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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is generally accepted that the introduction of hepatitis B vaccine to national programmes of immunization in developing countries is desirable, but it has so far been constrained by the high cost of the vaccine. To determine the potential minimal costs of the vaccine, a study has been carried out of the production of the vaccine in a developing country with a population of approximately 50 million. The study concludes that the manufacture of a plasma-derived hepatitis vaccine in some developing countries may be reasonable. A detailed financial evaluation using the best available information leads to several conclusions. In the hypothetical 50-million population country, a plasma-derived hepatitis B vaccine could be manufactured and made available at a price of approximately US$0.50 per dose packed in 10-dose vials if approximately 4 million doses per year are procured. An important condition of achieving this price level is that approximately 8% of total production is sold in the private sector for a profit. To establish these facilities, an initial capital investment of approximately US$3.7 million would have to be made. The minimal prices for hepatitis B vaccine that could be achieved in very large production facilities manufacturing many tens of millions of doses per year have also been estimated. Extension of the model to such quantities (10 to 20 million doses per year) suggests that the vaccine can be sold for less than US$0.10 per dose, thereby placing it in the same cost range as other EPI vaccines. Thus, hepatitis B vaccine may reach these cost levels when large-scale procurement is undertaken by governments and international donor agencies.
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PMID:Cost of plasma-derived hepatitis B vaccine production. 214 90

Hepatitis B is highly endemic in Senegal. The prevalence of hepatitis B antigens in the population was estimated to be 10 to 12% in 1982. According to the WHO recommendations, a hepatitis B vaccination program (HBV) was launched in 10 medical centers in the Kolda medical region to assess the feasibility of including HBV in the EPI. The epidemiological impact of HBV was also investigated by comparison of the vaccinated zone (VZ) to a control non vaccinated zone (NVZ). HBV coverage had a pattern similar to that of DPT-IPV, but at a lower level: the overall coverage with HBV was only 37.5%, and the drop out rate for HBV1-3 was only 34.4%. In addition, the coverage of the under one year age group was insufficient: 45% for HBV3 as compared to 78% for DPT3 (p < 0.0001). Routine vaccination records in the medical centers in the VZ were consistent with the findings of cluster surveys. Hepatitis B markers were less prevalent among vaccinated that non vaccinated children (8 versus 18.5%, p < 0.001). HB antigenemia was significantly less frequent in the VZ than the NVZ (3.9 versus 10.9, p < 0.0001), and the difference was even larger for all hepatitis markers (7.4 versus 23.7%, p < 0.0001). This study therefore suggests that the inclusion of HBV in the EPI should be continued and strengthened in less accessible regions by an adapted social mobilization program. HBV could then be extended to the whole medical district of Kolda in association with regular epidemiological and serological surveillance.
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PMID:[Inclusion of hepatitis B vaccination in the Expanded Program of Immunization: feasibility study in the medical region of Kolda (Senegal)]. 789 28

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and a public health concern in many developing countries. The main risk factor is the chronic carriage state of the hepatitis B virus which is found in about 20% of the adult population in many African and Asian countries. Other important risk factors are HCV infection, aflatoxin exposure and alcohol consumption. The Gambia Hepatitis Intervention Study was launched in 1986 with the aim of evaluating the efficacy of the hepatitis B vaccination, given in early infancy, in preventing HBV infection, its chronic carriage status, and later, HCC. For this purpose, a randomised vaccine trial was designed and carried out. Over a period of four years a total of 124.577 children were recruited, one half received the usual EPI vaccines (BCG, DTP, OPV, measles, yellow fever) and the other half the hepatitis B vaccine in addition to the EPI ones. Hepatitis B vaccination has been successfully integrated into the "Expanded Programme of Immunization" in The Gambia, since every new born baby can receive this vaccination in addition to the EPI vaccine. The first mid point evaluation showed that in four-year-old children, hepatitis B vaccine efficacy was 84% in preventing infection and 94% in preventing chronic carriage status of HBV. Other mid point evaluations are still ongoing. A nationwide Cancer Registry was set up to detect HCC cases in the cohort under study. Follow-up through the Cancer Registry is planned for the next 30 years.
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PMID:[Hepatocellular carcinoma: a preventable cancer]. 937 80

Hepatitis B and C are endemic in the Campania region of Italy, and as a result there are many patients with hepatitis-related cirrhosis. The medical community is therefore faced with a series of issues which must be dealt with and which are especially relevant to various areas of surgery. Abdominal wall hernias occur very frequently in cirrhotic patients, and hepatic cirrhosis has always been the harbinger of a negative outcome in patients undergoing inguinal hernia repair. The aim of this study, conducted on 52 cirrhotic patients who underwent inguinal hernioplasty, was to evaluate the effectiveness and safety of surgical treatment when certain parasurgical measures are used. These measures and the notes we inserted in our surgical protocol include the following: short-term antibiotic prophylaxis, perioperative infusion of concentrated platelets, not opening the hernia sac, application of human fibrin glue, elastic compression. All patients were treated according to the same protocol and the data was analysed using the statistics software EPI INFO 3.5.
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PMID:Hepatic cirrhosis and groin hernia: binomial or dichotomy? Our experience with a safe surgical treatment protocol. 2178 May 61