Publications by authors named "Philippa Matthews"

Background: Migrants to the UK face disproportionate risk of infections, non-communicable diseases, and under-immunisation compounded by healthcare access barriers. Current UK migrant screening strategies are unstandardised with poor implementation and low uptake. Health Catch-UP! is a collaboratively produced digital clinical decision support system that applies current guidelines (UKHSA and NICE) to provide primary care professionals with individualised multi-disease screening (7 infectious diseases/blood-borne viruses, 3 chronic parasitic infections, 3 non-communicable disease or risk factors) and catch-up vaccination prompts for migrant patients.

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  • The introduction of direct-acting antivirals (DAAs) offers hope for eliminating hepatitis C virus (HCV) by 2030, but some patients (2%-12%) experience treatment failure, potentially due to existing drug resistance.
  • A systematic review of 56 studies found a high prevalence of hepatitis C resistance-associated substitutions (RAS) among patients with virological failure after DAA treatment, ranging from 78% to 100% depending on the specific treatment regimen.
  • The findings highlight the importance of monitoring DAA-associated resistance and understanding its implications for future treatment strategies.
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Whilst many lessons were learned from the COVID-19 pandemic, ongoing reflection is needed to develop and maintain preparedness for future outbreaks. Within the field of infectious disease and public health there remain silos and hierarchies in interdisciplinary work, with the risk that humanities and social sciences remain on the epistemological peripheries. However, these disciplines offer insights, expertise and tools that contribute to understanding responses to disease and uptake of interventions for prevention and treatment.

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  • Optimizing treatment for hepatitis B is crucial for global efforts to eliminate viral hepatitis as a public health issue, as effective therapies like tenofovir and entecavir show varying success among patients.
  • Factors such as social barriers, stigma, low health awareness, and comorbidities contribute to inconsistent treatment results, especially in vulnerable populations.
  • Understanding the complexities of drug resistance and the socioeconomic challenges that affect therapy adherence is essential for improving treatment outcomes and ensuring equitable healthcare access.
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Background: An outbreak of acute severe hepatitis of unknown aetiology (AS-Hep-UA) in children during 2022 was subsequently linked to infections with adenovirus-associated virus 2 and other 'helper viruses', including human adenovirus. It is possible that evidence of such an outbreak could be identified at a population level based on routine data captured by electronic health records (EHR).

Methods: We used anonymised EHR to collate retrospective data for all emergency presentations to Oxford University Hospitals NHS Foundation Trust in the UK, between 2016-2022, for all ages from 18 months and older.

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Background: As nucleos/tide analogue (NA) therapy (e.g. entecavir and tenofovir) for chronic Hepatitis B virus (HBV) infection becomes more widely indicated and available, understanding drug resistance is essential.

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Background: The WHO's global hepatitis strategy aims to achieve viral hepatitis elimination by 2030. Migrant children and pregnant persons represent an important target group for prevention strategies. However, evidence on the burden of chronic hepatitis B (CHB) infection and the factors affecting its incidence is lacking.

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  • - The WHO aims to eliminate Hepatitis B virus (HBV) by preventing infections and reducing deaths, prompting an investigation into the beliefs and barriers faced by people living with HBV in rural KwaZulu-Natal, South Africa.
  • - A community dialogue revealed a significant lack of knowledge about HBV among community members and healthcare workers, while participants recognized symptoms of liver disease and identified common causes like alcohol and poor HIV treatment adherence.
  • - Barriers such as stigma, poverty, and referral delays hinder access to care, highlighting the need for targeted education and advocacy to improve HBV diagnosis, treatment, and prevention services that are accessible to the local population.
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  • - The study highlights the need for accurate estimates of SARS-CoV-2 infection and antibody levels across different regions and demographics to inform effective public health policies.
  • - Using advanced statistical models on UK COVID-19 data, the research reveals that not considering vaccination status leads to underestimating PCR positivity and significantly overestimating antibody levels, especially in low-vaccine groups.
  • - The findings emphasize the importance of accounting for vaccination and other key factors in future infectious disease surveys to ensure representative and reliable data.
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  • Managing chronic hepatitis B virus (HBV) infection is essential for the goal of eliminating viral hepatitis by 2030, but challenges like medication access and adherence issues persist.* -
  • A specific case study highlights a patient with both HBV and HIV who faced virological breakthrough despite receiving nucleos/tide analogue therapy due to factors like high viral load and interruptions in therapy.* -
  • The situation illustrates the need for personalized treatment plans and better support systems, especially for marginalized groups, along with comprehensive data collection to enhance patient care and retention.*
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Men in sub-Saharan Africa are less likely to accept HIV testing and link to HIV care than women. We conducted a trial to investigate the impact of conditional financial incentives and a decision support application, called EPIC-HIV, on HIV testing and linkage to care. We report the findings of the trial process evaluation to explore whether the interventions were delivered as intended, identify mechanisms of impact and any contextual factors that may have impacted the trial outcomes.

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Detecting and quantifying changes in the growth rates of infectious diseases is vital to informing public health strategy and can inform policymakers' rationale for implementing or continuing interventions aimed at reducing their impact. Substantial changes in SARS-CoV-2 prevalence with the emergence of variants have provided an opportunity to investigate different methods for doing this. We collected polymerase chain reaction (PCR) results from all participants in the United Kingdom's COVID-19 Infection Survey between August 1, 2020, and June 30, 2022.

