El objetivo del presente trabajo fue determinar la seroprevalencia del virus de la hepatitis C (VHC) y de la B (VHB) en donadores militares y civiles que acudieron al Banco de Sangre del Hospital Naval así como los factores de riesgo asociados. Se trata de un estudio transversal, descriptivo y retrospectivo, cuyos datos epidemiológicos y resultados del tamizaje general se obtuvieron de los Libros de registros del Banco de Sangre e Historias Clínicas en el caso de los donantes militares, en el período comprendido de Enero de 1999 hasta Abril de 2004. El Test de MUREX HBsAg Versión 3 y Hepanostika Anti-HBc UniForm fueron empleados para Hepatis B, mientras que para el virus de la Hepatitis C se utilizó el Test de Elisa de tercera generación. Un total de 7009 donantes fueron registrados entre 1999 y 2004. Se incluyeron en el presente estudio 320, aquellos que presentaban anticuerpos contra el virus C (anti-VHC) y, para el virus de la hepatitis B: Antígeno de superficie (AgSupHBV) y/o Antígeno Core-IgG. Los datos recolectados fueron procesados y analizados en el paquete estadístico SPSS versión 10 para Windows: Prueba de Ji cuadrado o Prueba de Fisher. RESULTADOS: La prevalencia de portadores de VHC y VHB fue de 0.74% y 0.34%, respectivamente. La mayor población de infectados se encuentra entre los 18 y 30 años y corresponde al personal de la sanidad naval para la Hepatitis B y de Infantería de Marina para la Hepatitis C. No se pudo encontrar factores de riesgo relacionados en ninguna de las dos etiologias debido a una tasa de negación del 96,4% del total de donantes. CONCLUSIONES: Los resultados demuestran una baja prevalencia de infección por virus de hepatitis B, pero elevada para la hepatitis C de acuerdo a los reportes nacionales e internacionales. La pobre o nula asociación entre los factores de riesgo y la enfermedad por hepatitis B y C, que estaría en relación a la limitada efectividad y poca utilidad de la AEC. Se hace necesario que el escrutinio, a través de la encuesta de predonación, sea mas completo, diseñando un cuestionario capaz de detectar más factores de riesgo, probablemente determinanates en la transmisión de los virus de la hepatitis B y C. / The aim of the present work was to determine the seroprevalence of the virus of the hepatitis C (VHC) and of the hepatitis B (VHB) in military and civil donors who came to the Bank of Blood of the Navy Hospital as well as the associate factors of risk. It is a question of a transverse, descriptive and retrospective study realized in the Bank of Blood, which information epidemiological and proved from the general tamizaje was obtained of the Books of records of the Bank of Blood and Clinical Histories in case of the military donors, in the included period of January, 1999 until April, 2004. Murex’s Test HBsAg Version 3 and Hepanostika Anti-HBc UniForm were used for Hepatitis B, whereas for the virus of the Hepatitis C there was in use Elisa's Test of third generation. A whole of 7009 donors was registered between 1999 and 2004.Were included in the present study 320, those who were presenting antibodies against the virus C (anti-VHC) and for the virus of hepatitis B: Surface antigen (HBsAg) and/or Antigen Core-IgG. The information was gathered, percentages were obtained and the results were analyzed by means of SPSS 10 Windows version Statistics Program: chi-square or Fisher’s Tests. RESULTS: The prevalence of carriers of VHC and VHB was 0.74% and 0.34%, respectively. The principal infection people are between 18 to 30 years old, and belong to health navy personal for HBV infection and Marine Infantry for HCV infection. It couldn’t find risks factors in relation to the two etiologists, due a negative rate of 96,4%. CONCLUSIONS: The results suggest a low prevalence of infection for VHB but high for VHC infection in the studied population as it are indicate in the national and international reports. The poor or useless association between de risks factors and the illness it could be in relation to a limited effective and a poor utility of de Confidential Autoexclusion Exam. It’s necessary that this exam must be complete and have the property to identify more risks factors on the transmission of HBV and HCV.

