Title: CSTE Hepatitis Survey Results
1CSTE Hepatitis Survey Results
- Frequencies and Percentages of Responses per
Question
Steven Wiersma MD, MPH Steven Connor MPH
2Background
- conceived as part of the cooperative agreement
between CSTE and CDC - baseline to determine activities of states with
respect to Hepatitis Prevention and Control
Issues - information will be used to develop small grants
for hepatitis planning - developed by the CSTE Hepatitis Workgroup of the
Infectious Disease Committee under the direction
of Steven Wiersma MD, MPH - external partners were asked to comment and a
final survey was fielded as a web-based
application
3Summary Statistics
- Number of states and territories surveyed, N57
- Total number of states and/or territories who
responded to the survey, N42 - Number of states and/or territories included in
this analysis, N40 (denominator 40) - Response rate of 70!
- States refers to both states and territories in
this presentation
4Does Your State Health Agency Feel There Is a
Need for a Written Hepatitis Prevention and
Control Plan Specific to Your Jurisdiction?
1) Percentages are of the 40 states who responded
to survey
5Number of states who have started to develop a
written hepatitis prevention and control plan
(N40)
6Stages of forming a written hepatitis prevention
and control plan (N21)
7Breakdown of areas of hepatitis prevention and
control included in both draft and/or completed
plans
Percentages from states who responded (N40)
8Which part of your state agency has been the lead
in the hepatitis prevention and control planning
process ?
n () Shared responsibility 11
(52.4) between departments Epidemiology 6
(28.6) No Response 4 (19.0)
N 21
9Date of completion of states who have a written
hepatitis plan and prospective date of completion
for those in draft or discussion form
Once completed, would you be willing to share
your states document with CSTE/CDC?
10Is (or will) your plan be a stand-alone plan, or
will it be incorporated as an annex into a
comprehensive disease control plan?
- n ()
- Hep plan will stand alone 10 (47.6)
- Hep plan incorporated 7 (33.3)
- Other 1 (4.8)1
- NR 3 (14.3)
N 21
1) Stated Hep plan will significantly integrate
with Epi, STDs, and HIV/AIDS programs
11Where do your funds for hepatitis planning come
from?
n () Dedicated state funds 4
(19.0) Prevention block grants 0 --- CDC
cooperative agreement 6 (28.6) No hepatitis
planning support 7 (33.3) Other 5
(23.8)
N 21
12What are the three most important barriers that
your state has faced in initiating the
development of a hepatitis plan?
- n ()
- 1) Lack of personnel resources 25 (62.5)
- 2) Lack of financial resources 23 (57.5)
- 3) Other competing demands 17 (42.5)
- Percentages total gt 100 because multi-answer
question
13What are the two most important resources/actions
needed by your state in order to complete a
hepatitis plan?
- n ()
- Securing funding and support 22 (55.0)
- Completion of national plan 17 (42.5)
- Legislative support 5 (12.5)
- Other 5 (12.5)
-
- N 40
14Organization and Funding
15Where is hepatitis prevention and control located
in your state organizational structure?
16How many paid full-time equivalents (FTEs) are
involved in hepatitis prevention and control in
your state?
- n ()
- None 3 (7.5)
- Less than one 5 (12.5)
- 1-2 11 (27.5)
- 3-4 7 (17.5)
- 5-6 2 (5.0)
- 7-8 0
- Greater than 8 2 (5.0)
17Is there a line item for Hepatitis Prevention and
Control in the state budget?
- YES NO NR
- n () n () n ()
-
- Hepatitis A 5 (12.5) 24 (60.0) 11 (27.5)
- Hepatitis B 6 (15.0) 22 (55.0) 12 (30.0)
- Hepatitis C 6 (15.0) 23 (57.5) 11 (27.5)
18What is your combined hepatitis (A, B, C)
prevention and control annual budget?
- n ()
- ? 50K 7 (17.5)
- 51K 99K 3 (7.5)
- 100K 199K 4 (10.0)
- 200K 299K 2 (5.0)
- 300K 399K 0
- 400K 499K 1 (2.5)
- 500K 999K 4 (10.0)
- ? 1 million 4 (10.0)
- No Response 15 (37.5)
19How much does your state currently spend per year
on hepatitis B vaccine for high-risk adults?
- n ()
- ? 50K 15 (37.5)
- 51K 199K 3 (7.5)
- ? 200K 6 (15)
- No Response 16 (40)
20How much does your state currently spend per year
on hepatitis C?
