Moed Saundria, Zaman Muhammad H
Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA.
Howard Hughes Medical Institute, Boston University, Boston, Massachusetts, USA.
BMJ Glob Health. 2019 Jul 18;4(4):e001704. doi: 10.1136/bmjgh-2019-001704. eCollection 2019.
Liver disease is a significant public health burden in both high-income and low-income countries, accounting for over 2 million annual, global deaths. Despite the significant mortality burden, liver diseases are historically a neglected problem due to a lack of accurate incidence and prevalence statistics, as well as national and international programmes targeting these diseases. A large portion of deaths due to liver diseases can be treated (eg, chronic hepatitis B), cured (eg, chronic hepatitis C) or prevented (eg, acute liver failure due to medications) if prompt diagnosis is made, but currently diagnostic methods fall short. Therefore, there is a critical need to fund the development of prompt, effective diagnostics for liver function, specifically in low-income and middle-income countries where the landscape for this testing is sparse. Here, we review and compare available and currently emerging diagnostic methods for liver injury in low-income and middle-income settings, while highlighting the opportunities and challenges that exist in the field.
在高收入和低收入国家,肝脏疾病都是一项重大的公共卫生负担,每年全球死亡人数超过200万。尽管有如此高的死亡率,但由于缺乏准确的发病率和患病率统计数据,以及针对这些疾病的国家和国际项目,肝脏疾病在历史上一直是一个被忽视的问题。如果能及时诊断,很大一部分因肝脏疾病导致的死亡是可以治疗的(如慢性乙型肝炎)、治愈的(如慢性丙型肝炎)或预防的(如药物性急性肝衰竭),但目前的诊断方法还存在不足。因此,迫切需要资助开发快速、有效的肝功能诊断方法,特别是在低收入和中等收入国家,这些国家的此类检测资源匮乏。在此,我们回顾并比较了低收入和中等收入环境中现有的以及目前正在出现的肝损伤诊断方法,同时强调了该领域存在的机遇和挑战。