Public Health Relevance of Hepatitis

Hepatitis – Public Health Relevance

Viral Hepatitis had been adding up to the burden of communicable diseases of Tuberculosis, HIV and Malaria. In the LMICs, various programmes have been initiated to combat this Public Health hazard.  New domains have been added to address the burden of Hepatitis and achieve the Sustainable Development Goal – Target 3. ^[1]

The World Health Organization (WHO) ^[1] published a strategy document that focused on eliminating viral Hepatitis by making strategic modifications in the pre-existing infrastructure. Five strategic directions were determined –

1. Information for focused action
2. Interventions for Impact
3. Delivering for equity
4. Financing for Sustainability
5. Innovation for Acceleration

Universal Health Coverage has also been covered in three strategic decisions, as globally, a large proportion of deaths are attributable to this disease.

In the fifth strategic direction, Bioinformatics tools can play a huge role. Life sciences and healthcare have made significant progress with substantial aids from the field of Bioinformatics. Along with data and analytics, various aspects of the disease could be addressed in screening technologies, engineered- testing devices and drugs. ^[2] To conclude, involving the multiple sectors would enhance the Research and Development field.

Reference

1. World Health Organization. Global health sector strategy on viral Hepatitis 2016-2021. Towards ending viral Hepatitis. World Health Organization; 2016.

//apps.who.int/iris/bitstream/handle/10665/246177/WHO?sequence=1

2. Rao VS, Das SK, Rao VJ, Srinubabu G. Recent developments in life sciences research: Role of bioinformatics. African Journal of Biotechnology. 2008;7(5).

file:///C:/Users/Swarnadeep/Downloads/58463-Article%20Text-103996-1-10-20100825.pdf

Other Interesting Reads

1. World Health Organization. Global hepatitis report 2017. World Health Organization; 2017.

//apps.who.int/iris/bitstream/handle/10665/255016/9789?sequence=1

2. Buckley GJ, Strom BL. A national strategy for the elimination of viral Hepatitis emphasizes prevention, screening, and universal treatment of hepatitis C.

//www.acpjournals.org/doi/abs/10.7326/M17-0766?journalCode=aim

Chronic hepatitis C (HCV) infection afflicts millions of people worldwide. While antiviral treatments are effective for some patients, many either cannot or choose not to receive antiviral treatment. Education about behavioural changes like alcohol avoidance and symptom management, in contrast, is universally recommended, particularly in HCV-infected persons from disadvantaged groups where liver risk factors are most prevalent. Self-management interventions are one option for fostering improved HCV knowledge and health-related quality of life (HRQOL). One hundred and thirty-two patients with VA with HCV (mean age of 54.6, 95% men, 41% ethnic minority, 83% unmarried, 72% unemployed/disabled, 48% homeless in last 5 years) were randomized to either a 6-week self-management workshop or an information-only intervention. The weekly 2-h self-management sessions were based on cognitive-behavioural principles and were adapted from an existing self-management programme that has been efficacious with other chronic diseases. HCV-specific modules were added. Outcomes including HRQOL, HCV knowledge, self-efficacy, depression, energy and health distress were measured at baseline and 6 weeks later. Data were analysed using ANOVA. When compared to the information-only group, participants attending the self-management workshop improved more on HCV knowledge (P < 0.001), HCV self-efficacy (P = 0.011), and SF-36 energy/vitality (P = 0.040). Similar trends were found for SF-36 physical functioning (P = 0.055) and health distress (P = 0.055). Attending the self-management programme improved disease knowledge and HRQOL 6 weeks later in this disadvantaged population. The intervention can improve the health of people with hepatitis C, independent of antiviral therapy. Future research will study longer-term outcomes, effects on antiviral treatment and costs.

Source : //onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2893.2010.01328.x

Nowadays, hepatitis is one of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes.

Lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. 

Thus, the implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions. That mentioned system paves the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions.

HEPATITIS is one most important public health problems.  Today world is facing a lot of hepatitis cases causing mortality and morbidity. hepatitis affects a person's liver. public awareness should be the priority of any intervention. other interventions include

1.prevention

2.improving testing of cases

3. screening

4. care of patients

5. treatment

6. education

7. strengthing surveillance to detect transmission of disease

8.Reducing Viral Hepatitis Caused by Drug Use Behaviors 

9. equity in treatment

Nowadays, hepatitis is one of the most important health priorities around the world, where informatics plays a very significant role in the following:-

•Specialized diseases prevention plans,
•Research,
•Information purposes,
•Carrying out various studies,
•Policy making,
•Decision-making processes,
•Disease management,
•Coping/healing with after-disease complications,
•Taking care of the deficiencies,
•Spreading awareness etc.

