Oral fluid collection by post for viral antibody testing

Area of Science:

• Epidemiology
• Public Health
• Immunology

Background:

• Hepatitis B virus (HBV) exposure prevalence data is crucial for public health strategies.
• Estimating HBV exposure in the Republic of Ireland required a robust methodological approach.

Purpose of the Study:

• To estimate the prevalence of hepatitis B virus exposure in the Irish population.
• To evaluate the use of oral fluid (saliva) self-collection by post for serological testing.
• To identify strategies for improving response rates in national health surveys.

Main Methods:

• A multistage stratified cluster sample of 962 households was selected from the Register of Electors.
• A four-letter approach with postal oral fluid collection kits was used, supplemented by reminders and telephone contact.
• Anonymous and unlinked testing for hepatitis B anti-core antibody (anti-HBc) was performed on collected specimens.

Main Results:

• A household response rate of 60.4% was achieved, with 98% of 1738 specimens suitable for testing.
• The estimated prevalence of anti-HBc in the Irish population was 0.51%.
• An observed design effect of 1.29 was noted.

Conclusions:

• This study represents the first national population survey utilizing postal self-collection of oral fluid samples for serological testing.
• The methodology employed demonstrates a novel and potentially widely applicable technique for future epidemiological research.
• The findings provide valuable data on hepatitis B exposure in Ireland, informing public health interventions.