J Korean Med Sci.  2015 Nov;30(11):1584-1588. 10.3346/jkms.2015.30.11.1584.

Fighting Hepatitis B in North Korea: Feasibility of a Bi-modal Prevention Strategy

• Unnewehr M
• Stich A

• KMID: 2351107
• DOI: http://doi.org/10.3346/jkms.2015.30.11.1584

Abstract

In North Korea, the prevalence of hepatitis B is high due to natural factors, gaps in vaccination, and the lack of antiviral treatment. Aid projects are urgently needed, however impeded by North Korea's political and economical situation and isolation. The feasibility of a joint North Korean and German humanitarian hepatitis B prevention program was assessed. Part 1: Hepatitis B vaccination catch-up campaign. Part 2: Implementation of endoscopic ligation of esophageal varices (EVL) by trainings in Germany and North Korea. By vaccinating 7 million children between 2010 and 2012, the hepatitis B vaccination gap was closed. Coverage of 99.23% was reached. A total of 11 hepatitis B-induced liver cirrhosis patients (mean age 41.1 yr) with severe esophageal varices and previous bleedings were successfully treated by EVL without major complications. A clinical standard operating procedure, a feedback system and a follow-up plan were developed. The bi-modal preventive strategy was implemented successfully. Parts of the project can serve as an example for other low-income countries, however its general transferability is limited due to the special circumstances in North Korea.

Keyword

Hepatitis B; Democratic People's Republic of Korea; Mass Vaccination; Esophagoscopy

MeSH Terms

Adult
Combined Modality Therapy/methods/statistics & numerical data
Democratic People's Republic of Korea/epidemiology
Esophageal and Gastric Varices/*embryology/*surgery
Esophagoscopy/statistics & numerical data
Feasibility Studies
Female
Hepatitis B/*epidemiology/*prevention & control
Hepatitis B Vaccines/*administration & dosage
Humans
Male
Mass Vaccination/*statistics & numerical data
Middle Aged
Prevalence
Retrospective Studies
Risk Factors
Secondary Prevention/methods/statistics & numerical data
Treatment Outcome
Hepatitis B Vaccines

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