Thus, informatics addresses challenges of hepatitis information, management and investigates the outcomes of establishing a hepatitis information management system to overcome such challenges. Informatics, intendes to study the implementation of Electronic hepatitis information management system.

Hepatitis virus infection is a major cause of liver-related mortality and morbidity globally, causing various challenges in adequate treatment and management. It highlights how health disparities in disease management gets complicated by a range of possible factors such as lack of adequate communication between patients and healthcare providers (HCPs) speaking different languages and are from different cultures, high cost of private visits to a physician, testing procedures, limited reach of information and educational materials (IECs) related to their health problems. Furthermore, patients may be located too far from the treatment center and thus are unable to access care when needed. Therefore, an efficient technological intervention that can address all such issues and facilitate two-way communication between patients and HCPs is needed. Also, a range of other technological innovations can be leveraged to provide more affordable and simplified approaches to testing for HBV and HCV infection and monitoring of treatment response. 

Chronic Hepatitis B management is especially critical and its burden is high due to a significant percentage of the population at risk who is either unvaccinated or are infected and require antiviral treatment. In such cases, information technology can play a pivotol role. For example, usage of mobile text messaging, video and audio consultation in facilitating the connection between HCPs and individuals with CHB having limited access to healthcare, can help in bridging the gap. Integrating viral hepatitis strategic information activities and indicators within national health information systems and tools, including for outbreak surveillance, and monitoring and evaluation of the national hepatitis response. Technical assistance to establish systems of surveillance, testing, haemovigilance and monitoring of supplies of blood and blood product needs to be established by way of Hepatitis Management Information System.

Resources:

1. Hyun C, McMenamin J, Ko O, Kim S
   Efficacy of a Mobile Texting App (HepTalk) in Encouraging Patient Participation in Viral Hepatitis B Care: Development and Cohort Study
   JMIR Mhealth Uhealth 2020;8(4):e15098
2. Syed ST, Gerber BS, Sharp LK. Traveling towards disease: transportation barriers to health care access. Journal of Community Health. 2013 Oct;38(5):976-993. DOI: 10.1007/s10900-013-9681-1. PMID: 23543372; PMCID: PMC4265215.
3. World Health Organization. Global health sector strategy on viral Hepatitis 2016-2021. Towards ending viral Hepatitis. World Health Organization; 2016.  //apps.who.int/iris/bitstream/handle/10665/246177/WHO?sequence=1
4. Peeling RW, Boeras DI, Marinucci F, Easterbrook P. The future of viral hepatitis testing: innovations in testing technologies and approaches. BMC Infect Dis. 2017;17(Suppl 1):699. Published 2017 Nov 1. doi:10.1186/s12879-017-2775-0

Advances in the diagnosis, monitoring, and treatment of hepatitis virus infection are urgently required if we are to meet international targets for elimination by the year 2030.Bioinformatics tools can play a huge role. Life sciences and healthcare have made significant progress with substantial aids from the field of Bioinformatics. Along with data and analytics, various aspects of the disease could be addressed in screening technologies, engineered- testing devices and drug. Surveillance and other health data are necessary to shape and direct effective viral hepatitis prevention, care, and treatment efforts. Data can also play an important role in making decisions on how resources can best be allocated to meet the needs of populations at risk for or infected with HBV or HCV. In order to achieve the goals of the Viral Hepatitis Action Plan, federal and nonfederal partners must build new relationships, identify opportunities to utilise HIT, and maximise our use of available data for informed decision- making. Innovations in viral hepatitis surveillance are needed to improve our understanding of and response to viral hepatitis. the implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health center, specialized clinics, and physicians connected to the hepatitis network.New laboratory tools and techniques can help us better understand and identify transmission among networks of individuals at risk, improve algorithms to screen and identify individuals with hepatitis B infection, and promote the development of improved viral hepatitis testing technologies. Federal partners will work toward developing standardized laboratory techniques, update practical and reliable algorithms for screening in high-risk populations, and develop more quantitative tests for use in diagnosis and monitoring viral hepatitis. 

