February 19, 2013
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Surveillance reporting of HCV, HBV incomplete in Michigan

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Reporting of chronic hepatitis B and C infections in Michigan significantly improved in Michigan, but still remained incomplete, according to researchers from the CDC and Michigan Department of Community Health

“Because underreporting has complicated the understanding of disease burden, in 2010 the Institute of Medicine requested that CDC perform a comprehensive evaluation of national viral hepatitis surveillance,” the researchers wrote in Morbidity and Mortality Weekly Report. “Hepatitis surveillance data rely on local and state estimates and a better understanding of reporting at these levels can inform strategies to improve national data quality.”

In Michigan, reporting chronic HBV infections became mandatory in 2004 and reporting chronic HCV infections became mandatory in 2000. Electronic reporting began in 2004 with the launch of the Michigan Disease Surveillance System (MDSS). The researchers identified clinically confirmed cases of HBV and HCV from a cohort study that took place from 2006 to 2008. They matched the cases to those reported in the MDSS to evaluate the completeness of reporting.

The cohort had 4,393 patients and 597 had confirmed chronic HBV infections and 3,036 had confirmed chronic HCV infections. Of the 597 cases of HBV infections, 490 were matched with MDSS. Of the 3,036 cases of HCV infections, 1,967 were matched with MDSS. Reporting of HCV infections varied by age group, sex and race/ethnicity. Reporting was more complete for those aged up to 30 years, males and non-Hispanic whites and Asians/Pacific Islanders.

“Given the complexity of chronic hepatitis surveillance and the limited resources available, public health authorities should explore new strategies to improve reporting, such as wider adoption of electronic reporting,” the researchers wrote. “This report offers a roadmap for using large datasets from clinical institutions to provide state and local health departments with insight into the disease burden represented by chronic viral hepatitis case reports.”

Disclosure: The researchers report no relevant financial disclosures.