Prognosis is very poor especially if induced by HCV
Gathering Information and Identifying Preliminary Issues
Analysis: Emergence of HCV 1. Liver cirrhosis: historic problem 2. Primarily due to schistomiasis in rural areas 3. Aggressive public health campaigns in the 1960’s-1980’s (worm infections, vaccines etc.) 4. Most injections were administered using glass syringes that were reused due to limited resources. 5. Campaigns targeted mainly school children and residents of rural areas (Nile Delta)
Today, 16% of all Egyptians are seropositive for HCV
50% of those infected have high enough viral load to be transmissible.
5 million are currently infected, 3.5 million are suffering from HCV-related complications
The virus continues to perpetuate as risk factors identified include: Blood transfusions, previous dental or hospital visits etc.
General distrust of public health entities in the country.
Access to QUALITY healthcare remains one of the biggest challenges for those suffering from HCV.
Recommendations: Theoretical Perspective 1. Model approach (small scale application first) 2. Multifaceted (Address all levels of the cycle) 3. Prioritized (reach the at risk first) 4. Efficient (utilize existing resources)
Recommendations: Action Plan 1. Phase Ia: Reform and Regulations Jan. 2008-2010 2. Phase Ib: National awareness campaign and prevention 2008-2010 (schools, mosques, hospitals etc.) 3. Phase IIa: Enforcement of Medical Standards 2010-Permenantly 4. Phase IIb: Enforcement of Public Policy 2010-2080 5. Phase III: Nationwide Implementation of the Program 2015-2080
Enduring Questions Why Hepatitis C in particular? Why Egypt in particular? Is Hepatitis C the only prevalent virus in Egypt?
Valuable Lesson Public health entities not only have the power to heal but the power to harm. It is a grave responsibility, one which careful planning, scrupulous execution and a sober understanding of the consequences.