The disease burden of hepatitis B in Uzbekistan.
OBJECTIVE
To describe the burden of hepatitis B illness in Uzbekistan by means of model-based estimates.


METHODS
A mathematical simulation model was developed to mimic the disease evolution of hepatitis B and calculate the size and age of specific HBV patient groups, defined according to the severity of their illness.


RESULTS
The calculations indicate that of 678000 neonates in Uzbekistan, 159185 (235 per 1000) would incur an HBV infection at some time during their lives. About 55095 persons (81 per 1000) would become chronic carriers of hepatitis B and 6307 persons (9.3 per 1000) are expected to die due to hepatitis B before they would die from another cause. In the overall population, we calculated that about 3074 Uzbeki die each year from the consequences of hepatitis B. Only 3.2% of these premature HBV-deaths are due to acute hepatitis B, whereas 96.8% are due to chronic hepatitis B. It was calculated that 2.1% of all deaths (or 1 in 47 deaths), and nearly 25% of deaths (or one in four deaths) between 30 and 40 years of age in Uzbekistan are due to hepatitis B. Vaccination seems easily defensible on the basis of rudimentary but very conservative cost-effectiveness calculations ($84 per carrier prevented; $735 per death prevented and $22 per life-year gained).


CONCLUSIONS
Hepatitis B represents a huge health problem in Uzbekistan, especially in young adults. The potential for prevention by vaccination seems very high, but demands a long-term vision if chronic hepatitis, in particular, is to be reduced. Routine hepatitis B vaccination was found to be a relatively cost-effective intervention in Uzbekistan.
Beutels
P
P
Centre for the Evaluation of Vaccination, Department of Epidemiology and Community Medicine, University of Antwerp, Belgium.
Musabaev
E I
EI
Van Damme
P
P
Yasin
T
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D008962:Models, Theoretical; D014610:Uzbekistan / Q000453:epidemiology