INTRODUCTION:
     Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes.Improvement of health information systems is the first step in progressive health system management capabilities. The healthcare decision makers at every managerial level should gain maximum benefit from information to be capable of making precise data-based decisions and policies, and meeting managerial requirements of healthcare service providers.
CHALLENGES:

1. Inconsistency and lack of integrity of data
2. Lack of communication between related units preventing timely information register of viral hepatic patients and services that are provided to them. Thus inhibiting the possibility of considering a follow-up process.

SOLUTIONS:
Implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure would be capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions. That mentioned system would pave the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions.

REFERENCES:

//www.ncbi.nlm.nih.gov/pmc/articles/PMC4954895/
//informatics.bmj.com/content/27/3/e100145

Posted by: @ashishjoshi

Let's share your thoughts on Role of informatics in hepatitis management/interventions.

 Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes. Thus, this study addressed challenges of hepatitis information management and investigated the outcomes of establishing a hepatitis information management system to overcome such challenges. To this end, this research intended to study the implementation of an Electronic hepatitis information management system. Methodology: This is an applied-developmental study with following specifications and procedures: preparation of study proposal and design, justification of the design's stakeholders, approval of the design by the Postgraduate Education Council of Faculty, determination of pilot hepatitis control center, software development, deciding on control, prevention, and treatment centers, and finally development of a network-based system for collecting and managing hepatitis information. Findings: Results indicated that the inconsistency and lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. 

REFERENCE:

//www.researchgate.net/publication/284278669_Implementation_of_Hepatitis_Information_Management_System_in_Iran

Hepatitis is a global health problem with millions of people dying from either end-stage liver disease, hepatocellular carcinoma, or other viral hepatitis-related diseases. Integrating informatics into hepatitis management plays a crucial role in specialized diseases prevention planning, and policy- and decision-making processes.

The implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable of providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions.

There is a rapid increase in the number and severity of hepatitis cases resulting in high morbidity and mortality. Clinical research involves drug discovery and development where software and bioinformatics tools play a significant role. This involves the use of informatics in developing new knowledge about health and disease, data management during clinical trials, and using clinical data for secondary research. In addition, new technology like molecular docking, molecular dynamics simulation, proteomics, and quantitative structure-activity relationship in clinical research results in faster and easier drug discovery. Software like electronic data capture, remote data capture, and electronic case report form (eCRF) is used to store the data. eClinical, Oracle clinical is software used for clinical data management and statistical analysis of the data.

Thus, informatics paves the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions in hepatitis management.

Citation:

Smith DA, Wang T, Freeman O, Crichton C, Salih H, Matthews PC, Davies J, Várnai KA, Woods K, Jones CR, Glampson B, Mulla A, Mercuri L, Shaw AT, Drumright LN, Romão L, Ramlakan D, Higgins F, Weir A, Nastouli E, Agarwal K, Gelson W, Cooke GS, Barnes E. National Institute for Health Research Health Informatics Collaborative: development of a pipeline to collate electronic clinical data for viral hepatitis research. BMJ Health Care Inform. 2020 Nov;27(3):e100145. doi: 10.1136/bmjhci-2020-100145. PMID: 33214194; PMCID: PMC7678229.

Gill SK, Christopher AF, Gupta V, Bansal P. Emerging role of bioinformatics tools and software in evolution of clinical research. Perspect Clin Res. 2016 Jul-Sep;7(3):115-22. doi: 10.4103/2229-3485.184782. PMID: 27453827; PMCID: PMC4936069.

Reza S, Jebraeil F, Akbar NA, Marjan G, Reza TM, Mehdi A, Mahlagha S, Farhad T. Implementation of Hepatitis Information Management System in Iran. Glob J Health Sci. 2015 Nov 17;8(6):250-5. doi: 10.5539/gjhs.v8n6p250. PMID: 26755478; PMCID: PMC4954895.

Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes.

Inconsistency and lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. This inhibited the possibility of considering a follow-up process. However, the implementation of this system and involvement of relevant units greatly solved these problems.

Implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions. That mentioned system paves the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions.

Reference: //www.ncbi.nlm.nih.gov

Public health relevance of Hepatitis :

         Hepatitis is a chronic disease that affects nearly a millions of people all around the world 🌎. 

