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World Hepatitis Day 2023 | Collections | MSF Science Portal
World Hepatitis Day 2023

World Hepatitis Day 2023

Viral hepatitis is a major cause of disease and death globally. To mark World Hepatitis Day (July 28th) we present a selection of recent MSF research exploring how to effectively deploy powerful medical tools that could turn the tide on hepatitis C and E—but now reach only a tiny fraction of people who desperately need them, especially in low-resource and emergency settings.

For hepatitis C, where groundbreaking new antiviral drugs can cure nearly all patients, MSF is piloting simplified, community-based models of care that offer rapid screening, diagnosis, and treatment under one roof. Some programs focus on the complex needs of highly vulnerable, hard-to-reach populations, such as people co-infected with HIV or TB or who inject drugs.

Turning to prevention, an ongoing vaccination campaign against hepatitis E in an outbreak setting is showing early signs of short-term protection. Final results from this South Sudanese refugee camp, where poor sanitation and water quality regularly lead to outbreaks, should help plug a key evidence gap that—along with other barriers discussed in a commentary article—impedes widespread uptake of the vaccine.

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Combatting antimicrobial resistance

Combatting antimicrobial resistance

Antimicrobial resistance is a growing public health crisis, especially in countries with fragile health systems, population displacement or ongoing conflict. In 2019 antibiotic-resistant bacteria directly caused an estimated 1.27 million deaths, and contributed to 4.95 million deaths, tolls that will continue to increase if no effective action is taken.


MSF’s approach to combatting antimicrobial resistance combines three pillars: infection prevention and control, microbiology and surveillance, and rational use of antibiotics via antibiotic stewardship. Several studies characterize patterns and prevalence of antibiotic resistance among MSF patients, from civilians wounded in Middle East conflicts to hospitalized neonates in Central African Republic and Haiti. New technologies developed by MSF and partners are expanding local capacity for rapid, accurate laboratory diagnosis of infections, so that clinicians can prescribe the right antibiotic for each patient. Other work assesses the practices and challenges related to optimizing rational antibiotic use within health facilities and communities.

If you're interested in learning more about MSF's work in antimicrobial resistance, view the full list of MSF's publications on the topic.

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Diabetes care in humanitarian settings

Diabetes care in humanitarian settings
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Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.
Diabetes affect hundreds of millions of people worldwide, a large majority of them living in low- and middle-income countries. Yet finding effective strategies, tools and policies for effectively managing this chronic illness—especially amid war, displacement or exclusion from care—is a neglected area of humanitarian medicine. Here we present a cross-section of work on this front by MSF and collaborators. Several studies assess the shift towards community-based, nurse-led models of care in rural settings. Others explore obstacles to diabetes care for war refugees living in camps in Jordan or Lebanon, highlighting how health programs can adapt to their needs. The demonstration that insulin retains potency for 30 days if cooled without refrigeration is opening doors to more patient self-management, as a case study in remote South Sudan shows. At the same time, MSF and others call for regulatory and financing policies that make diabetes medications and supplies cheaper, better adapted to humanitarian settings, and far more available to patients whose lives depend on them.
Conference Material
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Abstract

Safety of hepatitis E vaccination in pregnancy following the first mass reactive vaccination campaign in Bentiu, South Sudan

Nesbitt RC
2023-06-08 • Epicentre Scientific Day Paris 2023
2023-06-08 • Epicentre Scientific Day Paris 2023
BACKGROUND
Hepatitis E causes high mortality among pregnant women with case fatality risks of 10-25%, and adverse fetal outcomes. Hecolin® is a safe and efficacious vaccine against H...
Conference Material
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Slide Presentation

Two-dose vaccine effectiveness following the first reactive mass vaccination campaign against Hepatitis E in Bentiu, South Sudan

Nesbitt RC, Rumunu J, Asilaza VK, Gitahi P, Nkemenang P,  et al.
2023-06-07 • MSF Scientific Day International 2023
2023-06-07 • MSF Scientific Day International 2023
Journal Article
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Research

Nurse-led initiation of hepatitis C care in rural Cambodia

O’Keefe D, Samley K, Bunreth V, Marquardt T, Bobi SE,  et al.
2023-04-01 • Bulletin of the World Health Organization
2023-04-01 • Bulletin of the World Health Organization
OBJECTIVE
To determine whether a nurse-led model of care for patients with hepatitis C virus (HCV) infections can provide safe and effective diagnosis and treatment in a resource-poo...
Journal Article
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Research

Hepatitis C treatment program in Maputo, Mozambique, the challenge of genotypes and key populations: A 5-year retrospective analysis of routine programmatic data

Loarec A, Gutierrez AG, Muvale G, Couto AM, Nguyen AP,  et al.
2023-03-30 • Health Science Reports
2023-03-30 • Health Science Reports
BACKGROUND AND AIMS
Hepatitis C (HCV) programs face challenges, especially linked to key populations to achieve World Health Organization (WHO) goals of eliminating hepatitis. Médeci...
Journal Article
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Research

A simplified point-of-service model for hepatitis C in people who inject drugs in South Africa

Saayman E, Hechter V, Kayuni N, Sonderup MW
2023-03-04 • Harm Reduction Journal
2023-03-04 • Harm Reduction Journal

BACKGROUND

Globally, 9% of people who inject drugs (PWID), a key hepatitis C-infected population, reside in sub-Saharan Africa. In South Africa, hepatitis C seroprevalence in PW...

Journal Article
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Research

Epidemiological characteristics and real-world treatment outcomes of hepatitis C among HIV/HCV co-infected patients in Myanmar: A prospective cohort study

Swe TM, Johnson DC, Mar HT, Thit P, Homan T,  et al.
2023-02-17 • Health Science Reports
2023-02-17 • Health Science Reports
BACKGROUND AND AIMS
In Myanmar, public sector treatment programs for hepatitis C virus (HCV) infection were nonexistent until June 2017. WHO highlights the importance of simplificati...
Journal Article
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Commentary

Hepatitis E vaccine—Illuminating the barriers to use

Lynch JA, Lim JK, Asaga PEP, Wartel TA, Marti M,  et al.
2023-01-05 • PLOS Neglected Tropical Diseases
2023-01-05 • PLOS Neglected Tropical Diseases
Journal Article
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Research

Integrating hepatitis C treatment into multidrug-resistant TB care

Kirakosyan O, Melikyan N, Falcao J, Khachatryan N, Atshemyan H,  et al.
2022-06-21 • Public Health Action
2022-06-21 • Public Health Action
BACKGROUND
Direct-acting antivirals (DAAs) are not widely used for patients with chronic hepatitis C virus (HCV) infection and multidrug- or rifampicin-resistant TB (MDR/RR-TB). We d...