Evaluation of data quality improvement of chronic hepatitis B surveillance in EIP sites

Background: An estimated 730,000 US residents have chronic hepatitis B infection, but routine surveillance is characterized by sparse data. Objective: Our purpose was to measure the impact of supplemental funding on completeness of reporting. Methods: CDC-supported Emerging Infections Program (EIP) sites (Colorado, San Francisco, Minnesota, 34 counties in New York State, and Connecticut) were provided supplemental funding to actively investigate hepatitis B cases. Among chronic HBV cases reported in 2009, EIP sites selected a subset of cases for active investigation specifically to obtain better data for race/ethnicity and behavioral risk factors. All other cases not in the subset were routine. A variable was defined as complete if a valid value was documented; unknown or missing results were counted as incomplete. We compared percent complete among active and routine cases. Results: Of the 3,875 chronic hepatitis B cases reported, 907 (23.4%) were active. Active and routine cases were similar in age (median, 41 and 42 years, respectively), although gender differed slightly (male, 47% and 57%). The percentage with complete information was significantly greater for active versus routine cases for race/ethnicity (89% and 67% complete, p<0.0001), and cases with ≥1 risk factor (32% and 16%, p<0.0001). Risk factor identification with the greatest improvement among active compared to routine cases was men who have sex with men (37% and 2%, p<0.0001). Conclusions: Supplemental funding for active surveillance of chronic hepatitis B resulted in more complete data from EIP sites. These findings will provide better direction for future hepatitis funds.