Thesis (M.P.H.)--University of New South Wales, 2005. / Also available online.

<p>Adekvatni nadzor nad zaraznim bolestima predstavlja aktuelni izazov ne samo kod nas već i u razvijenim zemljama. Savremeni epidemiolo&scaron;ki nadzor nad zaraznim bolestima zasniva se na odgovarajućim definicijama slučaja. Njihova osnovna funkcija je olak&scaron;avanje prepoznavanja određenih bolesti i njihovo registrovanje na jednoobrazan način. Definisanje slučajeva zaraznih bolesti nije jednostavno, jer uključuje kliničke, epidemiolo&scaron;ke i laboratorijske parametre, uz istovremeno očekivanje visoke senzitivnosti i specifičnosti. Ciljevi istraživanja su bili da se utvrdi primenljivost definicija slučaja hepatitisa B i C na Klinici za infektivne bolesti Kliničkog centra Vojvodine, te da se utvrdi senzitivnost i specifičnost primenjenih definicija slučaja hepatitisa B i C. Uz postojeći dijagnostički algoritam Klinike za infektivne bolesti Kliničkog centra Vojvodine, uvedena su tri seta definicija hepatitisa B i C: Evropskog centra za prevenciju i kontrolu bolesti (ECDC) iz 2008. i 2012.godine kao i američkih Centara za kontrolu bolesti (CDC) iz 2012. godine. Istraživanje je sprovedeno na Klinici za infektivne bolesti Kliničkog centra Vojvodine i tokom 12 meseci, u skladu sa predloženim definicijama slučaja, identifikovano je 150 ispitanika obolelih od hepatitisa B i C. Utvrđene su sledeće činjenice: preporučene definicije slučaja su primenljive u Republici Srbiji za laboratorijske i kliničke kriterijume, dok uključivanje epidemiolo&scaron;ke povezanosti u definicije slučaja ima malo praktičnog značaja za prijavljivanje hepatitisa; definicije slučaja koje uključuju i obavezno prisustvo kliničkih kriterijuma (najče&scaron;će definicije verovatnog slučaja) imaju nisku senzitivnost, a visoku specifičnost, kao posledica prisustva infekcije i u odsustvu bilo kakvih kliničkih manifestacija; definicije slučaja koje se zasnivaju samo na laboratorijskim kriterijumima imaju maksimalnu senzitivnost i specifičnost.</p> / <p>Adequate surveillance of communicable diseases is the actual challenge, not only in our country but also in developed countries. Modern epidemiological surveillance of communicable diseases is based on the appropriate case definitions. Their main purpose of them is to facilitate the recognition of certain diseases and their registration in a uniform manner. Case definition of communicable diseases is not easy, because it involves clinical, epidemiological and laboratory parameters, along with the expectated high sensitivity and specificity.The objectives of the study were to determine the applicability of the casedefinitions for hepatitis B and C in the Clinic for Infectious Diseases of the Clinical Center of Vojvodina and to determine the sensitivity and specificity of the applied definition of cases of hepatitis B and C. In addition to existing diagnostic algorithm of the Clinic for Infectious Diseases, three sets of hepatitis B and C case definitions were introduced: the European Centre for Disease Prevention and Control in 2008 and 2012 as well as the US Centers for Disease Control in 2012. The study was conducted at the Clinic for Infectious Diseases Clinical Center of Vojvodina over 12 months, and in accordance with the proposed case definitions, 150 patients suffering from hepatitis B and C were identified. We found following facts: recommended case definitions are applicable in the Republic of Serbia for laboratory and clinical criteria, while the inclusion of epidemiological connection between the case definition has little practical significance for reporting hepatitis; case definitions that include the obligatory presence of clinical criteria (most common definition of probable cases) have low sensitivity and high specificity, as a result of the presence of infection in the absence of any clinical manifestations; case definitions that are based solely on laboratory criteria showed maximum sensitivity and specificity.</p>

Thesis (M.S.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-04, page: 2101. Adviser: Lu-Yu Hwang. Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [42]-49).

