Suchergebnisse

Chronic hepatitis B (HBV) is one of the major diseases of mankind, estimated to cause about 686,000 deaths per year mostly from liver cancer and cirrhosis. And globally about 240 million people are chronically infected with hepatitis B. Nonalcoholic fatty liver disease (NAFLD) is an emerging commonest cause of chronic liver disease in the world. We have searched for CHB, NAFLD in PUBMED, Google scholar and hard copies of local journals and related available articles were included in this review. Along with 184 countries of the world Bangladesh adopted hepatitis B vaccine in his EPI (expanded program on immunization) schedule for its prevention. And now about 95% of children are under cover of Hep B vaccine. Along with globally inlast two decades' seroprevalence of HBsAg reduced about four times in Bangladesh. The prevalence of recorded nonalcoholic fatty liver disease (NAFLD) varies considerably by ethnic group and Bangladeshi ethnicity is an independent risk factor for NAFLD. The prevalence of NAFLD in Bangladesh is vary from 4%-18.4% and it is increasing day by day. About 40% of them are nonalcoholic steatohepatitis (NASH). They are in danger of progression to cirrhosis and hepatocellular carcinoma (15-19%) in next 5 to 10 years. Now it's becoming a silent killer for our nation. Gradual development of affluence, sedentary life style and increasing prevalence of diabetes contributed behind it. No effective treatment is available till now. Life style change by diet, exercise and weight reduction is the main stay of treatment. NAFLD involve multiple organs that leads to death due to cardiac, neurological and liver disease. Government and health department should take multidisciplinary action programs in awareness building and make a national guideline for fatty liver management.

Hepatitis B virus (HBV) is endemic throughout Africa, but its prevalence in the Democratic Republic of the Congo (DRC) is incompletely understood. We used dried blood spot (DBS) samples from the 2013 to 2014 Demographic and Health Survey in the DRC to measure the prevalence of HBV using the Abbott ARCHITECT HBV surface antigen (HBsAg) qualitative assay. We then attempted to sequence and genotype HBsAg-positive samples. The weighted national prevalence of HBV was 3.3% (95% CI: 1.8–4.7%), with a prevalence of 2.2% (95% CI: 0.3–4.1%) among children. Hepatitis B virus cases occurred countrywide and across age strata. Genotype E predominated (60%), and we found a unique cluster of genotype A isolates (30%). In conclusion, DBS-based HBsAg testing from a nationally representative survey found that HBV is common and widely distributed among Congolese adults and children. The distribution of cases across ages suggests ongoing transmission and underscores the need for additional interventions to prevent HBV infection.

Aim. This study shows epidemiological characteristics and preventive measures implemented for the prevention and control of hepatitis B infections in Croatia. Method. We analyzed the data from obligatory infectious disease reports and notifications of death due to infectious diseases, data on the hepatitis B infections in Croatia, and data collected by survey of the population. Results. The average prevalence of the disease is 3.67 per 100,000 annually. All age groups are affected, but still a higher rate of the disease is found in the age groups from 15 – 19 and 20 – 29 years of age. Hepatitis B disease is 1.4 times more likely in men than in women. For the past 18 years, the average rate of mortality was 0.2%. The incidence of HbsAg-positive donors of blood is within the range of 0.65% in 1992 to 0.012% in 2011. The largest part of preventive measures implemented in Croatia against hepatitis B is predicted and required by legislation. The registrations of acute and chronic carriers of the virus are obligatory. High-risk groups have started being vaccinated since 1992. The obligatory vaccination of infants was introduced in the mandatory vaccination program in 2007. Routine testing of blood exclusively from voluntary donors for HbsAg presence is obligatory. The non-governmental organization 'Help' created for intravenous drug users, along with the 'Harm reduction' program implemented hepatitis B, C, and HIV/AIDS prevention program in 1995. Conclusion. In order to gain a better understanding of epidemiological characteristics of hepatitis B in Croatia, the specifics of its dynamics in small communities are required since the research of Croatian public health officials and researchers have shown that hepatitis B is spread in different ways.

Background: Extensive and judicious vaccination through multi-package plans is important for general prosperity, as the lack of vaccination gadgets can lead to poor well-being in the event of illness. Though, facts on adult devotion to multi-package vaccination are incomplete. Authors have endeavored to study devotion to multiparty vaccination schemes for hepatitis in adults in Pakistan. Methods: This review was led by means of the mysterious government electronic assistance record information from Medical Rehearsal Research Datalink. Persons 21 years of age and older with their first recognized hepatitis antibody segment were involved if they had predictable EHR information for one year prior to the perceived main segment of hepatitis An or for a large part of a year prior to the perceived main segment of hepatitis B or hepatitis A/B combination. We assessed the completion of segments and action plans for each counter-agent and devotion to suggested injection plans, also devotion to pre-selected extra stages after main inoculation plot, with affectability testing limited to adults who had data existing for a long period of time after the main segment. Interval time to peak was assessed by means of Kaplan-Meier systems. Results: The average age (SD) at onset remained 43 (17) years for hepatitis A (n = 375,886), 42 (17) years for hepatitis B (n = 72,635), and 39 (16) years for hepatitis A/B (n = 11,336). Females were involved in 53 to 56% of the cases of complicity of each counter-intelligence agent. Overall, 43,295 adults (12%) completed two-step hepatitis A treatment within the recommended one-year time frame; and 16,565 (23%) and 1,078 (11%) completed three-step hepatitis B and A/B treatment, exclusively, inside suggested seven-month time frame. These rates dropped to only 24, 36 and 34%, independently, when the timeframes were extended to three years for hepatitis An and 33 months for hepatitis B also hepatitis A/B inoculations. None of partners were able to fit into the proposed plans. Affectability reviews ...

