Modelling the impact of improving access to healthcare on Hepatitis B prevalence in the Thai-Myanmar border region

TL;DR

This study uses an agent-based model to evaluate how improving healthcare access for migrants and border communities in Thailand could significantly reduce Hepatitis B prevalence and help achieve elimination targets.

Contribution

It introduces a detailed agent-based model capturing migrant heterogeneity to assess intervention impacts on Hepatitis B in Thailand's border region.

Findings

Current interventions are effective for the Thai population but insufficient for migrants.

Improving healthcare access for migrants could significantly reduce Hepatitis B prevalence.

Quantified the level of healthcare improvement needed to reach elimination targets.

Abstract

Introduction: In Thailand, Hepatitis B is still endemic despite a strong program to eliminate the disease. A higher prevalence is reported in the border region and among migrants due to physical, financial and cultural barriers. Policies and programs targeting the border region and migrant communities have been suggested. Models can be used to understand and quantify the impact of these policies, given they can capture the heterogeneity within the population. Methods: In this study, we developed an Agent-based model that captures the differences between the Thai and migrant populations living in this region, notably the higher level of mobility, lower access to healthcare, and the higher prevalence of Hepatitis B among migrants, by modelling the origin of each individual explicitly. We used the model to estimate future trends of Hepatitis B prevalence in Thailand near the border with Myanmar under different scenarios of intervention. Results: Our study shows that although the current intervention level is effective in the Thai population, it is insufficient to reach national elimination targets due to high prevalence in migrants. Improving access to healthcare for migrants and the border region could potentially help to reach elimination targets, and we quantified the level of improvement needed to achieve elimination. Conclusion: Although there already exist policies to make healthcare more accessible to migrants and the border regions, they are still not yet effective due to financial and cultural barriers. Bringing down those barriers could reduce Hepatitis B prevalence in those communities and regions and contribute to reaching elimination targets in a reasonable timeline.