Hepatitis C Elimination in Moldova Is Feasible and Cost-Saving: A Modeling Study.

BACKGROUND: Moldova, an upper-middle-income country in Eastern Europe, is facing a high burden of hepatitis C virus (HCV). Our objective was to assist the National Agency of Public Health of Moldova in planning to achieve the World Health Organization's HCV elimination goals by 2030. METHODS: This study adapted a previously developed microsimulation model to simulate the HCV epidemic in Moldova from 2004 to 2050. Model outcomes included temporal trends in HCV infection, prevalence, mortality, and total cost of care, including screening and treatment. We evaluated scenarios that could eliminate HCV by 2030. RESULTS: Multiple strategies could lead to HCV elimination in Moldova by 2030. A realistic scenario of a 20% annual screening and 80% treatment rate would require 2.75 million individuals to be screened and 65 000 treated by 2030. Compared to 2015, this program will reduce HCV incidence by 98% and HCV-related deaths by 72% in 2030. Between 2022 and 2030, this strategy would cost $17.5 million for HCV screening and treatment. However, by 2050, the health system would save >$85 million compared to no investment in elimination efforts. CONCLUSIONS: HCV elimination in Moldova is feasible and can be cost saving, but requires resources to scale HCV screening and treatment.

An evaluation of the National Influenza Vaccination Program in the Republic of Moldova, 2023-2024.

During the 2023-2024 influenza season, the Republic of Moldova, a lower-middle income country seeking accession into the European Union, independently financed their influenza vaccine supply transitioning from external support from the Partnership for International Vaccine Initiatives, a collaboration conceived in 2015. As part of this transition, a mixed-methods evaluation was conducted from May 2023 - January 2024 to identify current strengths and weaknesses of the influenza vaccination program. A total of 157 interviews were conducted: one with the National Immunization Program (NIP), six with district health officers, 18 at health facilities, 18 with caregivers/parents, 34 with healthcare workers, 43 with adults with chronic diseases, 19 with pregnant women, and 13 vaccine observation sessions; further five expert interviews with an international organization, the insurance company, senior government officials in public health and within the ministry of health, and those involved with COVID-19 were conducted. The Republic of Moldova's NIP has benefited from decades of experience, internal commitments to progress, and contributions from external partners. Despite this progress, the evaluation recognized four areas for improvement. Recommendations from the evaluation assessment included: 1) develop a national strategy for immunization, including the establishment of national goals in consultation with the national immunization technical advisory group (NITAG); 2) expand immunization communications and advocacy initiatives, particularly to adults and pregnant individuals; 3) leverage trusted patient-doctor relationships and encourage vaccination as a healthcare norm with physician specialists; and 4) conduct operations research to better understand vaccine hesitancy in populations such as pregnant individuals. Additional thematic findings emphasized the importance of ensuring timely receipt of vaccine doses into the country no later than September, as medical providers reported difficulty administering doses when vaccines were delivered after September. Our findings outline ways to further strengthen the Republic of Moldova's self-sustained annual influenza vaccination program.

Characterisation of the Antibody Response in Sinopharm (BBIBP-CorV) Recipients and COVID-19 Convalescent Sera from the Republic of Moldova.

The early availability of effective vaccines against SARS-CoV-2, the aetiologic cause of COVID-19, has been at the cornerstone of the global recovery from the pandemic. This study aimed to assess the antispike RBD IgG antibody titres and neutralisation potential of COVID-19 convalescent plasma and the sera of Moldovan adults vaccinated with the Sinopharm BBIBP-CorV vaccine. An IgG ELISA with recombinant SARS-CoV-2 spike RBD and two pseudovirus-based neutralisation assays have been developed to evaluate neutralising antibodies against SARS-CoV-2 in biosafety level 2 containment facilities. A significant moderate correlation was observed between IgG titres and the overall neutralising levels for each neutralisation assay (ρ = 0.64, p < 0.001; ρ = 0.52, p < 0.001). A separate analysis of convalescent and vaccinated individuals showed a higher correlation of neutralising and IgG titres in convalescent individuals (ρ = 0.68, p < 0.001, ρ = 0.45, p < 0.001) compared with vaccinated individuals (ρ = 0.58, p < 0.001; ρ = 0.53, p < 0.001). It can be concluded that individuals who recovered from infection developed higher levels of antispike RBD IgG antibodies. In comparison, the Sinopharm-vaccinated individuals produced higher levels of neutralising antibodies than convalescent plasma.

Seroprevalence and risk assessment of viral hepatitis E infection in a group of exposed persons from Republic of Moldova.

INTRODUCTION: Viral hepatitis E is considered to be an important issue for public health in developing countries. The aim of the present study is to evaluate morbidity and risk factors in occupationally exposed groups such as people working on sausage production. METHODOLOGY: Seroprevalence of HEV (hepatitis E virus) and risk factors to infection were determined in a cross-sectional study of two groups of populations: people working on sausage production (n = 70) and persons without occupational exposure (people working in the textile industry n = 70) in Moldova, a country without reported cases of hepatitis E. RESULTS: The seroprevalence of HEV was 14.3% (CI 95%, 13.1-15.5%) in the group of exposed, compared with no cases in the non-exposed group that indicates on no previous infectious contact with hepatitis E virus. CONCLUSIONS: The increased seroprevalence of HEV among persons with occupational exposure to swine meat suggest animal-to-human transmission of this infection.