Se estudiaron 236 historias clínicas de pacientes atendidos en el Hospital Edgardo Rebagliati Martins, desde el año 2000 hasta julio del 2004.con fibrosis o cirrosis hepática por hepatitis viral B y C con el objetivo de evaluar el valor de diagnóstico de la ultrasonografía en comparación con el diagnóstico histopatológico. Se aplicó un sistema de puntaje ultrasonográfico a cada paciente de acuerdo a los signos US clasificándolos en una escala de 4-11. Se transcribieron los puntajes histopatológicos según el sistema METAVIR y se evaluó la sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo para la puntuación US, compuesta de superficie, parénquima, borde hepático y pared porta. A partir del punto óptimo se hallaron gráficos de curvas ROC lo que permitió tener una mejor visión de las pruebas de diagnostico. Se halló que una puntuación US 6 fue el mejor punto de corte para la predicción de Cirrosis y fibrosis grado III relacionados a HBV y HCV, con sensibilidad, la especificidad, el valor predictivo positivo y el valor predictivo negativo de 97.2%, 71.4%, 89.9%, 90.95 respectivamente. Las puntuaciones US están altamente y significativamente correlacionado 0.73(P<0.01) con la histopatología. La ultrasonografía en el diagnostico de la fibrosis y cirrosis por hepatitis B y C, muestra un mayor valor en la sensibilidad (85.39), la especificidad (85.71) y exactitud (85.59) en relación a la superficie del hígado. Los resultados demuestran que la ultrasonografía es un examen confiable para el diagnostico de la cirrosis y la fibrosis hepática tanto para la hepatitis viral B y C, aunque con mayor predicción para la hepatitis viral B. Los datos permiten concluir que la fibrosis y la cirrosis por hepatitis B y C, pueden ser correctamente diagnosticadas con un 85.59% de exactitud empleando un solo signo ultrasonográfico (superficie del hígado).

Source: Masters Abstracts International, Volume: 46-04, page: 2101. Adviser: Lu-Yu Hwang. Includes bibliographical references.

This thesis is focused on occurrence of viral hepatitises by clients in Psychiatric Hospital Červený Dvůr between 2000 and 2009. In my beachelor thesis was covered years from 2000 to 2004. Now I continue with this diploma thesis where I want the 10 year results join together to show how the situation is developing. The intravenous drug users are the aimed group. These drug users belong to a high-risk group in which hepatitises types A, B or C are spread the most thanks to their high-risk behaviour. These days researches and epidemiologic researches show that the intravenous drug users belong among the main high-risk groups endangered by infectious disease. Viral hepatitises represent a serious problem, mainly hepatitis type C, because there is no way of protection. This hepatitis is occuring without any symptoms of this disease by 50 ? 70 % people. By 70 ? 80 % it passes into a chronic stadium. It is possible to protect yourself by hepatitis type A vaccination. This hepatitis doesn´t change into a chronic stadium. It is easily spread by infected water or food. In our republic there occured several epidemics. Hepatitises started to spread among drug users and then they spread also among the rest of population. The last epidemic occured in 2008. Hepatitis type B represents high risks for the perceptive population. There is a vaccine and population have a chance to protect against it. In the Czech Republic there is vaccination carried out within special vaccination of people who have high-risk job, for example in health service. Children of HBsAg positive mothers are vaccinated after they are born. From 2001 hepatitis vaccination was put into regular vaccination of children aged under 1 year in our republic. Also 12 year old children are vaccinated from 2001. Hepatitis type B often becomes chronic and the mortality is 1 ? 2 %. Intravenous using of drug is important high-risk factor. It is one of the ways of transfering hepatitises type B and C. Next monitored indicators are the age of the clients, achieved level of education, basic drug, the age of the first usage of any drug, the age of intravenous application of drug and occurrence of hepatitises type A, B, C by clients. According to my research I used quantitative research which allows me to analyse problem of viral hepatitises by clients from Psychiatric Hospital in Červený Dvůr. The gained information was worked out by secondary analysis of medical data. The monitored group has 2499 clients in years 2000 ? 