{"id":4635,"date":"2018-07-30T11:17:57","date_gmt":"2018-07-30T09:17:57","guid":{"rendered":"http:\/\/www.easistent.ro\/?p=4635"},"modified":"2024-08-06T12:40:33","modified_gmt":"2024-08-06T10:40:33","slug":"hepatitele-virale-cum-putem-castiga-lupta","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=4635","title":{"rendered":"Hepatitele virale \u2013 cum putem c\u00e2\u015ftiga lupta?"},"content":{"rendered":"<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/09\/hepatita1.png\"><img class=\"alignleft size-medium wp-image-4614\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/09\/hepatita1-300x180.png\" alt=\"hepatita1\" width=\"300\" height=\"180\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/09\/hepatita1-300x180.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/09\/hepatita1.png 395w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>Hepatita viral\u0103, o cauz\u0103 major\u0103 a bolilor cronice de ficat, a cirozei \u015fi carcinoamelor hepato-celulare, a devenit o provocare de s\u0103n\u0103tate public\u0103 la nivel interna\u0163ional, comparabil\u0103 cu alte boli transmisibile importante precum HIV-SIDA, tuberculoza \u015fi malaria. De\u015fi inciden\u0163a noilor cazuri de infect\u0103ri a sc\u0103zut \u00een multe \u0163\u0103ri europene, modelele de prognoz\u0103 sugereaz\u0103 c\u0103 morbiditatea \u015fi mortalitatea vor continua s\u0103 creasc\u0103, \u00een condi\u0163iile \u00een care rata deceselor cauzate de hepatit\u0103 o dep\u0103\u015fe\u015fte deja pe cea dat\u0103 de HIV-SIDA \u015fi tuberculoz\u0103 luate \u00eempreun\u0103.<\/p>\n<p>Situa\u0163ia din Rom\u00e2nia este, de asemenea, deosebit de serioas\u0103. Cele mai multe statistici, inclusiv cea a Organiza\u0163iei Mondiale a S\u0103n\u0103t\u0103\u0163ii, ne plaseaz\u0103 pe primul loc din Europa \u00een privin\u0163a num\u0103rului total de cazuri de hepatit\u0103 C (\u00een acela\u015fi timp, cu un num\u0103r foarte mare \u015fi de cazuri de hepatit\u0103 B) \u0219i avem una dintre cele mai mici rate de diagnosticare \u015fi tratament.<\/p>\n<p>\u00cen ciuda poverii semnificative pe care o aduce comunit\u0103\u0163ilor din jurul lumii, hepatita a fost mai degrab\u0103 ignorat\u0103, p\u00e2n\u0103 recent, ca pericol la adresa s\u0103n\u0103t\u0103\u0163ii publice \u015fi dezvolt\u0103rii sociale.<\/p>\n<p>Tocmai de aceea, \u00eentrebarea \u201ecum putem elimina aceast\u0103 important\u0103 problem\u0103 de s\u0103n\u0103tate public\u0103, ce trebuie s\u0103 facem \u00een aceast\u0103 lupt\u0103?\u201d este de \u015fi mai mare gravitate \u015fi actualitate.<\/p>\n<p>Este nevoie de noi tratamente? De campanii na\u0163ionale de informare \u015fi educare? De schimb\u0103ri \u00een organizarea sistemelor na\u0163ionale de s\u0103n\u0103tate?<\/p>\n<p>Pentru a r\u0103spunde acestor \u00eentreb\u0103ri \u015fi a \u00eendruma autorit\u0103\u0163ile na\u0163ionale din domeniu, Organiza\u0163ia Mondial\u0103 a S\u0103n\u0103t\u0103\u0163ii a publicat, \u00een iunie 2016, o strategie global\u0103 privind hepatita viral\u0103 ce vizeaz\u0103 eliminarea ei ca problem\u0103 de s\u0103n\u0103tate public\u0103, p\u00e2n\u0103 \u00een anul 2030.<\/p>\n<p>Strategia OMS stabile\u015fte \u0163inte globale de reducere a infec\u0163iilor cronice cu 90% \u015fi a mortalit\u0103\u0163ii cu 65% p\u00e2n\u0103 \u00een 2030. Atingerea acestor \u0163inte va cere extinderea semnificativ\u0103 a interven\u0163iilor principale, inclusiv:<\/p>\n<ul>\n<li>vaccinarea \u00een copil\u0103rie contra hepatitei B<\/li>\n<li>vaccinarea la na\u015ftere sau alte m\u0103suri de prevenire a transmiterii de la mam\u0103 la copil<\/li>\n<li>sisteme \u00eembun\u0103t\u0103\u0163ite de asigurare a siguran\u0163ei s\u00e2ngelui pentru transfuzii \u015fi a produselor de s\u00e2nge<\/li>\n<li>siguran\u0163a injec\u0163iilor<\/li>\n<li>interven\u0163ii ce urm\u0103resc prevenirea transmiterii printre persoanele care-\u015fi injecteaz\u0103 droguri<\/li>\n<li>extinderea test\u0103rii, \u00eempreun\u0103 cu o mai bun\u0103 leg\u0103tur\u0103 cu administrarea unui tratament (OMS subliniaz\u0103 c\u0103 principalele provoc\u0103ri \u021bin de lipsa accesului la testare \u0219i tratament).