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CNAA / Theses / 2022 / /

Chronic hepatitis, liver cirrhosis and primary liver cancer in the Republic of Moldova: epidemiology, prognosis and control strategy


Author: Paraschiv Angela
Degree:doctor habilitat of medicine
Speciality: 14.00.30 - Epidemiology
Year:2022
Scientific consultants: Viorel Prisăcari
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Constantin Spînu
doctor habilitat, professor
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 21 September, 2022
Approved by NCAA on the 25 November, 2022

Abstract

Adobe PDF document – 1.08 Mb / in romanian
Adobe PDF document – 0.98 Mb / in english

Thesis

CZU [616.36-002.2+616.36-004+616.36-006]-036.22(478)(043.2)

Adobe PDF document 8.39 Mb / in romanian
279 pages

Keywords

chronic hepatitis, liver cirrhosis, primary liver cancer, control strategy

Summary

Thesis structure:The paper is exposed on 209 pages, includes 46 tables, 105 figures, 12 annexes and 7 chapters, 225 specialized bibliographic sources, published 47 scientific articles, of which 19 are single authors,

Field of study: 331.01.Epidemiology

The aim of the thesis: to study the epidemiological features and risk factors in the development of chronic hepatitis, liver cirrhosis and primary liver cancer, with the elaboration of the prognosis and strategy for reducing morbidity through these pathologies at the national level.

Research objectives: Assessment of the epidemiological situation by chronic hepatitis, liver cirrhosis and primary liver cancer in the Republic of Moldova. Determination of epidemiological features and risk factors responsible for chronic hepatitis and the development of cirrhosis and primary liver cancer. Determining the medical and socio-economic impact of chronic hepatitis, cirrhosis of the liver and primary liver cancer. Elaboration of the prognosis of the epidemiogenic situation in the Republic of Moldova regarding chronic hepatitis, liver cirrhosis and primary liver cancer depending on the evolution of risk factors. Development of a strategy to reduce morbidity from chronic hepatitis, liver cirrhosis and primary liver cancer.

Scientific novelty and originality: For the first time, the problem of chronic hepatitis, liver cirrhosis and primary liver cancer in the complex was studied, taking into account the close link between them, and also determined the social and economic impact as a whole. Based on the obtained results, the prognosis of the epidemiogenic situation by chronic hepatitis, liver cirrhosis and primary liver cancer was elaborated, as a result of the estimates regarding the real morbidity by chronic hepatitis and the strategy of elimination of chronic hepatitis was elaborated.

The scientific problem solved: the epidemiological features of chronic hepatitis morbidity, liver cirrhosis and primary liver cancer in complexity have been established, which has identified gaps in epidemiological surveillance in the public health service and the development of the plan for the elimination of chronic hepatitis in Moldova.

Theoretical significance: Contemporary views on the epidemiological features and causes of the evolution of chronic hepatitis in liver cirrhosis and primary liver cancer have been completed. The paper contributed by estimating the actual morbidity from chronic hepatitis at the national level and developing the prognosis of the epidemiogenic situation and developing a plan to eliminate chronic hepatitis in the Republic of Moldova, which included for the first time reducing cases of liver cirrhosis and primary liver cancer. The applicative value of the work: The results of the research allowed to determine the directions of action in order to detect and reduce the risk of formation of these pathologies; determined the economic and social impact, estimated the real morbidity regarding chronic hepatitis, developed the National Strategic Plan for the elimination of hepatitis, developed indicators for monitoring and evaluation of the implementation of the plan, including developed indicators of context, process and impact that need to be obtained by 2030 , updated National Clinical Protocols.

Implementation of scientific results: The results were implemented within ANSP, Epidemiology and Microbiology Discipline Nicolae Testemitanu SUMPh, conducted 3 workshops by the Order of the MH, including from 12.03.2021 Pre-testing questionnaires for data collection in viral hepatitis; Disposition of MH 457-d of 15.06.2021 Regarding the organization of the workshop on situational analysis in viral hepatitis B, C and D and control and response measures; Disposition of the MH no. 653-d of 06.09.2021 regarding the organization of the workshop on the elaboration of the Action Plan for the elimination of viral hepatitis for the period 2022-2030.