2009. The aim of this thesis is to get general knowledge about prevalence of viral hepatitises by clients of Psychiatric Hospital in Červený Dvůr from 2000 to 2009 and to consider their progress. The methodical procedure: there will be used a content analysis of medical data given by Psychiatric Hospital in Červený Dvůr. The result of this thesis is that it indicates and covered the develop of drug scene. Concerning the age the main group consists of 20 ? 24 year old men and women, next large group consists of clients aged 25 ? 29. The monitored group is also changing according to achieved level of education. In the first five years of research there dominated vocational school, but in the last five years there it changed into basic school. Among women there happened no change. There basic school still dominates. Concerning the drugs there also changed something. At the beginning there dominated clients using heroin, in the middle there meth dominated. Hepatitis type A in acute stadium was revealed by only two clients. Hepatitis type B noticed a slight increase. Hepatitis type C also noticed a sligh increase, but it is probably a sign of increase of clients with chronic form of this hepatitis.

Les travaux exposés dans cette thèse sont le reflet d'années d'efforts consacrées à la mise en place de diagnostics de qualités des hépatites virales au Laos au sein du Centre d'infectiologie Lao Christophe Mérieux (CILM), dont je suis aujourd'hui la directrice scientifique. En introduction, nous avons tenu à présenter les caractéristiques socio-économiques du Laos et ses défis sanitaires pour atteindre les Millennium Development Goals, qui guident les politiques publiques de pays en situation de développement. Nous avons jugé important de souligner ces points tout comme la présentation du CILM pour faire comprendre au lecteur le contexte de réalisation de ce travail. C'est grâce à une bio-banque riche de plus de 7,000 échantillons biologiques de patients infectés par les virus des hépatites virales B et C, que nous avons pu poser la question de recherche clé de cette thèse : Comment évoluent les hépatites virales chez les patients reçus depuis une dizaine d'années au CILM ? Cette question en a fait émerger une deuxième concernant la qualité du diagnostic dans les centres de soins à Vientiane. Ainsi, nous nous sommes intéressés aux kits de diagnostic rapide de l'hépatite B utilisés dans les structures de soins de Vientiane, comparés au standard utilisé dans notre laboratoire. Ces travaux, qui ont donné lieu à la publication de 2 articles (un troisième article a été soumis), jouent un rôle capital pour le pays, car ils donnent des axes d'intervention aux autorités de santé publique laotiennes pour combattre ce fléau. Nous avons choisi une présentation dichotomique des hépatites virales avec une partie dédiée aux hépatites B et une partie dédiée à l'hépatite C en raison de l'émergence d'une troisième question de recherche plus fondamentale. Il s'agit du risque de développement du cancer du foie chez les patients infectés, risque différent suivant que l'on est porteur d'une hépatite B ou d'une C. En effet, les outils diagnostiques pour déterminer la magnitude de ce risque sont peu ou pas accessibles pour les patients au Laos. [...] / The work presented in this thesis reflects many years of effort to devoted the implementation of quality diagnostics of viral hepatitis in Laos at the Centre d'infectiologie Lao Christophe Mérieux (CILM), of which I am now the scientific director. In the introduction, we wanted to present the socio-economic characteristics of Laos and its health challenges in order to achieve the Millennium Development Goals (MDG), which guide public policies in developing countries. We felt it was important to highlight these points as well as the presentation of the CILM to help the readers to understand the context in which this work was carried out. It is thanks to a bio-bank with more than 7,000 biological samples from patients infected with viral hepatitis B and C viruses, that we were able to ask the key research question of this thesis: What is the evolution of patients infected by viral hepatitis B/C who have been follow the viral load at CILM for the past ten years or so? This question raised a second one concerning the quality of diagnosis in health centres in Vientiane. For example, we were interested in the rapid diagnostic kits for hepatitis B used in Vientiane's health facilities, compared to the standard used in our laboratory. This work, which has resulted in the publication of 2 articles (a third article has been submitted), plays a crucial role for the country, as it provides Laotian public health authorities with a focus for action to combat this scourge.

Introdução: este documento trata de questões relativas à vigilância epidemiológica das hepatites B e C em doadores de sangue que foram notificados no SINAN NET no ano de 2007 no estado do Rio Grande do Sul. Faz parte uma revisão bibliográfica sobre os marcadores sorológicos e técnicas utilizadas pelos laboratórios do banco de sangue e vigilância epidemiológica. Relata as definições e os fluxos estabelecidos pelo PNHV e um artigo que compara os resultados do laboratório do banco de sangue com o laboratório da vigilância epidemiológica. Método: Discute os resultados obtidos neste estudo transversal, com as evidencias levantadas na revisão bibliográfica e busca responder as questões que serviram de estímulo para realização deste estudo. Os resultados concordam? Quanto se gasta para repetir os marcadores? Quanto tempo leva para um doador definir sua situação em relação à doença? Qual a proporção de doadores no quantitativo dos casos notificados de hepatites virais? Resultados: o coeficiente Kappa para o marcador HBsAg foi de 0,74 para o Anti-HBc 0,72 , para HBsAg e Anti-HBc associados foi 0,98 e para o Anti-HCV foi de 0,82. O gasto para repetição destes marcadores foi de R$ 28.956,55. O tempo de espera para o doador definir sua situação em relação à doença foi de uma mediana de 162 dias. A proporção de doadores notificados foi de 7,90%. Conclusão e considerações finais: Os resultados obtidos evidenciam que esta concordância existe, variando de substancial a concordância quase perfeita, para os casos de interesse da vigilância epidemiológica. O tempo de espera evidencia o não atendimento de um critério básico da vigilância epidemiológica, o da oportunidade. A vigilância epidemiológica aceitando o resultado dos laboratórios do banco de sangue como suficientes estará evitando gastos para o sistema de saúde, agilizando o processo de vigilância, aumentando a capacidade operacional do laboratório da vigilância bem como encurtando o tempo de espera do doador para definir sua situação de saúde. / Introduction: This document addresses issues related to epidemiological surveillance of hepatitis B and C in blood donors have been reported in SINAN NET in 2007 in Rio Grande do Sul is composed of a literature review on the serological markers and techniques used by the laboratories of the blood bank and epidemiological surveillance. On definitions and flows down the PNHV and an article comparing the results of laboratory blood bank with laboratory surveillance. Method: Discusses the results of this cross-sectional study, with the evidence raised in the review and seeks to answer the questions that served as a stimulus for this study. The results agree? How much is spent to repeat the markers? How long does it take for a donor set their status in relation to the disease? What proportion of donors in the quantity of reported cases of viral hepatitis? Results: Kappa coefficient for the marker HBsAg was 0.74 to 0.72 Anti-HBc, HBsAg and Anti-HBc was associated with 0.98 and the Anti-HCV was 0.82. Spending for repetition of these markers was $ 28,956.55 real. The waiting time for donors to define their status in relation to the disease was a median of 162 days. The proportion of donors reported was 7.90%. Conclusion and final remarks: The results show that this correlation exists, ranging from substantial to almost perfect agreement, for cases of interest for epidemiological surveillance. The waiting time shows the non-fulfillment of a basic criterion of epidemiological surveillance of opportunity. Epidemiological surveillance accepting the results of laboratory blood bank as insufficient, it will avoid costly to the health system, streamlining the process of monitoring, increasing the operational capacity of the laboratory surveillance as well as shortening the time for a donor to define their health situation.