This paper discusses the evaluation of Michigan's High‐Risk Hepatitis B Vaccination Program using ethnographic methods. Ninety‐six face‐to‐face interviews were conducted in Family Planning, Sexually Transmitted Disease, and Adolescent Health clinics throughout Michigan. The purpose of this evaluation was to determine why many Michigan residents who sought care at these clinics refused free hepatitis B vaccines and others failed to complete the vaccination series. Key reasons for refusal included lack of knowledge about hepatitis B, lack of knowledge about vaccines, and inconvenience. This paper explores how using ethnographic research methods—one—on—one interviews and participant—observation—captured data from this population that would likely have not been discovered using quantitative research methods.

Zusammenfassung
Hintergrund Die meisten Hepatitis-B-Virus-assoziierten Todesfälle
bei Erwachsenen sind die Folge von Infektionen, die diese bereits bei ihrer
Geburt oder in den ersten fünf Lebensjahren erworben haben.
Ziel Die Erweiterung der Leitlinie zur Prävention der
Mutter-zu-Kind-Übertragung des Hepatitis-B-Virus um antivirale
Prophylaxe.
Methode Die Leitlinie wurde von der Weltgesundheitsorganisation (WHO)
gemäß WHO-Standards umgesetzt. Die Zusammenfassung wurde durch
ein Team des WHO Collaborating Centre an der Donau-Universität Krems
(Österreich) auf Deutsch übersetzt.
Ergebnisse Neben der Empfehlung, schwangere Frauen auf das
Hepatitis-B-Virus (HBV) zu testen und Neugeborene so bald wie möglich
nach der Geburt gegen Hepatitis B zu impfen, wurden zwei neue Empfehlungen
formuliert: Schwangere, die positiv auf eine HBV-Infektion getestet werden,
sollen eine Tenofovir-Prophylaxe erhalten. Die WHO empfiehlt in Settings, wo
keine vorgeburtliche HBV-DNA-Bestimmung verfügbar ist, das Testen auf
HBeAg als Alternative. Damit soll die Eignung für eine
Tenofovir-Prophylaxe beurteilt werden.

In an era of limited healthcare budgets, mathematical models can be useful tools to identify cost-effective programs and to support policymakers in informed decision making. This paper reports results of our work carried out over several years with the Asian Liver Center at Stanford University, a nonprofit outreach and advocacy organization that is an international leader in the fight against hepatitis B and liver cancer. Hepatitis B is a vaccine-preventable viral disease that, if untreated, can lead to death from cirrhosis and liver cancer. Infection with hepatitis B is a major public health problem, particularly in Asian populations. We used new combinations of decision analysis and Markov models to analyze the cost-effectiveness of several interventions to combat hepatitis B in the United States and China. The results of our OR-based analyses have helped change United States public health policy on hepatitis B screening for millions of people and have helped encourage policymakers in China to enact legislation to provide free catch-up vaccination for hundreds of millions of children. These policies are an important step in eliminating health disparities, reducing discrimination, and ensuring that millions of people who need it can now receive hepatitis B vaccination or lifesaving treatment.

