title: Liver disease in Viet Nam: screening, surveillance, management and education: a 5-year plan and call to action.
abstract: Despite a high prevalence of liver disease in Viet Nam, there has been no nationwide approach to the disease and no systematic screening of at-risk individuals. Risk factors include chronic hepatitis B (estimated prevalence of 12%), chronic hepatitis C (at least 2% prevalence), and heavy consumption of alcohol among men. This combination of factors has resulted in liver cancer being the most common cause of cancer death in Viet Nam. There is a general lack of understanding by both the general public and health-care providers about the major risk to health that liver disease represents. We report here the initial steps taken as part of a comprehensive approach to liver disease that will ultimately include nationwide education for health-care providers, health educators, and the public; expansion of nationwide screening for hepatitis B and C followed by hepatitis B virus vaccination or treatment of chronic hepatitis B and/or hepatitis C; education about alcoholic liver disease; long-term surveillance for liver cancer; reduction of infection transmission related to medical, commercial, and personal re-use of contaminated needles, syringes, sharp instruments, razors, and inadequately sterilized medical equipment; and ongoing collection and analysis of data about the prevalence of all forms of liver disease and the results of the expanded screening, vaccination, and treatment programs. We report the beginning results of our pilot hepatitis B screening program. We believe that this comprehensive nationwide approach could substantially reduce the morbidity and mortality from liver disease and greatly lessen the burden in terms of both lives lost and health-care costs.
authors.affiliation: Division of GI Hepatology, University of California, San Diego, California 92103-8413, USA. rgish@ucsd.edu
authors.forename: Robert G
authors.initials: RG
authors.lastname: Gish
authors.forename: Tam D
authors.initials: TD
authors.lastname: Bui
authors.forename: Chuc T K
authors.initials: CT
authors.lastname: Nguyen
authors.forename: Duc T
authors.initials: DT
authors.lastname: Nguyen
authors.forename: Huy V
authors.initials: HV
authors.lastname: Tran
authors.forename: Diem M T
authors.initials: DM
authors.lastname: Tran
authors.forename: Huy N
authors.initials: HN
authors.lastname: Trinh
mesh_terms: D044466:Asian People; D019033:Delivery of Health Care, Integrated; D042241:Early Diagnosis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008403:Mass Screening / Q000379:methods; D009313:National Health Programs; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016730:Program Development; D013997:Time Factors; D014744:Vietnam / Q000453:epidemiology