The SPADE project
Hepatocellular carcinoma is the third leading cause of cancer-related death worldwide. This major public health issue stems primarily from chronic hepatitis B virus infection, which is mainly transmitted at birth—particularly among individuals born in Africa and Asia. As the infection is most often asymptomatic, diagnosis is frequently delayed. Without early diagnosis and access to treatment, up to 25% of patients with chronic hepatitis are at risk of developing hepatocellular carcinoma during their lifetime.
The hepatitis B virus continues to circulate in France, despite mandatory neonatal vaccination coverage since 2018. Inadequate screening and access to care for the specific populations affected contribute to this situation.
Prevention and screening efforts must be based on available epidemiological data and the characteristics of exposed populations. In the context of the Lyon metropolitan area, the SPADE project (SPAtial DEtection of HBV-infected people for targeted prevention interventions) is proposed based on the hypothesis that the residential locations of individuals living with the hepatitis B virus are not evenly distributed across the urban landscape.
The goal of SPADE is to identify the most relevant areas for screening interventions through the geographic analysis of hospital data and qualitative research into the living environments and access to care of people living with the virus. This approach will enable the development of targeted strategies based on the socio-spatial and psychosocial characteristics of the areas where people living with the hepatitis B virus—and their potentially infected contacts—reside.
Adopting a transdisciplinary approach, SPADE draws on expertise from the humanities and social sciences, infectious disease medicine, biology, public health, intervention research, and community health. The project’s mixed-methods approach encompasses the quantitative analysis of health data, a qualitative survey of individuals who tested positive for the hepatitis B virus, and the experience and knowledge of the various stakeholders involved in the field. This approach is essential to achieving the goal of eliminating viral hepatitis by 2030, as set by the WHO.
Project leaders:
Isabelle CHEMIN
Dr. Isabelle Chemin is currently a Research Director at INSERM U1350 (IHU EVEREST). Her research focuses on HBV variants and hepatocellular carcinoma (HCC), including prognostic and predictive markers for HCC, animal models, and field studies. She leads several projects involving countries in Africa and Latin America. She has contributed to technology transfer in The Gambia, Senegal, Brazil, and Venezuela, and aims to improve diagnosis and access to care for patients with hepatitis B and hepatitis D.
Mauricio FUENTES VALLEJO
Mauricio Fuentes Vallejo is a health geographer with experience in interdisciplinary public health research; he focuses on the integration of quantitative, qualitative, and participatory methodologies.
Since 2023, he has been a researcher in the Department of Humanities and Social Sciences at the Centre Léon Bérard, where he contributes to projects addressing social inequalities in cancer care—specifically the spatial concentration of healthcare services and the quality of life of cancer patients—as well as the analysis of spatial inequalities and contextual risk factors regarding sarcoma incidence in France.
