From prevention to monitoring: full chain analysis of viral hepatitis public health interventions
Summary: As a major global public health challenge, viral hepatitis poses a serious threat to human health. This document provides a comprehensive analysis of the entire chain of public health interventions for viral hepatitis, ranging from the development and implementation of prevention strategies, including vaccination, health education, blood safety management, etc., to the construction and operation of surveillance systems, such as disease surveillance, disease reporting, risk factor surveillance, etc. The key elements, problems and responses to them were explored in depth, with the aim of providing systematic theoretical and practical guidance for the effective prevention and control of viral hepatitis in order to advance further progress in the global fight against viral hepatitis.
Introduction
viral hepatitis is a group of infectious diseases caused by multiple hepatitis viruses, which can be classified as hepatitis A, B, C, D and E. It is transmitted in a variety of ways, leading to acute or chronic liver diseases, or even to cirrhosis and liver cancer, placing a heavy burden on individuals, families and societies. Therefore, a well-established chain of public health interventions is essential for the prevention and control of viral hepatitis.
II. Prophylactic strategy for viral hepatitis
1. Hepatitis B vaccine: Hepatitis B vaccine is the most effective means of preventing hepatitis B. Since its inception in 1982, its vaccination strategy has evolved. Among newborns, the first dose of hepatitis B was widely administered within 24 hours of birth and was completed in accordance with the procedure of 0, 1 and 6 months. Hepatitis B vaccinations are also recommended for high-risk groups such as health-care personnel, people exposed to blood on a regular basis and family members of persons with hepatitis B virus. Through large-scale vaccination campaigns, there has been a significant reduction in the surface antigen delivery of hepatitis B in many countries and regions. For example, since the introduction of the Hepatitis B vaccination programme, the surface antigen bearing rate of Hepatitis B has been significantly reduced from its previous high level, effectively controlling the spread of Hepatitis B. Hepatitis A vaccine: Hepatitis A vaccine consists mainly of live vaccines and detoxification vaccines. Group vaccinations are carried out in areas with high levels of hepatitis A or at risk of outbreaks. Vaccinations are also recommended for high-risk groups such as travellers and food workers to areas where hepatitis A is endemic. Vaccination can stimulate bodies to produce specific antibodies and prevent hepatitis A virus infection.
1. Raising public awareness of the ways in which viral hepatitis can be transmitted, prevention methods, symptoms and hazards are made available to the public through a variety of channels, such as television, radio, networks and community outreach. For example, the promotion of hepatitis B, mainly through mother-to-child transmission, blood transmission and sexual transmission, informs the public about the effective prevention of hepatitis B transmission by avoiding unnecessary injections, blood transfusions and the correct use of condoms. Raising public awareness of viral hepatitis contributes to changing behavioural malpractices and enhancing self-protection awareness. 2. Health-promoting behaviour: promoting healthy lifestyles, such as maintaining good hygiene practices, hand-washing and avoiding sharing food sets, toothbrushes, etc., that could transmit the virus. Health education activities are carried out in schools, enterprises, etc., to develop public health behaviours such as regular medical examinations and timely vaccinations, and to reduce the risk of viral hepatitis infection at source.
1. Rigorous blood donor screening: comprehensive health screening and viral marker testing of blood donors, including hepatitis B surface antigens, hepatitis C antibodies, HIV antibodies, syphilis antibodies, etc. High sensitivity detection reagents are used to ensure blood safety and reliability. For example, the application of nucleic acid detection techniques can further shorten the window period for the detection of viruses and reduce the risk of viral hepatitis transmitted through blood transfusions. 2. Regulation of blood collection and storage: blood collection is carried out in strict compliance with sterile protocols to ensure quality and safety of blood during collection, transport and storage. Increased supervision and inspection of blood management in blood stations and medical institutions to prevent the spread of viral hepatitis as a result of blood contamination or mishandling.
III. Monitoring system for viral hepatitis
1. Disease surveillance 1. Case reporting: a robust system for reporting viral hepatitis cases is in place, with all levels of health care reporting timely and accurate information on confirmed viral hepatitis cases, including basic patient information, clinical performance, laboratory results, epidemiological history, etc. Rapid collection and aggregation of case information is achieved through a web-based direct reporting system in order to keep abreast of the epidemic. For example, in the monitoring of hepatitis B and C, the reporting of new cases contributes to the analysis of epidemic trends, regional distribution and population characteristics. 2. Epidemic surveillance: Increased proactive surveillance of viral hepatitis outbreaks, which, in addition to cases reported by medical institutions, detect potential outbreaks through community surveys, sentinel surveillance, etc. In the case of a concentrated epidemic or an outbreak, timely epidemiological investigations are conducted to determine the means of transmission and the risk factors, and effective preventive and control measures are taken to prevent the spread of the epidemic.
