March 2017:  ASHM staff in Queensland, Senior Project Officer Katelin Haynes and Clinical Nurse Melinda Hassall, have concluded the coordination and delivery of five training courses on HIV, hepatitis B, hepatitis C and STIs for a wide audience in Far North Queensland having traveled to Cairns, Thursday Island and Bamaga from the 13-17 March 2017.

FNQ BBV-STI_TI_160317 450px.jpgThe Far North region was identified in the recent 2015 Third National Hepatitis B Mapping Report as the highest prevalence area for hepatitis B in Queensland, with an estimated prevalence of 2.52%, more than one percent higher than any other area in the state. Only 4.3% of patients within the PHN receive treatment or monitoring, and 1.6% are currently on treatment. This is well below the current National Hepatitis B Strategy target of 15% receiving treatment by 2017, and the Queensland Hepatitis B Action Plan 2016-2021 aim of all people living with chronic hepatitis B receiving appropriate monitoring or treatment by 2021. 

On Monday the 13th, the first Deadly Sex Networking Update (an education activity following the 2016 Deadly Sex Congress) was held in Cairns for Aboriginal and Torres Strait Islander Health Workers. This update in sexual health covered the "Take 10 to Test Today" campaign presented by Dr Annie Preston-Thomas and Cherrie Glasson, Mental Health First Aid presented by Mercy Baird and an update on cervical cancer screening by Dr Amanda Blinco. The session was attended by 19 Health Workers from a variety of services, including Wuchopperen, Gurriny Yealamucka, Mookai Rosie Bi-Bayan and Cairns Sexual Health.

Dr Peter Boyd, Director of Medicine and Gastroenterology at Cairns Hospital presented an update on treatment initiation and management for patients with chronic hepatitis B in the evening of 13th March. 11 Doctors and 1 Nurse attended the interactive session, which was also available as a webinar. There are now three HBV s100 prescribers in the Cairns and Hinterland HHS, with several more awaiting accreditation.

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On Wednesday 15th March, a HBV s100 Prescriber Course was run at the Thursday Island Community Wellness Centre. Dr Josh Hanson, general and infectious diseases physician, presented the course, with Dr Jennifer Wharton facilitating case study discussions. We anticipate that the number of HBV s100 prescribers on Thursday Island will rise to 5 following this course. With approximately 1000 people thought to be living with Chronic Hepatitis B in this region, local expertise in treatment and management of CHB is essential.

A course designed to strengthen BBV and STI testing and management in Primary Care was run on Thursday Island on Thursday 16th March. The 21 participants included doctors, nurses, Aboriginal and Torres Strait Islander Health Workers from Thursday Island Hospital and the Primary Health Care Centre, as well as three workers from Dauan Island Clinic who joined via videoconference for the training. Sessions were presented by Dr Darren Russell, Director of Cairns Sexual Health, Yoko Nakata, CNC at Men's and Women's Health Thursday Island, Mario Assan, Indigenous Public Health Officer, Dr Josh Hanson and Carla Gorton, Sexual Health, HIV & Viral Hepatitis coordinator (Cairns Sexual Health).

Across the two courses held on Thursday Island there was significant discussion on the management and monitoring of chronic hepatitis B patients, their children and household contacts. A database to aid the management of CHB patients in this region is currently under construction by a hepatitis B project team based in Cairns. Dr Jowita Kozlowska who travelled from Cairns to attend the training is also working on a project to identify all women with CHB of child bearing age to assist in the prevention of mother to child transmission of hepatitis B. ASHM will continue to work with staff in the region and in Cairns to further enhance workforce capacity to address chronic hepatitis B in this region, which is Queensland's highest prevalence area.

The BBV and STI testing and management course was also presented in Bamaga on Friday the 17th, with 20 nurses, community workers and Aboriginal and Torres Strait Islander Health Workers from the Bamaga Hospital, Bamaga Primary Health Care Centre and NPA Family and Community Services in attendance. Dr Darren Russell, Dr Glen Curran, hepatitis B CNC at Cairns Sexual Health presented clinical content, while Aaron Tamwoy, Youth Health Project Coordinator at NPA Family and Community Services and Lesley Unwin, Men's and Women's Health Worker, Bamaga Hospital presented on their work in order to facilitate local connections.

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Overall, there were 79 participants across the 5 training courses. They would not have been possible without the commitment of Dr Josh Hanson and Dr Darren Russell, the engagement and enthusiasm of local staff including Yoko Nakata, Dr Jennifer Wharton, Martha Horgan, Lesley Mallard, Dr Tony Brown, Kate Gallaway and the support of Cairns Sexual Health and their staff. ASHM looks forward to facilitating more training in these remote areas in the future.

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