HCV-Related Burden of Disease in Europe:
A Systematic Assessment of
Incidence, Prevalence, Morbidity, and Mortality

The report provides a collection of HCV-related burden of disease data, relevant for researchers and health care decision makers concerned with hepatitis C virus infection in Europe. It adds data-based information to presently available expert estimates and indicates data, which are in need for update. The data emphasise, that hepatitis C is a major health problem and point out the importance and potential benefit of preventive antiviral treatment. A limitation of the analysis is the use of regional instead of country-specific HCV attributable fractions. This may not have a strong influence on regional burden of disease estimates but yield inaccurate results for single countries.

Incidence

• At present, no uniform hepatitis C surveillance exists at the European level. Considering the heterogeneity of national hepatitis C surveillance, temporal and especially geographic variations of incidence figures must be interpreted with caution.

• Presently, the most consistent collection of European incidence data is provided by WHO. Analysing the data for the WHO European region, we did not identify regional patterns like north-south-divide or east-west-gradients.

• Further efforts are needed to increase the sensitivity of HCV surveillance and to standardise national surveillance data in Europe.

Prevalence

• The most comprehensive collection of HCV prevalence data for countries of the WHO European region was published by WHO in 1999. According to that data, high prevalence rates (> 1.2%) predominate in Eastern and Southern countries, whereas low prevalence rates (<= 0.1%) are more frequently found in the North. However, it is widely accepted that WHO data do not necessarily represent true HCV prevalences and that the data should be updated.

• As revealed by our investigation, WHO prevalence data frequently differ from estimates from other sources and are not always consistent with incidence data. Most interestingly, it was found, that WHO data often are lower than prevalence estimates communicated on national levels, which is important, because WHO data are perceived on an international level and currently used in research and health policy,

• Further studies assessing the age-specific HCV prevalence in representative population samples are needed and data communicated on an official international level should to be updated.

Mortality

• According to our calculation, HCV caused more than 86 000 deaths in the WHO European region in 2002, which is more than twice the number estimated for HIV/AIDS.

• HCV accounted for 35% of the cirrhosis and 32% of the liver cancer deaths. The latter is not consistent with the frequently cited statement, that HCV accounts for 60% of hepatocellular carcinomas.

• Countries with highest HCV-related mortality (> 12 deaths per 100 000) were Austria, Croatia, Georgia, Germany, Hungary, Italy, Kyrgyzstan, Moldova, Romania, Slovenia, and Sweden.

• Death rates for HCV-related cirrhosis and liver cancer show opposite East-West gradients, which might indicate a competing risk situation, where patients in the East die from cirrhosis before they develop liver cancer.

Quality of life

• Presently, the only data, allowing a consistent cross-country comparison of burden of disease resulting from HCV-related quality of life impairment, are DALYs and YLD estimated by the WHO GBD study in 2002. No expert estimates are available for that kind of burden.

• According to our calculations, HCV caused approximately 1.2 Million DALYs lost in the WHO European region in 2002, of which about one sixth can be attributed to quality of life impairment. Contrasting the DALYs to figures reported for other diseases, reveals that hepatitis C is a major health problem, comparable to HIV/AIDS with 1.4 Mio. DALYs.

• About 95% of the HCV-related DALYs were accumulated by patients in advanced disease stages (cirrhosis or liver cancer), which underlines the importance and potential benefit of preventive antiviral treatment.

• Countries with highest HCV-related DALY rates (> 155 DALYS per 100 000) are Croatia, Germany, Hungary, Kazakhstan, Kyrgyzstan, Moldova, Romania, Russia, Slovenia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan.

Transplantation

• According to our calculations, about a quarter of the liver transplants in Europe are related to HCV. Although this is lower than previous expert estimates, HCV is still a dominating cause for liver transplantation, contributing significantly to the high demand of donor organs.

• Considering the already existent shortage of donor livers, and that many HCV infections, acquired by contaminated blood products prior to the 90s, have not yet progressed to the stage of cirrhosis, the need for health care action, like preventive antiviral treatment, becomes obvious.

