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TABLE D-5.1 Morbidity and Mortality due to Acute Hepatitis B

Region

Population at Risk (millions)

Annual Incidence Rate (per 100,000)

Number of Cases

Deathsa

High Risk Regions

 

 

 

 

South and east Asia

1,516

68b

1,030,880

1,546

Sub-Saharan Africa

407

68b

276,760

415

Oceania

5

68b

3,400

5

Moderate Risk Regions

 

 

 

 

Central Asia

1,146

60c

687,600

1,031

North Africa

124

60c

74,400

112

South America

397

40d

158,800

238

Total

 

 

2,231,840

3,347,

aAssuming a case fatality rate of 1.5 per 1,000 cases.

bIncidence rate in China assumed applicable to all high-risk regions.

cAssumed to be close to Israel’s rate of 50 to 80 per 100,000.

dAssumed to be between rates in Israel and the United States.

SOURCE: Francis, personal communication, 1985.

Cases and deaths were divided proportionally by population size into the 5 to 14 and 15 to 59 years age groups. It was assumed that all cases in the under 5 years age group are asymptomatic, and that the number of cases in people 60 years of age and over is insignificant.

Cases were distributed into the acute categories as follows: 5 to 14 years age group, 25 percent in category A, 50 percent in category B, and 25 percent in category C; 15 to 59 years age group, 25 percent in category A, 25 percent in category B, and 50 percent in category C. An additional 3 percent of cases in each age group were assigned to category E, representing cases of chronic acute hepatitis (Berlin, 1980). Table D-5.2 shows the disease burden resulting from acute hepatitis B.

Primary Hepatocellular Carcinoma

PHC may occur in chronic hepatitis B carriers 20 years or more after an acute infection. The average survival rate of PHC is 6 months, so the numbers of cases and deaths are equal. The incidence rates in different populations are shown in Table D-5.3. Because of the time lag between acute hepatitis infection and PHC onset, it was assumed that the disease affects only two age groups. Cases and deaths were distributed proportionally according to the size of the population in each age group, and all cases were assigned to category E. Table D-5.4 shows the disease burden estimates for PHC.



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