and data about risk factors collected MSM excluded N=1309 7
29 april 2020 HCV among non-western migrants living in Amsterdam
Results
HCV positive Western (ref) Non-western migrants Missing OR; 95% CI 2nd generation non-western (ref) 1st generation non-western Missing OR; 95% CI No IDU in non-western (ref) IDU in non-western OR; 95% CI 1) Pregnant women
N=5146 17/5146 (0.3%) 3/2546 (0.1%) 12/2017 (0.6%) 2/583 (0.3%)
5.0; 1.4-18.0
0/404 (0%) 12/1612 (0.7%) 0/1 -
2) STI clinic
N=3895 12/3895 (0.3%) 6/2502 (0.2%) 6/1393 (0.4%) 1.8; 0.6-5.6
2/820 (0.2%) 4/571 (0.7%) 0/2 2.9; 0.5-15.8
3/1387 (0.2%) 3/6 (50.0%)
461.3; 64.9-3278.4
3) General population
N=1309 8/1309 (0.6%) 2/476 (0.4%) 6/828 (0.7%) 0/5 1.7; 0.35-8.60
1/64 (1.6%) 5/764 (0.7%) 0.4; 0.05-3.60
2/404 (0.5%) 1/25 (3.3%)
8.4; 0.7-95.7
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29 april 2020 HCV among non-western migrants living in Amsterdam
Results
*First generation non-western migrants
Netherlands Morocco* Turkey* Surinam* Estimated HCV prevalence by WHO 0.1-0.4% >3% 2-3% 1-2% 1) Pregnant women
N=5146 0.1% (2/2320) 0% (0/482) 0.4% (1/218) 0% (0/281)
2) STI clinic
N=3895 0.3% (6/2263) 0% (0/37) 0% (0/14) 0% (0/177)
3) General population
N=1309 0.2% (1/424) 0.4% (1/255) 0% (0/309) 3.0% (2/66) 31 years (28-35 years) 25 years (22-31 years) 49 years (39-60 years)
Age (median; IQR))
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29 april 2020 HCV among non-western migrants living in Amsterdam
Results
Fig: distribution of risk groups among blood donors based on phylogenetic analysis (van de Laar et al., 2006) 4% 11% 24% 27% 24% IDU and MSM Transfusion and nosocomial Transfusion and nosocomial IDU IDU and MSM Endemic 10%
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29 april 2020 HCV among non-western migrants living in Amsterdam
Western and European HCV Network
Western participants 1b no IDU 1b ?
1b IDU 2 ?
3a IDU (N=3) 3a no IDU 4d IDU 1a ?
South European participants 1b no IDU
*
3a IDU* Eastern Europe participants 4d IDU 3a IDU* 3a ?* 3a ?
1a ?* (*=first generation)
Other HCV network
3a IDU Pakistan* 4a North Africa (born NL) 4d 4a 4h 4d 4d 2a 2 2 2 Egypt* Egypt* Angola* Ethiopia* Turkey* Philippines* Surinam* Surinam* Dominican Republic*
4% 27% 11% 24% 24% 10% Fig: distribution of risk groups among blood donors based on phylogenetic analysis (van de Laar et al., 2006) IDU and MSM Transfusion and nosocomial Transfusion and nosocomial IDU IDU and MSM Endemic
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Conclusion
Increased HCV prevalence among first generation migrants of non-western ethnicity – Possibly related to exposure to non-medical and medical equipment in country of origin – Largest migrant groups (Morocco, Turkey) in Amsterdam had a lower HCV prevalence than expected HCV infections in migrants from Eastern and Southern European ethnicity related to IDU Screening and information campaigns should be focussed on groups of 1st generation non-western ethnicity (excluding Moroccan and Turkish people)
29 april 2020 HCV among non-western migrants living in Amsterdam
Acknowledgements
Thijs van de Laar
Anneke van den Hoek
Arjen Speksnijder
Gijs Baaten
Ineke Stolte
Titia Heijman
Roel Coutinho
Public Health Service of Amsterdam, The Netherlands Public Health Service of Amsterdam, The Netherlands Public Health Service of Amsterdam, The Netherlands Public Health Service of Amsterdam, The Netherlands Public Health Service of Amsterdam, The Netherlands Public Health Service of Amsterdam, The Netherlands Academic Medical Center (AMC), National institute for Public Health and the Environment, The Netherlands
Maria Prins
Public Health Service of Amsterdam, Academic Medical Center (AMC), The Netherlands
Data manager, analysts, interviewers
All participants of the three different surveys
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