Disease elimination

疾病消除
  • 文章类型: Journal Article
    Cascade-of-care (CoC) monitoring is an important component of the response to the global hepatitis C virus (HCV) epidemic. CoC metrics can be used to communicate, in simple terms, the extent to which national and subnational governments are advancing on key targets, and CoC findings can inform strategic decision-making regarding how to maximize the progression of individuals with HCV to diagnosis, treatment, and cure. The value of reporting would be enhanced if a standardized approach were used for generating CoCs. We have described the Consensus HCV CoC that we developed to address this need and have presented findings from Denmark, Norway, and Sweden, where it was piloted. We encourage the uptake of the Consensus HCV CoC as a global instrument for facilitating clear and consistent reporting via the World Health Organization (WHO) viral hepatitis monitoring platform and for ensuring accurate monitoring of progress toward WHO\'s 2030 hepatitis C elimination targets.
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  • 文章类型: Review
    BACKGROUND: Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran.
    METHODS: The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3rd national consensus on management of Hepatitis C in Iran, held on 22nd of July 2016.
    RESULTS: Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered.
    CONCLUSIONS: Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection.
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  • 文章类型: Journal Article
    世界卫生组织(WHO)西太平洋区域(WPR)麻疹消除核查指南于2012年制定。本文概述了澳大利亚解决该指南五行证据的方法,这导致世卫组织区域核查委员会(RVC)于2014年3月对消除进行了正式核查。
    这些标准是通过国家麻疹通报来解决的,来自选定实验室的数据,国家儿童免疫登记册,和三项国家血清调查(1998/1999、2002、2007)。
    澳大利亚通过国家或哨点数据达到或超过了所有指标目标。实验室和流行病学监测是高质量的,85%的病例记录为进口/进口相关(目标80%);第一剂麻疹疫苗的覆盖率在2008-2012年接近94%,第二剂疫苗的覆盖率在2012年增加到91%(目标>95%).澳大利亚政府不断承诺增加免疫覆盖率,并且证明了没有任何单一麻疹基因型的持续传播。
    这是成功应用WPRRVC指南的第一个文档。这些指标具有一定的灵活性,但似乎为判断消除麻疹的成就提供了适当的严谨性。我们的经验可以帮助其他寻求核实其消除状态的国家。
    The World Health Organization (WHO) Western Pacific Region (WPR) Guidelines on verification of measles elimination were established in 2012. This article outlines Australia\'s approach to addressing the guideline\'s five lines of evidence, which led to formal verification of elimination by the WHO Regional Verification Commission (RVC) in March 2014.
    The criteria were addressed using national measles notifications, data from selected laboratories, the national childhood immunization register, and three national serosurveys (1998/1999, 2002, 2007).
    Australia met or exceeded all indicator targets with either national or sentinel data. Laboratory and epidemiological surveillance were of high quality, with 85% of cases documented as imported/import-related (target 80%); coverage with the first dose of measles vaccine was close to 94% in 2008-2012 and second dose coverage increased to 91% in 2012 (target >95%). There is ongoing commitment by the Australian Government to increase immunization coverage, and the absence of sustained transmission of any single measles genotype was demonstrated.
    This is the first documentation of the successful application of the WPR RVC guidelines. The indicators afford some flexibility but appear to provide appropriate rigor to judge achievement of measles elimination. Our experience could assist other countries seeking to verify their elimination status.
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