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Utilizing Electronic Laboratory Reporting Data to Assess the Burden of Hepatitis C in Arizona

Tsang, Clarisse A. MPH; Khan, Mohammed A. MSPH; Brady, Shane M. MPH; Erhart, Laura M. MPH; Komatsu, Kenneth K. MPH

Journal of Public Health Management and Practice: May 14, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000001011
Research Full Report: PDF Only

Context: Hepatitis C virus (HCV) infections must be reported to public health departments in Arizona; however, Arizona Department of Health Services has not had the resources to conduct comprehensive HCV surveillance since 2008 and thus monitoring HCV is difficult. Cases were traditionally reported via mail, fax, or telephone; however, beginning in 2009, clinical laboratories could report HCV results through electronic laboratory reporting (ELR).

Objective: To assess completeness of ELR in capturing HCV case reports and its utility for HCV surveillance and describing the current burden of HCV.

Design: Two components of study: (1) HCV reporting from all sources for 2 months in 2015 was de-duplicated at the patient level and cross-matched with the 1998-2008 database and 2009-2015 ELR data to identify cases newly reported during the 2-month period and calculate the proportion reported through ELR. (2) HCV ELR results during 2009-2015 were similarly de-duplicated and compared with the 1998-2008 database to identify newly reported cases.

Setting: Hepatitis C virus patients reported to Arizona Department of Health Services.

Participants: Hepatitis C virus case patients reported during 1998-2008 and through ELR during 2009-2015. Hepatitis C virus patients through paper reports for January and June 2015.

Main Outcome Measures: (1) Using 2 months of all HCV reporting in 2015 to examine the proportion of cases captured by ELR and the differences in the type of reports captured by ELR and non-ELR sources only. (2) Compared sex, birth year, viral load, and genotype from ELR-only data to other surveillance data.

Results: Electronic laboratory reporting accounted for 1260 (64%) HCV cases newly reported during the 2 months, with 698 (36%) newly identified from non-ELR sources only. Based on these findings, an estimated 11 534 HCV cases were newly reported in 2015 (172 cases per 100 000 population). During 2009-2015, a substantial amount (23%) of newly reported cases were among persons born after 1978.

Conclusions: Utilizing ELR data alone can provide meaningful HCV surveillance and offers a less resource-intensive means to describe HCV burden and identify trends in newly reported cases. An assessment like this one can provide a tool for HCV monitoring in other jurisdictions that lack resources for HCV surveillance as more laboratories transition to ELR.

Arizona Department of Health Services, Office of Infectious Disease Services, Phoenix, Arizona.

Correspondence: Clarisse A. Tsang, MPH, Arizona Department of Health Services, Office of Infectious Disease Services, 150 North 18th Ave, Phoenix, AZ 85007 (

The authors thank Teresa Jue for assisting with data collection and management, Eli Price and Sara Johnston for assisting with ELR data, and Jonathan Gonzalez for assisting with data analysis, Arizona Department of Health Services.

The authors declare no conflicts of interest.

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