Abstract
BackgroundUnsafe injections, through infectious bodily fluids, are a major route of transmission for hepatitis B and C. Viral hepatitis burden among people who inject drugs is particularly high in many Member States of central and Eastern Europe while national capacity and willingness to address it varies greatly.In 2013, the World Health Organization conducted a survey assessing national viral hepatitis efforts of 194 national governments. Here, we present a sub-analysis of this global survey focusing on questions relating to people who inject drugs in the WHO European Region.MethodsThe initial survey included 43 questions covering awareness, data, prevention, and screening and treatment. It was sent in five languages to identified national focal points. This sub-analysis included 11 questions and 53 Member States in the WHO European Region. Descriptive analyses of national activities are presented. As a secondary outcome bivariate analyses of differences between Member States of the European Union (EU) and European Free Trade Association (EFTA) compared to those not in said grouping are presented.ResultsForty-four of the 53 Member States responded to the survey (response rate of 83%). More than three-quarters reported offering publicly-funded treatment for HBV or HCV (82% and 80%, respectively), with a significantly higher proportion of EU/EFTA Member States (P=0.004 and P=0.010, respectively). Half of Member States (53%) reported the existence of a national policy for hepatitis prevention and control; however less than one-third (27%) reported having written national strategies. Under half of the responding Member States reported holding events for World Hepatitis Day 2012. One-fifth reported offering hepatitis B and C testing free of charge, with less than one-third reportedly conducting regular serosurveys among people who inject drugs.ConclusionsFindings highlight key gaps requiring attention in order to improve national policies and programmes in the region and ensure an adequate response to injection drug use-associated viral hepatitis. Further studies are required to assess quality and impact of national policies and services.
Highlights
Hepatitis B and C (HBV and HCV) are transmitted through exposure to infectious bodily fluids
Transmission may be through infected blood products or transfusions as well as contaminated injections in medical settings and among people who inject drugs (PWID)
This study presents a sub-analysis of survey data from the Member States of the World Health Organization (WHO) European Region, focusing on policy issues and activities that are relevant to the prevention and control of viral hepatitis among people who inject drugs
Summary
Hepatitis B and C (HBV and HCV) are transmitted through exposure to infectious bodily fluids. Modelling suggests that there were 240 million HBV surface antigen (HBsAg) positive persons in 2005 [4] and more than 185 million people were HCV antibody-positive (anti-HCV) in 2010 [5]. According to Global Burden of Disease estimates, HBV and HCV together caused 1.3 million deaths in 2010 [6];on par with other major infectious diseases including malaria (causing 660,000 deaths in 2010) [7], tuberculosis and HIV (causing 1.4 and 1.7 million deaths in 2011, respectively) [8,9]. Through infectious bodily fluids, are a major route of transmission for hepatitis B and C.
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