BACKGROUND: Chronic hepatitis B is associated with high morbidity and mortality. Chronic hepatitis B requires long-term management aiming at reduction of the risks of hepatocellular inflammatory necrosis, liver fibrosis, decompensated liver cirrhosis, liver failure, and liver cancer, and improving health-related quality of life. The Chinese herbal medicine formula Xiao Chai Hu Tang has been used to decrease discomfort and replication of the virus in people with chronic hepatitis B. However, the benefits and harms of Xiao Chai Hu Tang formula have never been established with rigorous review methodology. OBJECTIVES: To assess the benefits and harms of Xiao Chai Hu Tang formula versus placebo or no intervention in people with chronic hepatitis B. SEARCH METHODS: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE Ovid, Embase Ovid, and seven other databases to 1 March 2019. We also searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp), ClinicalTrials.gov (www.clinicaltrials.gov/), and the Chinese Clinical Trial Registry for ongoing or unpublished trials to 1 March 2019. SELECTION CRITERIA: We included randomised clinical trials, irrespective of publication status, language, and blinding, comparing Xiao Chai Hu Tang formula versus no intervention or placebo in people with chronic hepatitis B. We included participants of any sex and age, diagnosed with chronic hepatitis B according to guidelines or as defined by the trialists. We allowed co-interventions when the co-interventions were administered equally to all the intervention groups. DATA COLLECTION AND ANALYSIS: Review authors independently retrieved data from reports and after correspondence with investigators. Our primary outcomes were all-cause mortality, serious adverse events, and health-related quality of life. Our secondary outcomes were hepatitis B-related mortality, hepatitis B-related morbidity, and adverse events considered 'not to be serious'. We presented the meta-analysed results as risk ratios (RR) with 95% confidence intervals (CI). We assessed the risks of bias using risk of bias domains with predefined definitions. We used GRADE methodology to evaluate our certainty in the evidence. MAIN RESULTS: We included 10 randomised clinical trials with 934 participants, but only five trials with 490 participants provided data for analysis. All the trials compared Xiao Chai Hu Tang formula with no intervention. All trials appeared to have been conducted and published only in China. The included trials assessed heterogeneous forms of Xiao Chai Hu Tang formula, administered for three to eight months. One trial included participants with hepatitis B and comorbid tuberculosis, and one trial included participants with hepatitis B and liver cirrhosis. The remaining trials included participants with hepatitis B only. All the trials were at high risk of bias, and the certainty of evidence for all outcomes that provided data for analyses was very low. We downgraded the evidence by one or two levels because of outcome risk of bias, inconsistency or heterogeneity of results (opposite direction of effect), indirectness of evidence (use of surrogate outcomes instead of clinically relevant outcomes), imprecision of results (the CIs were wide), and publication bias (small sample size of the trials). Additionally, 47 trials lacked the necessary methodological information needed to ensure the inclusion of these trials in our review. None of the included trials aimed to assess clinically relevant outcomes such as all-cause mortality, serious adverse events, health-related quality of life, hepatitis B-related mortality, or hepatitis B-related morbidity. The effects of Xiao Chai Hu Tang formula on the proportion of participants with adverse events considered 'not to be serious' is uncertain (RR 0.43, 95% CI 0.02 to 11.98; I2 = 69%; very low-certainty evidence). Only three trials with 222 participants reported the proportion of people with detectable hepatitis B virus DNA (HBV-DNA), but the evidence that Xiao Chai Hu Tang formula reduces the presence of HBV-DNA in the blood (a surrogate outcome) is uncertain (RR 0.62, 95% CI 0.45 to 0.85; I2 = 0%; very low-certainty evidence). Only two trials with 160 participants reported the proportion of people with detectable hepatitis B virus e-antigen (HBeAg; a surrogate outcome) (RR 0.72, 95% CI 0.50 to 1.02; I2 = 38%; very low-certainty evidence) and the evidence is uncertain. The evidence is also uncertain for separately reported adverse events considered 'not to be serious'. FUNDING: two of the 10 included trials received academic funding from government or hospital. None of the remaining eight trials reported information on funding. AUTHORS' CONCLUSIONS: The clinical effects of Xiao Chai Hu Tang formula for chronic hepatitis B remain unclear. The included trials were small and of low methodological quality. Despite the wide use of Xiao Chai Hu Tang formula, we lack data on all-cause mortality, serious adverse events, health-related quality of life, hepatitis B-related mortality, and hepatitis B-related morbidity. The evidence in this systematic review comes from data obtained from a maximum three trials. We graded the certainty of evidence as very low for adverse events considered not to be serious and the surrogate outcomes HBeAg and HBV-DNA. We found a large number of trials which lacked clear description of their design and conduct, and hence, these trials are not included in the present review. As all identified trials were conducted in China, there might be a concern about the applicability of this review outside China. Large-sized, high-quality randomised sham-controlled trials with homogeneous groups of participants and transparent funding are lacking.

To assess the current uptake of hepatitis B vaccine and attitudes towards immunization among accident and emergency practitioners in the UK, a postal survey was carried out. Questionnaires were sent to 742 members of the British Association for Accident and Emergency Medicine (BAEM). Four hundred and six (55%) replies were received. Of 351 respondents in career-grade posts 309 (88%) had received a full course of immunizations. Five respondents were not immunized and not intending to be so, reporting 13 different factors influencing their decisions. The risks of hepatitis B in nonimmune subjects are discussed, as are new government guidelines on the protection of health care workers from hepatitis B infection.

This paper deals with the teaching and learning of mathematical modeling of hepatitis B virus (HBV) transmission. We first present the teaching of infectious diseases and more precisely the disease of hepatitis B in the Moroccan curriculum. In addition, we develop various activities in order to build the three forms of an HBV epidemic model that are visual, continuous and discrete. These activities can develop in students many abilities and skills such as mathematical reasoning, complex problem solving, modelling and communication. Furthermore, the construction of this HBV epidemic model will be done through the ordinary differential equations (ODEs) which are programmed in the teaching of mathematics in high Moroccan school.


Received: 6 December 2022 / Accepted: 19 April 2023 / Published: 5 May 2023