Strategies to manage hepatitis C virus infection disease burden-Volume 4.

The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 17 countries in Africa, Asia, Europe, Latin America and the Middle East, and interventions for achieving the Global Health Sector Strategy on viral hepatitis targets-"WHO Targets" (65% reduction in HCV-related deaths, 90% reduction in new infections and 90% of infections diagnosed by 2030) were considered. Scaling up treatment and diagnosis rates over time would be required to achieve these targets in all but one country, even with the introduction of high SVR therapies. The scenarios developed to achieve the WHO Targets in all countries studied assumed the implementation of national policies to prevent new infections and to diagnose current infections through screening.

Addressing barriers to the prevention, diagnosis and treatment of hepatitis B and C in the face of persisting fiscal constraints in Europe: report from a high level conference.

In the WHO-EURO region, around 28 million people are currently living with chronic viral hepatitis, and 120,000 people die every year because of it. Lack of awareness and understanding combined with the social stigma and discrimination exacerbate barriers related to access to prevention, diagnosis and treatment services for those most in need. In addition, the persisting economic crisis has impacted on public health spending, thus posing challenges on the sustainable investment in promotion, primary and secondary prevention, diagnosis and treatment of viral hepatitis across European countries. The Hepatitis B and C Public Policy Association in cooperation with the Hellenic Center for Disease Prevention and Control together with 10 partner organizations discussed at the Athens High Level Meeting held in June 2014 recent policy developments, persisting and emerging challenges related to the prevention and management of viral hepatitis and the need for a de minimis framework of urgent priorities for action, reflected in a Call to Action (Appendix S1). The discussion confirmed that persisting barriers do not allow the full realisation of the public health potential of diagnosing and preventing hepatitis B and C, treating hepatitis B and curing hepatitis C. Such barriers are related to (a) lack of evidence-based knowledge of hepatitis B and C, (b) limited access to prevention, diagnosis and treatment services with poor patient pathways, (c) declining resources and (d) the presence of social stigma and discrimination. The discussion also confirmed the emerging importance of fiscal constraints on the ability of policymakers to adequately address viral hepatitis challenges, particularly through increasing coverage of newer therapies. In Europe, it is critical that public policy bodies urgently agree on a conceptual framework for addressing the existing and emerging barriers to managing viral hepatitis. Such a framework would ensure all health systems share a common understanding of definitions and indicators and look to integrate their responses to manage policy spillovers in the most cost-effective manner, while forging wide partnerships to sustainably and successfully address viral hepatitis.

The state of hepatitis B and C in the Mediterranean and Balkan countries: report from a summit conference.

The burden of disease due to chronic viral hepatitis constitutes a global threat. In many Balkan and Mediterranean countries, the disease burden due to viral hepatitis remains largely unrecognized, including in high-risk groups and migrants, because of a lack of reliable epidemiological data, suggesting the need for better and targeted surveillance for public health gains. In many countries, the burden of chronic liver disease due to hepatitis B and C is increasing due to ageing of unvaccinated populations and migration, and a probable increase in drug injecting. Targeted vaccination strategies for hepatitis B virus (HBV) among risk groups and harm reduction interventions at adequate scale and coverage for injecting drug users are needed. Transmission of HBV and hepatitis C virus (HCV) in healthcare settings and a higher prevalence of HBV and HCV among recipients of blood and blood products in the Balkan and North African countries highlight the need to implement and monitor universal precautions in these settings and use voluntary, nonremunerated, repeat donors. Progress in drug discovery has improved outcomes of treatment for both HBV and HCV, although access is limited by the high costs of these drugs and resources available for health care. Egypt, with the highest burden of hepatitis C in the world, provides treatment through its National Control Strategy. Addressing the burden of viral hepatitis in the Balkan and Mediterranean regions will require national commitments in the form of strategic plans, financial and human resources, normative guidance and technical support from regional agencies and research.

Influence of nutritional and oral hygiene habits on oral health in Croatian island children of school age.

AIM: The aim of this cross-sectional (analytical) study was to investigate the influence of nutritional and hygienic habits on oral health in children. MATERIALS AND METHODS: There were 143 children aged six to thirteen years attending primary school Blato, Blato, Croatia who participated in this study. Children were divided into groups according to age in younger primary school children (6-9 years old, n=82) and older primary school children (10-13 years old, n=61): according to gender in males (n=53) and females (n=90). The study was conducted by using a questionnaire of nutritional and hygienic habits and clinical dental examination. Decayed-missed-filled tooth index (DMFT) and plaque index were calculated. DIAGNOdent pen was used to assess caries presence on the first permanent molars. RESULTS: There are no statistically significant differences in the consumption of sugar and sweetened beverages among the tested groups. There were 124 (86.71%) children brushing their teeth one or more times a day. The DMFT index for older children (10-13 years, DMFT=2.66±2.45) was significantly higher (p <0.001) than the DMFT index in younger children (6-9 years, DMFT=1.08±1.36). There is no statistically significant difference in the DMFT index between the sexes (p = 0.405). Results obtained by comparing the plaque index value among children of different ages and sexes show that there are no statistically significant differences among the comparable groups as well as the values obtained with the device KaVo DIAGNodent Pen in both groups (age and gender). STATISTICS: Statistical analysis was carried out using the MedCalc for Windows software version 11.5.1.0 (MedCalc software, Mariakerke, Belgium). For comparison of continuous variables, the Mann-Whitney U test was used, and a ?2-test was used to compare the category variables. The level of statistical significance was set at p <0.05. CONCLUSION: Results of this study showed that DMFT index is higher in older children than in younger children although their nutritional and oral hygiene habits are similar. Oral health in children of different sexes was the same as well as their nutritional and oral hygiene habits.