- n ()
- ? 100K 4 (10.0)
- 101K 500K 3 (7.5)
- ? 501K 2 (5.0)
- NR 31 (77.0)
21Does your state have a hepatitis B coordinator?
27.5
62.5
10.0
(n25)
N 40
22Who oversees the work of the hepatitis B
coordinator?
N 25
23Does your state have a hepatitis C coordinator?
(n15)
N 40
24Who oversees the work of the hepatitis C
coordinator?
N 15
25SURVEILLANCE ACTIVITIES
26Does your state have statutes that specifically
require reporting of each of the following
disease conditions?
- n ()
- Hep A, acute 28 (70.0)
- Hep B, acute 28 (70.0)
- Hep B, perinatal infection 24 (60.0)
- Hep B, HBsAg pregnancy 24 (60.0)
- Hep B, chronic 15 (37.5)
- Hep C, acute 27 (67.5)
- Hep C, chronic 14 (35.0)
27Does your state have statutes that specifically
require reporting of each of the following
disease conditions? (cont.)
- n ()
- Hep unspecified/other, acute 18 (45.0)
- Hep Delta, acute 15 (37.5)
- Hep E, acute 10 (25.0)
- Hep non-A, non-B, acute 16 (40.0)
- Hep non-A, non-B, non-C, acute 11 (27.5)
- Registry for all markers of hepatitis 3 (7.5)
28What tests are states labs performing?
- n ()
- IgM antibody to hep A virus 21 (52.5)
- Hep B surface antigen 23 (57.5)
- Antibody to Hep C virus 17 (42.5)
- HCV RNA (PCR) 11 (27.5)
- HCV RIBA 8 (20.0)
- Molecular testing of Hep A 1 (2.5)
- Molecular testing of Hep B 0 ---
29Does your state have a database for monitoring
- YES NO NR
- n () n () n ()
- Chronic hep B? 14(35) 13(32.5) 13(32.5)
- Chronic hep C? 13(32.5) 14(35) 13(32.5)
N 40
30Policy Development
31Are there currently any legislative bills in your
state system specifically addressing viral
hepatitis?
- n ()
- Yes 4 (10.0)
- No 25 (62.5)
Has your state developed any statewide policies
for hepatitis prevention and control?
n () Yes 20 (50.0) No 9 (22.5)
N 40
32Outreach
33What type of hepatitis outreach does your state
conduct?
- n ()
- None 3 (7.5)
- Partner notification 17 (42.5)
- Community education 21 (52.5)
- Counseling and testing 14 (35.0)
- Partner referral 18 (45.0)
- Referral of Hep C partners 8 (20.0)
N 40
34Counseling, Testing, and Referral
35Is hepatitis C counseling and testing available
in publicly-funded sites in your state?
- n ()
- Yes 10 (25.0)
- No 19 (47.5)
- NR 11 (27.5)
N 40
36Adult Vaccinations
37How is hepatitis vaccine for adults purchased and
administered in your state?
- n ()
- State purchase, Local administration 11 (27.5)
- State Local purchase, Local administration 5 (12
.5) - State Local purchase and administration 1 (2.5)
- Vaccine not purchased nor administered 4 (10.0)
- Other 8 (20.0)
- NR 11 (27.5)
N 40
38Does your state use the federal contract to
purchase vaccine?
- n ()
- Yes 26 (65.0)
- No 3 (7.5)
- NR 11 (27.5)
N 40
39Treatment
40Does your state have a mechanism for referring
persons with chronic hepatitis (B or C) for
medical evaluation and potential treatment?
- n ()
- Yes 14 (35.0)
- No 15 (37.5)
- NR 11 (27.5)
N 40
41Prevalence Studies
42Has your state done hepatitis C prevalence
estimates statewide?
- n ()
- Yes 12 (30.0)
- No 16 (40.0)
- Unknown 0 ---
- NR 12 (30.0)
N 40
43Strengths and Weaknesses
- Strength
- Response rate of 70
- Pilot tested
- Weakness
- Several states indicated that questions found on
survey were difficult to answer - People stated that survey was very political,
possibly creating bias
44Next Steps
- SSurvey results will be utilized to develop RFP
to states - SSteering committee will review submitted
proposals and select awardees - SElected states will receive funding to advance
planning activities - FFunded States will meet to share information
regarding the planning process