Table 6.
Suggested metrics by target area to improve prevention, treatment, and care for patients with liver diseases in the Asia-Pacific region
| Metrics | |
|---|---|
| Viral hepatitis | |
| Improve coverage of hepatitis B immunisation, including a timely birth dose | Hepatitis B birth-dose vaccination (% coverage); three-dose hepatitis B vaccine for infants (% coverage); three-dose hepatitis B vaccine for health-care workers and other high-risk populations (% coverage) |
| Improve blood and injection safety | Blood donations screened with high-quality nucleic acid tests (% coverage); use safely engineered syringes and injection devices (% coverage) |
| Harm reduction for intravenous drug users | Number of sterile syringe or needle sets distributed per person per year for people who inject drugs |
| Improvements in sanitation and water quality | Households with an improved drinking water source (% coverage); households using improved sanitation facilities (% coverage) |
| Screening of high-risk groups for HBV and HCV in primary care settings | Proportion of patients in primary care who have been assessed for risk factors of HBV and HCV (% coverage); proportion of patients at high risk for HBV and HCV who have been tested (% coverage) |
| Increase the proportion of patients with chronic hepatitis B and C who have been diagnosed | Estimated proportion of patients with chronic hepatitis B and C who have not been diagnosed (% coverage) |
| Increase access to appropriate management and care for patients with chronic hepatitis B and C | Proportion of patients with chronic hepatitis B and C eligible for treatment with antiviral drugs (% coverage) |
| Monitor mortality related to acute and chronic hepatitis infections | Incidence of acute hepatitis A and E; mortality related to acute hepatitis A and E; incidence of acute hepatitis B and C; mortality related to acute hepatitis B and C; incidence of chronic HBV and HCV infections; mortality related to chronic HBV and HCV infection |
| Monitor morbidity related to chronic hepatitis infections | Number of patients with cirrhosis or hepatocellular carcinoma associated with HCV or HBV; number of liver transplantations for HCV or HBV; HBsAg prevalence in children younger than 5 years |
| Alcohol-related liver disease | |
| Reduce alcohol intake and ameliorate risky alcohol-related behaviours | Total (recorded and unrecorded) alcohol consumed per capita (ages ≥15 years) within a calendar year in L of pure alcohol; age-standardised prevalence of heavy episodic drinking in adolescents and adults |
| Early detection and treatment of alcoholic liver diseases | Proportion of adult patients in primary care who have had a measure of alcohol consumption or risk in the preceding year |
| Reduce the burden of liver diseases attributed to alcohol use | Alcohol-related morbidity and mortality in adolescents and adults; mortality related to alcohol-attributable cirrhosis; number of patients with alcohol-related cirrhosis or hepatocellular carcinoma; number of liver transplantations for alcohol-related liver disease |
| NAFLD | |
| Promoting physical activity | Prevalence of insufficient physically activity in adolescents (defined as <60 min of moderate to vigorous activity daily); age-standardised prevalence of insufficiently physical activity in people aged ≥18 years (defined as <150 min of moderate-intensity activity per week, or equivalent); per-capita travel (km per day) |
| Promoting healthy food consumption | Sugar consumption per capita (g per day); age-standardised mean proportion of total energy intake from saturated fat in people aged ≥18 years; age-standardised prevalence of people aged ≥18 years; consuming less than five total servings (400 g) of fruit and vegetables per day |
| Stopping the increase in diabetes, hyperlipidaemia, and obesity | Age-standardised prevalence of increased blood glucose or diabetes in children, adolescents, and adults; prevalence of overweight and obesity in children, adolescents, and adults; age-standardised prevalence of increased total cholesterol in children, adolescents, and adults |
| Early detection and treatment of NAFLD | Proportion of adult patients in primary care who have had their body-mass index recorded in the preceding year; prevalence of NAFLD or non-alcoholic steatohepatitis in patients in secondary care |
| Reducing the burden of liver disease attributed NAFLD | Number of patients with cirrhosis or hepatocellular carcinoma associated with NAFLD; number of liver transplantations for NAFLD |
| All liver diseases | |
| Increased facilities and expertise for diagnosis, treatment, and care of patients with liver disease | Proportion of secondary and tertiary care hospitals with a doctor trained in liver diseases; proportion of secondary care hospitals with 24 h endoscopy facilities; survival of hospital inpatients with liver disease by cause of admission |
| Improved access to liver transplantation facilities | Organ donations per million people per year; waiting time for liver transplants from deceased donors by blood group; proportion of liver transplants from living donors; proportion of publicly funded tertiary care hospitals equipped for liver transplantations |
| Increasing awareness of liver disease in the general population and governments | Existence of Government-supported national liver plans; existence of public health-sponsored public awareness campaigns (number per year); number of patient support groups and non-governmental organisations involved |
| Research into epidemiology, risk factors, prevention, and control of liver diseases | Number of research papers published on liver diseases in local journals per country; proportion of research papers published on liver disease in global journals per country |