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Descriptive Epidemiology Assignment

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VIRAL ACUTE HEPATITIS A
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1. Definition of the problem
Nature: Acute hepatitis A has a significant impact on the health of people. It is a
self-limiting viral illness following an acute course of disease.
Extent: It affects a lot of people all over the world especially in the developing countries
where the hygiene is poor. The risk of hepatitis A infection is associated with a lack of
safe water, and poor sanitation and hygiene (such as dirty hands).
Significance: Due to its effects, it leads to a lot of days of a fruitful work life of an
individual.
2. Description of Agent
Hepatitis A is caused by the Hepatitis A virus and it is transferred through the oro-fecal route of
infection. The incubation period of hepatitis A is usually 1428 days. The hepatitis A virus is
transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or
water that has been contaminated with the faeces of an infected person. In families, this may
happen though dirty hands when an infected person prepares food for family members.
Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or
inadequately treated water.
3. Description of condition
Once transferred into the susceptible individual, the virus multiplies within the host and
leads to an inflammation of the liver parenchymal cells leading to liver failure and the
characteristic symptoms of hepatitis A like jaundice, fever etc. Symptoms of hepatitis A
range from mild to severe, and can include fever, malaise, loss of appetite, diarrhoea,
nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the skin
and whites of the eyes). Not everyone who is infected will have all of the symptoms.
Adults have signs and symptoms of illness more often than children. The severity of
disease and fatal outcomes are higher in older age groups. Infected children under 6 years
of age do not usually experience noticeable symptoms, and only 10% develop jaundice.
Among older children and adults, infection usually causes more severe symptoms, with
jaundice occurring in more than 70% of cases. Hepatitis A sometimes relapses. The
person who just recovered falls sick again with another acute episode. This is, however,
followed by recovery.
Cases of hepatitis A are not clinically distinguishable from other types of acute viral
hepatitis. Specific diagnosis is made by the detection of HAV-specific Immunoglobulin G
(IgM) antibodies in the blood. Additional tests include reverse transcriptase polymerase
chain reaction (RT-PCR) to detect the hepatitis A virus RNA, and may require specialised
laboratory facilities.
There is no specific treatment for hepatitis A. Recovery from symptoms following

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infection may be slow and may take several weeks or months. Most important is the
avoidance of unnecessary medications. Acetaminophen / Paracetamol and medication
against vomiting should not be given.
Hospitalization is unnecessary in the absence of acute liver failure. Therapy is aimed at
maintaining comfort and adequate nutritional balance, including replacement of fluids
that are lost from vomiting and diarrhoea.
4. Examination of sources of data on morbidity & mortality in the selected health problem
A recurring question about viral hepatitis is why it receives so little funding and attention
from global health policy makers and donors. For example, the Sustainable Development
Goals have a goal to “end the epidemics of” HIV, tuberculosis, and malaria by 2030 while
only “combating” hepatitis, despite the fact that hepatitis accounts for more deaths than
each of those infections individually
One reason for this is the difficulty in accurately quantifying and explaining the morbidity
and mortality related to viral hepatitis. This difficulty stems from the fact that hepatitis
deaths are caused by five distinct viruses (hepatitis AE) with different routes of
transmission, that death occurs decades after infection, and that when people die with
hepatitis-related liver cancer and cirrhosis, these deaths are not always linked to the
underlying infection
Assessment at global, country and regional levels
In The Lancet, Jeffrey Stanaway and colleagues4 have made a major advance in
addressing these challenges. Using the Global Burden of Disease (GBD) Study approach,
which estimates the causes of mortality and morbidity and their relative importance, they
have assessed the burden of disease caused by viral hepatitis from 1990 to 2013 at the
country, regional, and global levels.
The main conclusion from their analysis is that viral hepatitis accounted for 1.45 million
deaths increase compared with the 0.89 million deaths in 1990. Morbidity also increased
in terms of years lived with disability (from 0.65 million [0.450.89] to 0.87 million and
disability-adjusted life-years (DALYs; from 31.7 million to 42.5 million
The biggest increase was noted for hepatitis C infection, for which the rate of DALYs
increased by 43%. Most of the morbidity and mortality is caused by hepatitis B and C
infections (96% of mortality and 91% of DALYs in 2013), because these two viruses
cause chronic, life-long infections, resulting in progressive liver damage that leads to
cirrhosis and hepatocellular carcinoma. Finally, the burden of disease was not equally
distributed worldwide.
High mortality rates in Oceania, Africa and Asia

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VIRAL ACUTE HEPATITIS A \ 1. Definition of the problem Nature: Acute hepatitis A has a significant impact on the health of people. It is a self-limiting viral illness following an acute course of disease. Extent: It affects a lot of people all over the world especially in the developing countries where the hygiene is poor. The risk of hepatitis A infection is associated with a lack of safe water, and poor sanitation and hygiene (such as dirty hands). Significance: Due to its effects, it leads to a lot of days of a fruitful work life of an individual. 2. Description of Agent Hepatitis A is caused by the Hepatitis A virus and it is transferred through the oro-fecal route of infection. The incubation period of hepatitis A is usually 14–28 days. The hepatitis A virus is transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. In families, this may happen though dirty hands when an infected person prepares food for family members. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water. 3. Description of condition Once transferred into the susceptible individual, the virus multiplies within the host and leads to an inflammation of the liver parenchymal cells leading to liver failure and the characteristic symptoms of hepatitis A like jaundice, fever etc. Symptoms of hepatitis A range from mild to severe, ...
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