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.
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

OBJECTIVETo build the colony immune defence and to control the periodic epidemics of hepatitis A after a mass vaccination of live attenuated hepatitis A vaccine.

METHODSThrough yearly observing the correlation of the accumulative inoculation rates of live attenuated hepatitis A vaccine, the crowd immune standard and the morbidity of hepatitis A after administered live attenuated hepatitis A vaccine among susceptible population and surveilling anti-HAV IgG in the different epidemic areas.

RESULTS(1) The accumulative inoculation rates of live attenuated hepatitis A vaccine was 34.15% in 8 years from 1993 to 2000, among which they were 84.46%, 82.23% and 15.14% in the preschool children, primary and middle school student and 15 - 45 age groups respectively. The morbidity of hepatitis A decreased to 8.26/100,000 in 2000. (2) The crowd positive rates of anti-HAV IgG were 74.24% in 1998 and 83.68% by 2000. Among which they were 74.02%, 68.49%, 79.41%, 85.71% and 90.80% in 2 - 4, 6 - 8, 13 - 15, 20- and 30 - 39 age groups respectively. (3) The accumulative inoculation rates were 37.36%, 51.08% and 28.68% in the inspection areas of Tongtai, Binhai and Yandu respectively. The crowd positive rates of anti-HAV IgG in three inspect area were 85.71%, 85.94% and 78.63% respectively. It was noticed the correlation between the accumulative inoculation rates and the crowd positive rates of anti-HAV IgG was (r(city) = 0.91, F = 15.10, P < 0.03).

CONCLUSIONThe results showed that the crowd positive rates of anti-HAV IgG had increased to 85% while, the colony immune defence of hepatitis A was effectively built to break the periodic epidemics of hepatitis A. The morbidity of hepatitis A decreased to the lowest level in the history.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hepatitis A ; epidemiology ; prevention & control ; Hepatitis A Vaccines ; immunology ; Hepatitis A Virus, Human ; immunology ; Hepatitis Antibodies ; blood ; Humans ; Immunoglobulin G ; blood ; Male ; Mass Vaccination ; statistics & numerical data ; Middle Aged ; Vaccines, Attenuated ; immunology

Influenza vaccination is important for cancer survivors, a population with impaired immunity. This study was designed to assess influenza vaccination patterns among Korean cancer survivors. In this cross-sectional analysis, data were obtained from standardized questionnaires from 943 cancer survivors and 41,233 non-cancer survivors who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2007-2011). We identified the adjusted influenza vaccination rates and assessed factors associated with influenza vaccination using multivariate logistic regression. Cancer survivors tended to have a higher adjusted influenza vaccination rate than the general population. The rates for influenza vaccination in specific cancer types such as stomach, hepatic, colon, and lung cancers were significantly higher than non-cancer survivors. Among all cancer survivors, those with chronic diseases, elderly subjects, and rural dwellers were more likely to receive influenza vaccination; those with cervical cancer were less likely to receive influenza vaccination. Cancer survivors were more likely to receive influenza vaccinations than non-cancer survivors, but this was not true for particular groups, especially younger cancer survivors. Cancer survivors represent a sharply growing population; therefore, immunization against influenza among cancer survivors should be concerned as their significant preventative healthcare services.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Comorbidity ; Disease Susceptibility/mortality ; Educational Status ; Female ; Health Behavior ; Humans ; Influenza Vaccines/*therapeutic use ; Influenza, Human/*mortality/*prevention & control ; Male ; Mass Vaccination/*utilization ; Middle Aged ; Neoplasms/*mortality ; Republic of Korea/epidemiology ; Risk Factors ; Sex Distribution ; Social Class ; Survival Rate ; Survivors/*statistics & numerical data