<\/li>\n<\/ul>\n<p>Tocmai pentru a \u00eencuraja extinderea vaccin\u0103rii \u015fi a test\u0103rii pentru hepatita viral\u0103, Strategia promoveaz\u0103 educarea popula\u0163iei.<\/p>\n<p>Avem vaccinuri eficace \u015fi sigure \u015fi, totu\u015fi, num\u0103rul celor care se vaccineaz\u0103 este insuficient. Mai este important de \u015ftiut c\u0103 administrarea seriei complete a vaccinului hepatitei B ofer\u0103 protec\u0163ie pe toat\u0103 durata vie\u0163ii, \u00een propor\u0163ie mai mare de 90%.<\/p>\n<p>Extinderea screening-ului pentru hepatitele B \u015fi C este esen\u0163ial\u0103 pentru eliminarea lor de pe lista pericolelor de s\u0103n\u0103tate public\u0103, p\u00e2n\u0103 \u00een anul 2030, permi\u0163\u00e2nd referirea celor infecta\u0163i c\u0103tre medic pentru recomandarea unui tratament \u015fi a m\u0103surilor de stopare a transmiterii c\u0103tre alte persoane.<\/p>\n<p>Din fericire, extinderea screening-ului este fezabil\u0103, deoarece avem deja teste de s\u00e2nge precise care pot detecta infectarea cu virusurile hepatitelor B \u015fi C cu ani \u00eenainte s\u0103 apar\u0103 simptomele \u015fi s\u0103 \u00eenceap\u0103 deteriorarea ficatului.<\/p>\n<p>Din p\u0103cate, exist\u0103 \u00een societate un anumit grad de stigmatizare a persoanelor infectate, ceea ce devine o barier\u0103 invizibi\u0103, dar important\u0103, pentru screening-ul \u015fi diagosticarea la timp a hepatitelor virale.<\/p>\n<p>De asemenea, oamenilor le este fric\u0103 de consecin\u0163ele poten\u0163iale dup\u0103 diagnosticare \u2013 frica c\u0103 \u00ee\u015fi vor pierde locul de munc\u0103 sau frica c\u0103 vor fi izola\u0163i din punct de vedere social. Mul\u0163i prefer\u0103 s\u0103 nu \u015ftie c\u0103 sunt infecta\u0163i, pentru a nu avea de \u00eenfruntat consecin\u0163ele confirm\u0103rii diagnosticului de hepatit\u0103 viral\u0103.<\/p>\n<p>Autorit\u0103\u0163ile medicale recomand\u0103 urm\u0103toarea abordare \u00een privin\u0163a extinderii screening-ului:<\/p>\n<ul>\n<li>Screening-ul tuturor persoanelor cu risc ridicat de infectare (cum ar fi de exemplu consumatorii de droguri injectabile).<\/li>\n<\/ul>\n<ul>\n<li>Screening-ul pentru hepatita B al tuturor femeilor gravide.<\/li>\n<\/ul>\n<ul>\n<li>\u00cen multe \u0163\u0103ri, autorit\u0103\u0163ile de s\u0103n\u0103tate public\u0103 deruleaz\u0103 campanii de educare \u0163intite c\u0103tre grupurile de risc.<\/li>\n<\/ul>\n<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/09\/hepatita2.png\"><img class=\"alignleft size-full wp-image-4615\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/09\/hepatita2.png\" alt=\"hepatita2\" width=\"175\" height=\"246\"><\/a>Av\u00e2nd \u00een vedere amploarea \u015fi intensitatea interven\u0163iilor necesare pentru eradicarea hepatitei ca problem\u0103 de s\u0103n\u0103tate public\u0103, profesioni\u015ftii din sistemul medical sunt chema\u0163i s\u0103 joace un rol activ \u00een implementarea acestora \u015fi o pot face, indiferent de pozi\u0163ia pe care o ocup\u0103 \u00een sistem.<\/p>\n<p>\u00cen primul r\u00e2nd, este necesar\u0103 identificarea nevoilor de \u00eengrijiri \u015fi servicii de screening, diagnosticare \u015fi tratament ale grupului de pacien\u0163i pe care \u00eei servesc sau comunit\u0103\u0163ii \u00een care opereaz\u0103 \u015fi a modului \u00een care unitatea lor medical\u0103 adreseaz\u0103 aceste nevoi. \u00centreb\u0103rile urm\u0103toare sunt fundamentale: Pacien\u0163ii no\u015ftri au o rat\u0103 crescut\u0103 a infec\u0163iilor cronice \u015fi au nevoie de testare \u015fi \u00eengrijiri? Sau ne confrunt\u0103m cu o rat\u0103 crescut\u0103 a unor infec\u0163ii noi \u015fi avem nevoie s\u0103 ne concentr\u0103m pe servicii de preven\u0163ie? Ce servicii sau asisten\u0163\u0103 legat\u0103 de hepatita viral\u0103 putem s\u0103 le oferim acestor pacien\u0163i?