Community interventions for HBV/HCV in migrants: Delphi-based indicators for monitoring & evaluation

Abstract Background Chronic hepatitis B and C drive preventable liver cancer and death. In Europe, migrants and refugees from high-endemic regions bear much of this burden, yet community programmes that could close diagnosis and treatment gaps lack shared metrics. We convened experts to craft a harmonised indicator set for monitoring screening, prevention and care. Methods A scoping review of community HBV/HCV interventions (PubMed, Jan 2005-Jun 2024) produced 275 candidate indicators. A two-round online Delphi survey engaged hepatology, public health and migrant health specialists: 41 invited, 14 (34 %) completed both rounds. Indicators gaining ≥67 % combined “agree/somewhat agree” on five quality criteria advanced; panellists then ranked operational relevance within six health domains. Results Consensus retained 50 indicators in the following domains: prevention (9 indicators), testing (9), linkage-to-care (8), treatment & care (8), morbidity (7) and health system (9). Twentynine (58 %) secured unanimous support; mean agreement 95.3% (SD 7.0). Eighteen indicators, the top three per domain, were proposed for routine use. Top-ranked metrics captured key cascade steps: screening acceptability, HBV/HCV prevalence, prompt result communication, specialist referral and treatment initiation. “Cost per test-positive participant” drew the lowest agreement (43%). Conclusions This first consensus-based framework equips programme managers and policymakers with a practical, internationally relevant tool to assess community hepatitis services for migrants and refugees. Using the set will standardise reporting, highlight bottlenecks and guide resources, advancing WHO 2030 elimination targets through earlier diagnosis, vaccination and curative-therapy uptake. Key messages • Consensus yielded 50 indicators in six domains to systematically track community hepatitis B/C services for migrant and refugee populations. • Implementing the core indicator set will boost early detection and linkage to care, propelling viral hepatitis elimination goals.