• The variation of HCV-related transplantation rates (0.002/100 000 in Bulgaria to 0.563/100 000 in Spain) may indicate under-treatment with liver transplantation in some countries.

Education and Training in Occupational Health in the Kingdom of Saudi Arabia: Current and future perspectives.

Seifeddin Gaafar Ballal, MBBS. MSc, DIH, DTCD, PhD, MFOM, FFOM.

Professor and Consultant Occupational Physician, College of Medicine, King Faisal University, Dammam.

Abstract

For centuries, the economy of the Kingdom of Saudi Arabia  was dependent on small-scale agriculture and rearing livestock by nomads who kept moving their animals in search of forage. During the early 1960s a partial survey of industry in the Kingdom, that did not include the southern and northern regions, recorded a total of 624 establishments. The country now has progressed to be the major oil producer and exporter in the world today and is rapidly industrializing. The number of operating factories has increased from 472 in 1395H to 3,906 in 1427H. This expansion might well be accompanied by an increased risk of work-related safety and health hazards. It goes without saying that the safety, skills and quality of the working population are the key to the success of the development of any country. With this in mind it prudent that these employees be trained in the discipline of work place hazards control. This requires the qualified personnel to deliver such training. In spite of this rapid expansion in industrialization and the great increase in the number of medical colleges, teaching of occupational health has very much lagged behind. All universities that have medical colleges either have few or no teaching hours assigned to this discipline. The exception is King Faisal University in Dammam which runs an MSc program in Occupational Medicine and health jointly with UCLA in addition to 9 hours offered to the undergraduates. A new MSc program in Public Health with a major in Occupational Medicine will be launched soon. It is recommended that medical colleges and technical institutions devote more time in their curricula for occupational health and safety training. Programs should be tailored to suit the different categories of occupational health and safety providers. 

The World Hepatitis Alliance

Raising Awareness Around The World

Charles Gore

The World Hepatitis Alliance was created in 2007 because globally viral hepatitis, despite having a prevalence, morbidity and mortality on a par with HIV/AIDS, TB and malaria, had almost no visibility or priority. A patient-led NGO with a Board drawn from 7 world regions, the Alliance’s mission is to improve awareness, prevention, diagnosis and access to treatment on behalf of the 500 million people currently infected with either chronic hepatitis C or hepatitis B and the millions more at risk of becoming infected each year.

Awareness has centred around the establishment of World Hepatitis Day (WHD) on May 19^th, a global event allowing patient groups and Governments to highlight the appropriate hepatitis priorities for their country. The first WHD in 2008 involved 200 patient groups in 50 countries and generated 1200 media pieces. With such a large proportion of the prevalent pool undiagnosed, a frequent theme was the need for testing.

Since then the Alliance has been helping patient groups and others to work with Governments to put in place 12 Asks that together comprise a comprehensive viral hepatitis strategy; has been working with WHO to create a Hepatitis Atlas that gives an accurate, current country-by-country picture of the global viral hepatitis situation; and has been working with individual countries to have a robust resolution on viral hepatitis adopted by the World Health Assembly.

The Alliance is now looking forward to working with the Government of Kuwait to develop an effective strategy against viral hepatitis, and hepatitis C in particular, that will make Kuwait a leader in the region.

Office workplace Musculoskeletal hazards

 among Bank workers in Kuwait

Dr. Qassem Ahmed Shareef Akrouf

Musculoskeletal disorders (MSDs) caused by the use of Display Screen Equipments or Video Display Units (DSE/VDUs) are becoming an important public health problem. The rapid rate of technological development has affected Kuwait. The use of electronic data is common amongst companies and organizations here, as elsewhere around the developed world. Reviewing the local literature in the state of Kuwait did not reveal any major studies dealing with MSDs at work. The current study was formulated to: assess the pattern of musculoskeletal hazards and risks in the office workplaces (bank) in Kuwait, describe elements of a Health and Safety programme in the workplace as well as, ergonomic factors, and to identify the impact of demographic, occupational, psychological and social factors on musculoskeletal disorders. This is a cross-sectional observational study; the study population is composed of 800 office employees working in one major Kuwait bank and who work with DSE/ VDUs and telephone banking. A self-administered modified validated questionnaire (12-Items General Health Questionnaire GHQ12, Nordic Musculoskeletal Questionnaire NMQ) is used. (80%) of workers suffered from at least one attack of MSDs during the past year. The most affected body parts are: the neck (53.5%), lower back (51.1%), shoulders (49.2%), and upper back (38.4%). (42%) of workers suffered from at least one disabling attack of MSDs during the previous year.

