{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:49Z","timestamp":1785545089088,"version":"3.56.0"},"reference-count":24,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic hepatitis B (CHB) remains a significant health burden for at least a hundred thousand Canadians. The government of Canada has endorsed the global strategy to eliminate hepatitis as a public health threat by 2030, but effectively targeting public health interventions is complicated by the silent nature of the disease, which can remain asymptomatic for decades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study develops a framework to estimate the prevalence of CHB and the proportion of the infected population that remains undiagnosed. We apply the proposed method to national data from Canada, from 2007 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We infer the prevalence and undiagnosed proportion of CHB by fitting a mathematical state-transition model, based on the natural history of CHB, to observed CHB-related events. Data for the calibration were obtained from the Public Health Agency of Canada and Statistics Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We estimate the national prevalence of CHB in Canada in 2021 to be 0.483% (95% CI 0.443%-0.535%). The corresponding percentage of undiagnosed cases was estimated to be 54.3% (95% CI 50.9%-58.9%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The estimates of CHB prevalence obtained via our method are in line with previous estimates obtained from national seroprevalence studies. More specialized estimates, stratified by province or age cohort, may be achievable with detailed health administrative data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/66309","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T07:38:20Z","timestamp":1746171500000},"page":"e66309-e66309","source":"Crossref","is-referenced-by-count":0,"title":["Estimating Chronic Hepatitis B Prevalence and Undiagnosed Proportion in Canada, 2007-2021: Mathematical Framework Development"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8734-0896","authenticated-orcid":false,"given":"Julien","family":"Smith-Roberge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1833-823X","authenticated-orcid":false,"given":"Farinaz","family":"Forouzannia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-1797","authenticated-orcid":false,"given":"Abdullah","family":"Hamadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8113-3619","authenticated-orcid":false,"given":"Zeny","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3841-5841","authenticated-orcid":false,"given":"Nashira","family":"Popovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-0052","authenticated-orcid":false,"given":"William W L","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"R1","unstructured":"World Health Organization. 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King\u2019s Printer for Ontario; 2023."},{"issue":"43","key":"R9","doi-asserted-by":"publisher","first-page":"E1299","DOI":"10.1503\/cmaj.200290","article-title":"Prenatal hepatitis B screening, and hepatitis B burden among children, in Ontario: a descriptive study","volume":"192","author":"Biondi","journal-title":"Can Med Assoc J"},{"issue":"11","key":"R10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0225366","article-title":"A model-based framework for chronic hepatitis C prevalence estimation","volume":"14","author":"Hamadeh","journal-title":"PLoS One"},{"issue":"19","key":"R11","doi-asserted-by":"publisher","first-page":"429","DOI":"10.14745\/ccdr.v40i19a02","article-title":"Estimated prevalence of Hepatitis C Virus infection in Canada, 2011","volume":"40","author":"Trubnikov","journal-title":"Can Commun Dis Rep"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1002\/sim.4780110612","article-title":"Estimating the stage\u2010specific numbers of HIV infection using a markov model and back\u2010calculation","volume":"11","author":"Longini","journal-title":"Stat Med"},{"issue":"9","key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/26409","article-title":"Estimation of COVID-19 period prevalence and the undiagnosed population in Canadian Provinces: model-based analysis","volume":"7","author":"Hamadeh","journal-title":"JMIR Public Health Surveill"},{"key":"R14","unstructured":"Kim J . 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