1. Virus detection techniques: the development and refinement of laboratory detection techniques for viral hepatitis to improve the accuracy and sensitivity of the tests. In addition to the traditional ELISA testing of viral antibodies, nucleic acid detection techniques, such as the PCR, play an important role in viral load detection, genotype identification, etc. For example, in Hepatitis C treatment, the effects of treatment can be assessed through the HCV RNA quantitative testing, which guides clinical use. Quality control: Establishment of a laboratory quality control system for rigorous quality control and evaluation of reagents, instruments, personnel operations, etc. In-room quality assessments are carried out on a regular basis to ensure accuracy and comparability of results between different laboratories and to provide reliable laboratory data support for the diagnosis, treatment and outbreak monitoring of viral hepatitis.
1. Behavioural risk factors: monitor behavioural risk factors associated with viral hepatitis transmission, such as unsafe injection behaviour, unsafe sexual behaviour, shared razors, etc. Data are collected through questionnaires, on-site observations, etc., to analyse the characteristics of the distribution of these risk factors among different populations and regions and to provide a basis for the development of targeted interventions. For example, in some areas where drug users are concentrated, the proportion of syringes shared is monitored for intervention projects such as needle exchange. 2. Environmental risk factors: Monitoring of environmental factors such as water, food and assessment of the risk of water and food transmission of hepatitis A and E. For example, in areas where hepatitis E is prevalent, pollution from drinking water sources is monitored, and surveillance and inspection of food hygiene is strengthened to prevent hepatitis E from being infected by eating contaminated water or food.
Issues and challenges facing the entire chain of public health interventions
1. Vaccination coverage is uneven: in some poor, remote or special population groups, such as mobile populations, unemployed persons, etc., the vaccination rate for hepatitis B still needs to be increased. Issues such as vaccine supply and cold chain management may also affect the effectiveness and coverage of vaccinations. 2. Health education has limited effectiveness: some members of the public have less acceptance of health education information and have difficulty changing health behaviour. The approach and content of health education needs to be further optimized to fit the needs and cultural context of different populations.
1. Monitoring data quality issues: Cases in some health institutions are reported in a timely, inaccurate and incomplete manner. The reliability of laboratory results may also be affected by factors such as the quality of reagents and the level of human technology, leading to uneven monitoring data quality. 2. Inadequate integration of monitoring systems: monitoring systems for different types of viral hepatitis are relatively independent and lack effective integration and synergy. Poor data-sharing and information-sharing between disease surveillance, laboratory surveillance and risk factor surveillance has influenced a comprehensive analysis and assessment of the overall viral hepatitis epidemic.
Responses and perspectives
1. Improving access to vaccination: Increased vaccination support for disadvantaged areas and special population groups, improvement of the cold chain distribution system for vaccines, and ensuring safe supply of vaccines. Vaccination campaigns have been conducted to raise public awareness of vaccination initiatives and initiatives. 2. Innovative models of health education: using new media, mobile Internet, etc., to develop diverse health education products, such as science short video, mobile phone applications, etc., to improve the taste and interaction of health education. Development of individual health education programmes for different population groups to improve the effectiveness of health education.
1. Strengthening data quality control: strengthening training and supervision of medical institutions and laboratories, establishing data validation and feedback mechanisms, and improving the accuracy and completeness of case reports and laboratory testing data. 2. Promote the integration of surveillance systems: establish a unified information platform for viral hepatitis surveillance, integrate data resources for disease surveillance, laboratory surveillance and hazard monitoring, and achieve data sharing and connectivity. Multidisciplinary and collaborative research is carried out to synthesize monitoring data and provide a more comprehensive and scientific basis for the development of viral hepatitis prevention and control strategies.
Conclusions
The entire chain of public health interventions for viral hepatitis covers two key areas of prevention and monitoring. Effective prevention strategies such as vaccination, health education and blood safety management can significantly reduce the incidence of viral hepatitis. A well-developed monitoring system, in turn, allows for timely tracking of the epidemic, assessment of the effectiveness of controls and identification of potential problems. Despite the problems and challenges currently faced in the chain-wide interventions, the continuous optimization and refinement of the various components of the response is expected to further increase the level of control of viral hepatitis, reduce the harm to human health caused by viral hepatitis and ultimately achieve the global control goal of viral hepatitis.
Hepatitis
