Capacity to report on mortality attributable to chronic hepatitis B and C infections by Member States: An exercise to monitor progress towards viral hepatitis elimination

Abstract

Viral hepatitis is globally leading causes of death, and 96% of these are due to hepatitis B and C (HBV/HCV) late outcomes. The first Global Health Sector Strategy (GHSS) aims to reduce by 65% the mortality associated with HBV/HCV, and an indicator (C10) is proposed to monitor progress. Data on viral hepatitis and liver-related mortality are required, and different methods of estimation can be used, depending on availability and quality of sources. We aimed to understand the current situation and practicality of calculating C10, accessing available sources to estimate initial figure for Europe. We listed and compiled regional and national data sources reporting deaths from HCC, cirrhosis and chronic liver disease (CLD) and available estimates of attributable fraction. We critically appraised quality of data, highlighting gaps in current data and estimated mortality attributable to HBV and HCV, for 31 EU/EEA countries from 2010 to 2015. Mortality data are available for 30/31 countries. Quality varies but 60% of national sources report with specificity as required by WHO indicator. Attributable fraction is only available through the literature search. We estimated C10 for 87.6% country-years. Deaths attributable to HBV/HCV for this period and region were 292 600, while HCV deaths were three times higher. Incomplete data for 2015 prevented calculation of time trends. Regional sources are outdated for monitoring C10, but national sources are capable of reporting mortality data. Sources for attributable fraction are sparse, outdated and much needed. We recommend improvement of death registration allowing measuring this indicator. Studies measuring attributable fraction on national and subnational levels are crucial.

Identifying Expert Opinions on the Challenges and Barriers Faced by Iraq's National Plan for Controlling Hepatitis B

“…Documentation challenges: Documentation challenges related to accurately reporting HBV-associated mortality highlight the limitations of current healthcare systems in capturing precise data. Issues such as misregistration of causes of death, unregistered deaths, and inadequate surveillance systems necessitate investments in healthcare infrastructure, training programs, and digital health solutions to enhance data collection and analysis [13,14,15,16,17] .…”

Identifying Expert Opinions on the Challenges and Barriers Faced in Implementing Iraq’s National Plan for Controlling Hepatitis B

“…Documentation challenges related to accurately reporting HBV-associated mortality highlight the limitations of current healthcare systems in capturing precise data. Issues such as misregistration of causes of death, unregistered deaths, and inadequate surveillance systems necessitate investments in healthcare infrastructure, training programs, and digital health solutions to enhance data collection and analysis [14][15][16][17][18].…”

Hospital discharges of hepatocellular carcinoma and non-alcohol related cirrhosis in the EU/EEA and United Kingdom: a descriptive analysis of 2004–2015 data

“…Approximately 96% of viral hepatitis deaths are due to late health outcomes of chronic HBV and HCV infections including cirrhosis and hepatocellular carcinoma (HCC) [3]. In the European Union (EU), European Economic Area (EEA) and United Kingdom (UK) where an estimated 4.7 and 3.9 million people have chronic HBV and HCV infection respectively [4], just under 300,000 deaths were estimated to be attributable to HBV and HCV between 2010 and 2015 [5]. Recent reports, however, suggest that mortality from liver cancer continues to increase across most European countries [5][6][7].…”

“…In the European Union (EU), European Economic Area (EEA) and United Kingdom (UK) where an estimated 4.7 and 3.9 million people have chronic HBV and HCV infection respectively [4], just under 300,000 deaths were estimated to be attributable to HBV and HCV between 2010 and 2015 [5]. Recent reports, however, suggest that mortality from liver cancer continues to increase across most European countries [5][6][7]. In order to have a better understanding around the progress towards the elimination targets and to provide countries with information on the impact of the viral hepatitis epidemics, data on morbidity should also be considered.…”