<\/p>\n<p>\u00cen multe cazuri, unit\u0103\u0163ile medicale pot amplifica efectul interven\u0163iilor \u00een comunitate prin realizarea de parteneriate cu organiza\u0163iile care ofer\u0103 servicii sociale, \u00een special grupurilor cu risc ridicat de infectare. \u00cempreun\u0103, aceste organiza\u0163ii pot capitaliza oportunit\u0103\u0163ile de extindere a screening-ului, diagnostic\u0103rii \u015fi trat\u0103rii hepatitelor virale, oferind, astfel, pacien\u0163ilor \u015fi comunit\u0103\u0163ilor pe care le servesc accesul de care au nevoie la aceste \u00eengrijiri, \u00een momentul \u00een care au nevoie \u015fi \u00een modul cel mai favorabil acestora. Acestea sunt condi\u0163ii absolut necesare pentru a \u0163ine \u00een grafic eforturile interna\u0163ionale \u015fi na\u021bionale de eradicare, p\u00e2n\u0103 \u00een 2030, a acestei grave probleme de s\u0103n\u0103tate public\u0103.<\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>Autor: Mirela Musta\u021b\u0103, Redactor executiv eAsistent<\/em><\/strong><\/p>\n<p><strong>Surse de documentare:<\/strong><\/p>\n<p><a href=\"https:\/\/www.hepmag.com\/blog\/viral-hepatitis-us-opportunities-winning-fight\">https:\/\/www.hepmag.com\/blog\/viral-hepatitis-us-opportunities-winning-fight<\/a><\/p>\n<p><a href=\"https:\/\/adevarul.ro\/news\/societate\/romania-loc-europa-numarul-cazurilor-hepatita-c-1_588f6efb5ab6550cb8f18bf3\/index.html\">https:\/\/adevarul.ro\/news\/societate\/romania-loc-europa-numarul-cazurilor-hepatita-c-1_588f6efb5ab6550cb8f18bf3\/index.html<\/a><\/p>\n<p><strong>The United States <\/strong><a href=\"https:\/\/www.hhs.gov\/sites\/default\/files\/National%20Viral%20Hepatitis%20Action%20Plan%202017-2020.pdf\"><strong>National Viral Hepatitis Action Plan 2017-2020 (Action Plan)&nbsp; &#8211; PDF<\/strong><\/a><strong>&nbsp;<\/strong><\/p>\n<p><a href=\"https:\/\/raportuldegarda.ro\/articol\/planul-oms-eliminare-hepatitelor-crearea-sistem-strategic-comunicare-asupra-bolii\/\">https:\/\/raportuldegarda.ro\/articol\/planul-oms-eliminare-hepatitelor-crearea-sistem-strategic-comunicare-asupra-bolii\/<\/a><\/p>\n<p><a href=\"https:\/\/raportuldegarda.ro\/articol\/planul-organizatiei-mondiale-a-sanatatii-de-eliminare-a-hepatitei-virale-pana-in-2030\/\">https:\/\/raportuldegarda.ro\/articol\/planul-organizatiei-mondiale-a-sanatatii-de-eliminare-a-hepatitei-virale-pana-in-2030\/<\/a><\/p>\n<p><a href=\"https:\/\/www.eurosurveillance.org\/images\/dynamic\/EE\/V22N09\/art22728.pdf\">https:\/\/www.eurosurveillance.org\/images\/dynamic\/EE\/V22N09\/art22728.pdf<\/a><\/p>\n<p>Global Health Sector Strategy on Viral Hepatitis 2016-2021, World Health Organization, June 2016<\/p>\n<p><a href=\"https:\/\/hepvu.org\/hepatitis-b-overcoming-multiple-challenges-eliminate-disease\/\">https:\/\/hepvu.org\/hepatitis-b-overcoming-multiple-challenges-eliminate-disease\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hepatita viral\u0103, o cauz\u0103 major\u0103 a bolilor cronice de ficat, a cirozei \u015fi carcinoamelor hepato-celulare, a devenit o provocare de s\u0103n\u0103tate public\u0103 la nivel interna\u0163ional, comparabil\u0103 cu alte boli transmisibile importante precum HIV-SIDA, tuberculoza \u015fi malaria. De\u015fi inciden\u0163a noilor cazuri de infect\u0103ri a sc\u0103zut \u00een multe \u0163\u0103ri europene, modelele de prognoz\u0103 sugereaz\u0103 c\u0103 morbiditatea \u015fi [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4614,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,3],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4635"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4635"}],"version-history":[{"count":2,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4635\/revisions"}],"predecessor-version":[{"id":8809,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4635\/revisions\/8809"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/4614"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4635"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4635"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4635"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}