         ☆ Public awareness is very important about this disease. 

         ☆ Educating the people 

         ☆ Screening of the disease 

         ☆ Care of patients are very important. 

 Management:

        Oracle Clinical is a software used for clinical data management & statistical analysis of data. 

Healthcare system has become more extensive currently that information technology has become an essential tool to be handled with efficiency by healthcare workers. Thus, medical science has pushed its boundaries beyond, involving policy makers, managers, engineers and academicians. Informatics in public health can be applied for:

• Surveillance 
• Prevention
• Preparedness
• Health promotion

Burden of hepatocellular carcinoma (HCC) is largely due to high prevalence of chronic hepatitis B virus (HBV). It has affected a huge  population in the US and it is more prevalent among non-Hispanic Asians.

Elimination of HBV requires:

• Diagnosis
• Monitoring 
• Treatment

which can be made possible by efficient, routine clinical data obtained through unbiased electronic pipeline. 

TTD, Pharm GKB and DisGeNET are applied to achieve the targets of HBV treatment using Chinese medicine Yin Zhi Huang granules (YZHG). Analytical results indicated, treatment of HBV by YZHG showed multicomponent, multitarget and multichannel pharmacological effect for its mechanism of action.

Globally, 2 million people have been affected by HBV and this presents to be a major health problem. Bioinformatic tools have enabled to understand its origin, evolution and transmission. HBV's reaction to antiviral agents are also revealed by this technology.

Implementation of electronic system for the management, prevention and control of HBV is a regional and national requirement. The highest infrastructure of this system, besides providing data, aids in:

• Counseling centers 
• Health centers
• Specialized clinics for HBV
• Network of physicians involved in hepatitis research
• Follow up of patients

National institute for Health Research (NIRH) aims to improve the quality and availability of data for further research in therapeutic areas in collaboration with health informatics. It identified a rich set of data points in viral hepatitis regarding information on clinical assessments, lab test results, antiviral treatment and health outcomes. This dictionary generated a potential for research in disease prevalence and treatment response. Further, HBsAg and HBeAg have been tracked as protein biomarkers to monitor HBV infection.

Bioinformatics, a supportive system for public health system, should be periodically updated and errors to be eradicated so that its volume of transacting data is maximized. The challenges in the performance of electronic healthcare should be analyzed so that the output can bring down the morbidity and mortality rates in HBV.

Citation

1. Chak E, Li CS, Chen MS Jr, MacDonald S, Bowlus C. Electronic health record alerts enhance mass screening for chronic hepatitis B. Sci Rep. 2020 Nov 5;10(1):19153. doi: 10.1038/s41598-020-75842-8. PMID: 33154429; PMCID: PMC7644717.

2. Zhang J, Liu X, Wu J, Zhou W, Tian J, Guo S, Jia SS, Meng Z, Ni M. A bioinformatics investigation into the pharmacological mechanisms of the effect of the Yinchenhao decoction on hepatitis C based on network pharmacology. BMC Complement Med Ther. 2020 Feb 12;20(1):50. doi: 10.1186/s12906-020-2823-y. PMID: 32050950; PMCID: PMC7076901.

3. Trevor Graham Bell and Anna Kramvis (July 27th 2016). The Study of Hepatitis B Virus Using Bioinformatics, Bioinformatics - Updated Features and Applications, Ibrokhim Y. Abdurakhmonov, IntechOpen, DOI: 10.5772/63076. 

4. Smith DA, Wang T, Freeman O, Crichton C, Salih H, Matthews PC, Davies J, Várnai KA, Woods K, Jones CR, Glampson B, Mulla A, Mercuri L, Shaw AT, Drumright LN, Romão L, Ramlakan D, Higgins F, Weir A, Nastouli E, Agarwal K, Gelson W, Cooke GS, Barnes E. National Institute for Health Research Health Informatics Collaborative: development of a pipeline to collate electronic clinical data for viral hepatitis research. BMJ Health Care Inform. 2020 Nov;27(3):e100145. doi: 10.1136/bmjhci-2020-100145. PMID: 33214194; PMCID: PMC7678229.

Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes.

The inconsistency and lack of integrity of data, as well as the lack of communication between related units help timely information register of viral hepatic patients and services that are provided to them. This eases the follow-up process also.

The implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions. That mentioned system paves the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions.