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In 2016, the World Health Assembly adopted the Global Health Sector Strategy (GHSS) on viral hepatitis. The GHSS called for elimination of viral hepatitis B and C infection as a public health problem (defined as a 90% reduction in incidence [95% for HBV and 80% for HCV] and 65% reduction in mortality by 2030, compared with the 2015 baseline). A broad range of countries have now developed national viral hepatitis plans, and several countries also requested guidance from the World Health Organization (WHO) on the establishment of global criteria for measuring elimination of viral hepatitis and a standardized process for validation of elimination. WHO has developed this interim guidance for countries and other stakeholders seeking validation of elimination of viral hepatitis as a public health problem, with a specific focus on hepatitis B virus (HBV) and hepatitis C virus (HCV). It provides a global framework for the processes and standards for validation of elimination, and overall proposes the use of absolute impact targets to validate elimination at the national level (instead of, although equivalent to, the relative reduction targets originally defined in the 2016 GHSS) in combination with a set of programmatic targets.
The global community has committed to elimination of mother-to-child transmission, or vertical transmission, of HIV, syphilis and hepatitis B virus (HBV) as a public health priority and reducing global disease burden, quality reproductive, maternal and child health services to a level no longer a public health concern. Achieving and maintaining elimination requires strong political and public health commitment. Strengthened, resilient health systems improve a broad range of services and outcomes while similarities in prevention interventions add to the benefit of an integrated approach. Validation is an attestation that a country has successfully met standard criteria for elimination, or for being at one of the 3 levels of achievement on the ‘Path to Elimination’ while delivering quality services for women, girls and their children, through the life-course, respecting human rights and ensuring gender equality and community engagement. It requires systems that comprehensively identify and monitor new infections and infant outcomes. Establishment of criteria for validation began in 2007 with global consultations while lessons learnt advised publication of 2 editions of global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis (the ‘Orange Book’). This document, the third version, adds on EMTCT of HBV, bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.
The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for five key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines. Particularly for key populations, social, legal, structural and other contextual factors both increase vulnerability to HIV, viral hepatitis and STIs and obstruct access to health and other essential services. These guidelines highlight the critical importance of addressing structural barriers in all settings as a priority. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching these key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services to these groups.
Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease. The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expanded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care. The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
These consolidated guidelines are aimed at supporting the generation of responsive person-centred data from routine national health management information systems across the HIV cascade, from prevention, testing and treatment to longer-term health care. They build upon the 2017 Consolidated guidelines on person-centred HIV patient monitoring and case surveillance, which describe information that should be collected in primary HIV patient monitoring tools, and the 2020 Consolidated HIV strategic information guidelines, which cover aggregate indicators for managing and monitoring programmes. The purpose of this guideline consolidation is to provide the recommended data elements, indicators and guidance on data systems and their use across the spectrum of health sector HIV services in one place. This document focuses on strengthening the analysis and use of routine data at each stage of the cascade and emphasizes?/addresses? person-centred HIV prevention, testing and treatment, integration of HIV-related infections, the use of routine surveillance data to measure impact, and the development and use of digital health data systems and their governance. It also identifies the gaps and limitations in these data, and the need for strengthening the use of data in all HIV-related strategic information, including population-based surveys, modelling, community-led monitoring and other sources.
Hepatology: An Evidence-Based Clinical Compendium provides current and comprehensive insights into the field of hepatology, covering various aspects such as diagnosis, management, control, techniques, procedures, and technology. By offering the latest information, the book ensures that readers stay up-to-date with the rapidly evolving landscape of hepatology. The comprehensive scope covers a wide range of topics related to liver diseases, including epidemiology, pathogenesis, and pathophysiology. It features contributions from esteemed experts worldwide and is enhanced with high-quality diagrams. The book serves as a valuable resource for scientists and researchers, offering a solid foundation for their investigations and clinical inquiries.Moreover, the book goes beyond the discussion of epidemiology, pathogenesis, and pathophysiology, and presents updated treatment and management guidelines for liver diseases, making it a go-to reference for Clinicians treating liver diseases. - Presents current and comprehensive insights into the diagnosis, management, control, techniques, procedures, and technology in hepatology - Facilitates evidence-based decision-making for better patient care, enabling practitioners to effectively incorporate research findings into their treatment approaches - Guides the selection of optimal treatment and management options, equipping readers with valuable resources to overcome challenges encountered in clinical practice - Enhances knowledge and skills for clinical practice, offering valuable support to healthcare professionals seeking to improve their expertise