Nusair Majed, Rayyan Yaser, Hammoudeh Waseem, Al-Khatib Mohammed Amer, Mansour Eid, Snehanshu Snehanshu, Bassil Nathalie, Kozma Sam, Ghazzawi Imad Al
Prince Hamza Hospital, Amman, Jordan.
Jordan University Hospital, Amman, Jordan.
J Virus Erad. 2020 Feb 20;6(1):1-6. doi: 10.1016/S2055-6640(20)30004-2.
Hepatitis B virus (HBV) infection remains a worldwide public health problem. The last major review of the HBV care pathway in the Middle East was published in 2011. This article aims to assess the current situation of the HBV care pathway in Jordan, identify gaps and barriers and recommend initiatives that could be taken to improve disease management across all stages of the care pathway.
A Delphi process was used between February and October 2017, including a literature review (PubMed and Google Scholar) for published articles on HBV in Jordan, followed by individual interviews with various healthcare professionals and group discussions with leading Jordanian hepatologists and gastroenterologists to provide context to the results of the literature review.
The national prevalence of HBV is estimated to be around 2.4% and has declined from 9.9% in the pre-vaccination era. There is limited data on the burden of HBV-related hepatocellular carcinoma in the country. Awareness of various aspects of the disease is considered low among the general population and medium among primary care providers. There are several mandated national screening structures, however, established protocols for those that test positive and subsequent linkage-to-care are not optimal. In conclusion, significant improvements have been made in the past 30 years in Jordan in terms of decline in HBV prevalence. However, efforts must be made by all key stakeholders to optimise screening and linkage-to-care of patients and reduce both morbidity and mortality in the country.
乙型肝炎病毒(HBV)感染仍然是一个全球性的公共卫生问题。中东地区上次对HBV治疗路径的重大综述发表于2011年。本文旨在评估约旦HBV治疗路径的现状,找出差距和障碍,并推荐可采取的举措,以改善治疗路径各阶段的疾病管理。
2017年2月至10月期间采用了德尔菲法,包括对约旦发表的关于HBV的文章进行文献综述(PubMed和谷歌学术),随后对不同的医疗保健专业人员进行个人访谈,并与约旦主要的肝病学家和胃肠病学家进行小组讨论,以便为文献综述的结果提供背景信息。
据估计,该国HBV的全国流行率约为2.4%,自疫苗接种前时代的9.9%以来有所下降。该国关于HBV相关肝细胞癌负担的数据有限。普通人群对该疾病各方面的认识较低,初级保健提供者的认识中等。该国设有多个法定的全国筛查机构,然而,针对检测呈阳性者的既定方案以及后续的治疗衔接并不理想。总之,在过去30年里,约旦在HBV流行率下降方面取得了显著进展。然而,所有关键利益相关者都必须努力优化患者的筛查和治疗衔接,降低该国的发病率和死亡率。