Chronic Hepatitis (Hep) B infection disproportionately affects low- and middle-income countries such as those in SouthEast Asia and Africa. Chronic Hep B infection can lead to serious health consequences like liver cancer and cirrhosis. The United States Centers for Disease Control & Prevention recommends screening individuals from Hep B-endemic regions for asymptomatic chronic infection. Specifically, the CDC recommends a single blood test for Hepatitis B virus for anyone born in a region with 2% or greater prevalence. This screening guideline is relevant for a large immigrant population in Seattle.
Together with Dr. H. Nina Kim, Dr. Ejara performed a retrospective study of guideline adherence among adults treated within UW affiliated primary care clinics between 2016 and 2019.
Among 2,329 screen-eligible adults, only 27% were screened in the study period. Among them, 6% had a positive test for Hepatitis B Surface Antigen, a marker of current infection.
A study of local medical records showed low likelihood of guideline-concordant screening for Hepatitis B and high prevalence of infection among those screened. This research highlights a need for new strategies to meet this important care gap for communities like the East African community in Seattle, to which Dr. Ejara belongs.
Dr. Ejara presented this research at the 2021 national conference of the Society of General Internal Medicine. He published predictors of screening adherence and follow-up testing in the May 2022 issue of the Journal of Community Health (PMID: 35587329). Dr. Ejara plans to use this research to create awareness on the practice gap and advocate for urgent and consistent implementation of the recommended guidelines.