The problem of preventing viral hepatitis today is very acute all over the world. One of the most common infectious diseases in Ukraine - viral hepatitis A. The growth of viral hepatitis B is recorded, which often prone to progressive course, the development of cirrhosis and malignant liver diseases.
Head of the Office of Prevention of Infectious Diseases Ministry of Health (MOH) of UkraineMuharskaya Lyudmila Miroslavovna gave an exclusive interview to the scientific editor of the portal Sape Irina Yuryevna on the prevalence and prevention of viral hepatitis in the country.
Lyudmila Miroslavovna, please tell us what the dynamics the incidence of viral hepatitis in Ukraine?
In 2001 occurredan increase of 36.07%general morbidity viral hepatitis compared with 2000. Of cases Hepatitis B disease is more than 2% registered (in 2000 - by 11%).
According to data for 2000, it should be noted that among children at the age of 14 years throughout Ukraine as a whole the incidence of viral hepatitis increased by 53%: viral hepatitis A - by 56%, and B - by 18%.
If we talk about the statistical indicators of morbidity hepatitis of the entire population by regions, it is possible to distinguish Ternopil (growth by 96%), Volyn (an increase of 88%), Donetsk (an increase of 72%), Ivano-Frankivsk (an increase of 43%) of the region (2000 data).
Among children, this incidence rate is most noticeable. in Transcarpathian (3 times), in Chernihiv (2.6 times), in Donetsk, Volyn, Vinnitsa (2.4 times) areas. Only in seven regions of the country of 27 revealed a decrease in the incidence of viral hepatitis (2000 data).
Lyudmila Miroslavovna, recently registered worldwide increase in the number of patients with viral hepatitis C. What are the data on this disease in Ukraine?
Accounting for the number of patients with hepatitis C is carried out by analyzing the total incidence of viral hepatitis with the exception of indicators of hepatitis A and B. Since 2003 it is planned to allocate the incidence rate in the documents of the Ministry of Health hepatitis C with a separate line.Today, the laboratory of therapeutic and prophylactic the country's institutions are not yet sufficiently equipped with modern diagnostic sets for determining the type of pathogen of viral hepatitis. Therefore, we do not we can objectively estimate the prevalence of other types of hepatitis - E and D.
Lyudmila Miroslavovna, how can you avoid hepatitis?
Hepatitis A is an infection that is transmitted by fecal-oral by. Therefore, its effective prevention consists, first of all, in strict observance of sanitary and hygienic requirements in children's groups. Large it is important to carry out health education campaigns explaining the ways transmission of infection, the first signs of the disease. Unfortunately, today such Work is carried out inactively and in insufficient volume. In Ukraine, there are water outbreaks of hepatitis A. So, such an outbreak was recently observed in Torez Donetsk region. Therefore, priority must be given to ensuring population quality water supply.
An effective method of preventing hepatitis B is vaccination. In Ukraine, such vaccination was started in 1996. But the vaccinated level persons was low - from 3% to 5%. Since 2000, in accordance with the Order of the Ministry of Health Of Ukraine No. 276 of 10/31/2000, “On the Conduct of Vaccinations in Ukraine” Hepatitis B vaccination is introduced into the vaccination schedule. Children recommended vaccinate on the first day of life, at the age of one and six months of life. Provided vaccination in other categories, except for children. These are medical professionals, who perform manipulations and have professional contact with blood and faces who need vaccination for epidemiological indications. In 2001, vaccination against Hepatitis B was made by 14% of adults.
It is very important to observe the phasing of vaccination for the production of high level of protection against the hepatitis B virus, i.e. all three doses must be administered vaccines as recommended by the immunization schedule.
According to 2001 data, 11% of children are fully vaccinated against hepatitis B. The highest percentage of children vaccinated is in Zaporizhzhya (71 %), Kherson (61%), Chernivtsi (61%) regions. Perhaps such a difference in the coverage of vaccination of children by regions and Ukraine as a whole is due to the fact that until 2000, oblast institutions could purchase vaccines independently and for due to this, vaccination against this disease was ensured in 2001.
Lyudmila Miroslavovna, is there any data on the frequency of medical vaccinations?
Yes, contraindications are always taken into account when vaccinating children. to their conduct. In Ukraine as a whole, according to 2001 data, temporary contraindications have 8% of children, long-term - 3%. But this data varies by region. For example, in the Zaporozhye region, on average, 14% of persons have contraindications for vaccinations, and in Kherson - 3%, in Chernivtsi - 3%. Such differences in country indicators may be due to different approaches to assessing the condition of children, although in the Order MH No. 276 clearly outlines all contraindications for vaccinations.
Please tell me what other measures are being taken to prevent hepatitis b and c?
Viral hepatitis B and C are transmitted through the blood and biological fluid. Ukraine has a very strict control of all donor drugs. blood enzyme immunoassay for the presence of antibodies to these viruses.
It is very important examination of women during pregnancy. At special measures for the prevention of viral hepatitis have been developed and treatment of hepatitis in newborns.
According to the legislation, the state assumes the obligation to ensure the procurement of essential vaccines in accordance with the Age Vaccination Schedule. Since 2001, vaccines have been procured centrally. Unfortunately, the Ministry Health has not received about 30% of the planned funds for the purchase vaccines in 2001.
We have applied for assistance in the supply of vaccines during World Alliance for Vaccines and Immunization (GAVI - Global Alliance) Vaccination and Immunization). We hope that this assistance will be provided to us and in the second half of 2002 and the beginning of 2003 we will be able to provide more number of children with hepatitis B vaccine