Abstract

For centuries, the economy of the Kingdom of Saudi Arabia  was dependent on small-scale agriculture and rearing livestock by nomads who kept moving their animals in search of forage. During the early 1960s a partial survey of industry in the Kingdom, that did not include the southern and northern regions, recorded a total of 624 establishments. The country now has progressed to be the major oil producer and exporter in the world today and is rapidly industrializing. The number of operating factories has increased from 472 in 1395H to 3,906 in 1427H. This expansion might well be accompanied by an increased risk of work-related safety and health hazards. It goes without saying that the safety, skills and quality of the working population are the key to the success of the development of any country. With this in mind it prudent that these employees be trained in the discipline of work place hazards control. This requires the qualified personnel to deliver such training. In spite of this rapid expansion in industrialization and the great increase in the number of medical colleges, teaching of occupational health has very much lagged behind. All universities that have medical colleges either have few or no teaching hours assigned to this discipline. The exception is King Faisal University in Dammam which runs an MSc program in Occupational Medicine and health jointly with UCLA in addition to 9 hours offered to the undergraduates. A new MSc program in Public Health with a major in Occupational Medicine will be launched soon. It is recommended that medical colleges and technical institutions devote more time in their curricula for occupational health and safety training. Programs should be tailored to suit the different categories of occupational health and safety providers

Abstract

The Evolution of the Supreme Health and Safety Committee In Bahrain

In the last 30 years governments around the world commenced focusing on Environment, Health and Safety and the importance they play in creating and sustaining profitable businesses. They have also released that polluting the environment, injuring personnel, causing ill health, loss of productivity and damage to proprieties due to accidents are longer acceptable. Most countries embarked on major health and safety initiatives that enabled them improve the situations and ensure that events like the above are minimized to as low as reasonably practicable.

The Kingdom of Bahrain wanted to ensure that it also dealt with the situation effectively and as much as possible improved the country Health and safety Management systems and processes. The government wanted that all concerned stakeholders are actively involved and engaged in the creation of proactive health and safe working environment.

Abstract

Creativity at the work place

General Background :   Creativity is an increasingly critical topic for contemporary organization. Science has speculated that we are using 10% of our brain capacity. In this workshop we will learn how to access and cultivate 90% of unrealized potential.

People who know how to harness their own creative juices can tap into their creativity and believe in the vast powers of their own ideas will become successful in virtually everything they do. Just as we learn other skills- to read, to write, and to do math- it is necessary to train ourselves to properly harness the power of our brains in order to think originally, brain storm, and utilize that huge creative power.

General Objectives: At the end of the lecture the participant is expected to :

1. Develop an understanding of many forms of creativity and their applications.

2. Assess his creativity and risk taking style.

3. Identify new ways to perceive and solve problems.

4. Gain knowledge of Edward de Bono's lateral thinking.

5. Learn how to get good ideas implemented.

The Art of Presentation and Communication Skills

General Background : In the modern commercial world a good presentation will often add a positive dimension to the decision making process. A talented speaker can carry an audience or group. The ability to present powerfully and in a persuasive manner is a core executive competency. Careers can be enhanced by a mastery of presentation skills.

The ability to speak effectively is one of the most powerful tools for personal and professional success. Participants will learn what causes public-speaking fear and how to avoid it, the roles of appearance and body language, how to most effectively communicate your message and more.

Copyright 2009 gccoh.com All Rights Reserved - info@gccoh.com - Powered by alrowaq.net