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Plan of Action for the Prevention, Care &
Treatment of Viral Hepatitis, Egypt 2014-2018
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.....we have been overwhelmed during the last couple of months with more than 800,000 patients registered so far to receive treatment for HCV. Patients are registered on the web for appointments at one of our 26 treatment centers (currently expanding the numbers of centers to accommodate the increasing numbers of patients), they complete their requested investigations and then data are uploaded on the database, patients are prioritised accordingly to receive treatment or deferred and their papers once approved centrally are sent for endorsement by the Ministry of Health and treatment is then dispensed. So far in two months treatment was dispensed to more than 12,000 patients but the numbers are increasing and we expect to start treating ten to twelve thousand more on monthly basis, expceting to treat 150,000 in 2015.
Excerpts from attached Plan:
Since 2006, a total of 26 treatment centers have been established in Egypt to provide subsidized HCV treatment to more than 200,000 patients.
To prepare the Plan of Action for the Prevention, Care & Treatment of Viral Hepatitis, Egypt (referred to in this report as the Viral Hepatitis Plan of Action), during September and October 2012 the MOHP Viral Hepatitis Unit convened expert workgroups from various national and international agencies. Workgroup members were tasked with developing components of the action plan specific to their area of expertise. To engage stakeholders in the planning process, the workgroup solicited input from other agencies, professional societies, and community-based organizations.
Worldwide, about 1 in every 12 persons (480-520 million people) is living with viral hepatitis. Globally, an estimated 78% of primary liver cancer and 57% of liver cirrhosis cases are caused by viral hepatitis, and 1 million deaths from viral hepatitis occur each year.4,5,6 Chronic hepatitis B and C are among the leading causes of infectious-disease death worldwide. The proportion of persons living with viral hepatitis is greatest in Asia, Sub-Saharan Africa, and Egypt; however, prevalence of HCV infection is high among subpopulations (e.g., people who inject drugs [PWIDs] and persons living in correctional settings) in almost all parts of the world.
Egypt has the highest prevalence of HCV in the world, with 10% of its population 15-59 years of age being chronically infected.12 The chronic infection rate increases with age and goes up to more than 25% for 50-60 year-olds. Among 15-19 year-olds, 4% are chronically infected, demonstrating on-going HCV transmission. An estimated 150,000 new HCV infections occur each year in Egypt1 and HCV morbidity and mortality are predicted to double in the coming 20 years.13 The HCV epidemic in Egypt is thought to have originated with unsafe injections administered for a mass anti-schistosomiasis campaign conducted in that country during the 1960s and 1970s, representing the world's largest iatrogenic transmission of blood-borne pathogens to date.14 Currently, contact with infected blood through medical procedures (including unsafe injection practices) is considered the primary mode of HCV transmission in Egypt. In urban areas, illicit drug use also contributes to the epidemic.
A major concern in Egypt is unsafe medical injections, primarily through reuse of disposable syringes. Because of the popular belief among Egyptians that injections are more effective than oral medications without additional risk,15 the frequency of therapeutic injections is very high in Egypt compared with other low income countries; the estimated average number of injections per person per year is 4.2 in Egypt versus 1.5 in other countries.15 An estimated 8% of injections are unsafe (i.e., the provider does not use a syringe taken from a closed, sealed packet)......

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