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  • Chronic hepatitis B infection (CHB) affects 300 million people and is part of a global effort by the United Nations and WHO to eliminate it as a health threat by 2030.
  • Peer support workers (PSWs) are people who have experienced similar health issues and can help others by providing education and emotional support, especially for those with CHB.
  • Investing in peer support can help improve healthcare access, reduce stigma, and ultimately contribute to the goal of eliminating hepatitis B around the world.
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  • Chronic hepatitis B infection is rampant in the WHO African Region, with only a small fraction diagnosed or treated; the report outlines efforts to initiate a hepatitis B virus (HBV) program in Kenya.
  • The 'STRIKE-HBV' Study, launched in March 2023 in Kilifi, focused on identifying people living with HBV through free testing at a hospital and targeted outreach, successfully establishing a framework for HBV screening and care.
  • Data collected from March 2023 to March 2024 showed effective screening, with 30 seropositive cases identified among 1,862 participants, despite facing challenges like procurement delays for testing kits and vaccinations.
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  • The study investigates how the COVID-19 pandemic affected routine monitoring of chronic Hepatitis B virus (HBV) patients in the UK, focusing on key biomarkers like alanine transferase (ALT) and HBV viral load.
  • Researchers analyzed anonymized health record data from five NHS Trusts to compare biomarker monitoring before and during the pandemic.
  • Findings showed a significant drop in both the number of patients monitored and the frequency of biomarker measurements during the pandemic, prompting the need for interventions to address these health service disruptions.
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Introduction: In South Africa, the HIV care cascade remains suboptimal. We investigated the impact of small conditional financial incentives (CFIs) and male-targeted HIV-specific decision-support application (EPIC-HIV) on the HIV care cascade.

Methods: In 2018, in uMkhanyakude district, 45 communities were randomly assigned to one of four arms: (i) CFI for home-based HIV testing and linkage to care within 6 weeks (R50 [US$3] food voucher each); (ii) EPIC-HIV which are based on self-determination theory; (iii) both CFI and EPIC-HIV; and (iv) standard of care.

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  • Syndromic surveillance traditionally depends on healthcare-seeking patients, but this study suggests that involving community cohorts can yield valuable insights, especially given the presence of multiple respiratory viruses during the 2022/23 winter season in the UK.
  • The research analyzed data from nearly 33,000 tests, revealing SARS-CoV-2, RSV, and influenza A/B positivity rates, with peaks of these viruses occurring at different times and varying by age group, highlighting that younger individuals were most affected by RSV and older individuals by SARS-CoV-2.
  • Findings indicated that many individuals who tested positive reported few symptoms, complicating the ability to distinguish between the viruses solely based on symptoms, and
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Background: Hepatitis B virus (HBV) elimination requires expanding and decentralising HBV care services. However, peripheral health facilities lack access to diagnostic tools to assess eligibility for antiviral therapy. Through the Hepatitis B in Africa Collaborative Network (HEPSANET), we aimed to develop and evaluate a score using tests generally available at lower-level facilities, to simplify the evaluation of antiviral therapy eligibility in people living with HBV.

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The WHO African region bears a disproportionate burden of morbidity and mortality related to chronic hepatitis B virus (HBV) infection and accounts for an estimated 70% of new HBV infections worldwide. We investigated the extent to which HBV clinical trials represented populations in this region by searching the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for interventional clinical trials published in English between database inception and May 29, 2023, using the search term "Hepatitis B".

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  • After the emergence of Omicron variants, reinfections of SARS-CoV-2 saw a significant rise, prompting a study of around 45,000 reinfections from the UK's COVID-19 Infection Survey.
  • The study found that reinfections typically featured lower viral loads and fewer self-reported symptoms compared to initial infections.
  • It was revealed that protection against reinfection was stronger in individuals with more recent infections, and vaccination within the last 180 days reduced reinfection risk, particularly among those aged 30-45.
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Chronic hepatitis B infection (CHB) is a significant problem worldwide with around 300 million people infected. Ambitious goals have been set towards its elimination as a public health threat by 2030. However, accurate seroprevalence estimates in many countries are lacking or fail to provide representative population estimates, particularly in the WHO African Region (AFRO).

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Objectives: We evaluated a hepatitis B virus (HBV) screening programme, delivered by a specialist pan-London multidisciplinary outreach team, to understand population characteristics and care cascade among people who experience extreme social exclusion (Inclusion Health (IH) groups).

Methods: Point-of-care HBV screening was performed in temporary accommodation for people experiencing homelessness (PEH) and people seeking asylum (initial accommodation centres, IACs) via a mobile unit staffed by peers with lived experience, nurses, and doctors. We analysed demographics and HBV characteristics of adults screened between May 2020 and January 2022.

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Background: Migrants in Europe face a disproportionate burden of undiagnosed infection, including tuberculosis, blood-borne viruses, and parasitic infections and many belong to an under-immunised group. The European Centre for Disease Control (ECDC) has called for innovative strategies to deliver integrated multi-disease screening to migrants within primary care, yet this is poorly implemented in the UK. We did an in-depth qualitative study to understand current practice, barriers and solutions to infectious disease screening in primary care, and to seek feedback on a collaboratively developed digitalised integrated clinical decision-making tool called Health Catch UP!, which supports multi-infection screening for migrant patients.

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