Prevalence and risk factors of hepatitis C virus infection in Armenia, 2021

Abstract Background Liver damage caused by hepatitis C virus (HCV) is common, especially in low- and middle-income countries. Chronic HCV infection is among the leading causes of chronic liver disease, cirrhosis and hepatocellular carcinoma. Data on prevalence and risk factors of HCV infection are important for planning effective interventions to fight the virus. This study investigated the prevalence of HCV, its genotypes and factors associated with chronic HCV infection in Armenia. Methods The study included 3838 individuals 18 years and older selected via stratified two-stage cluster sampling from all regions of Armenia. Anti-HCV antibodies were detected using a third generation immunoassay. Those testing positive were further tested by Polymerase Chain Reaction and genotyping. Shortly after testing, the participants underwent a telephone survey. Logistic regression model was fitted to identify factors associated with chronic HCV infection. Results The participants mean age was 49.5 years, 70.0% were female. The prevalence of HCV antibodies weighted by age and sex was 1.9% (95% CI 1.5, 2.3), and chronic HCV infection - 0.7% (95% CI 0.4, 0.9), with genotype 3 being the most common (41.7%), followed by genotypes 2 (37.5%) and 1 (20.8%). The prevalence of both antibodies and chronic infection were higher among 50-69 years old (3.4% and 1.3%, respectively). In weighted analysis, the risk factors for chronic HCV infection included male sex (95% CI 1.23, 11.59), having tattoos (95% CI 1.10, 7.80), and reporting liver disease (95% CI 1.24, 14.61). Being employed was protective (95% CI 0.14, 0.93). Conclusions This study was the first attempt to measure the prevalence of HCV infection among the general population of Armenia, creating prerequisites for estimating the HCV-related disease burden and developing strategies to cope with it. The identified risk factors demonstrate that there is still room for strengthening safety measures to prevent the transmission of HCV in Armenia. Key messages • The prevalence of HCV antibodies is 1.9% among adult population of Armenia, increasing with age. Over one-third of seropositive cases have chronic infection caused by HCV genotypes 3, 2 or 1. • Having tattoos is associated with higher risk of being infected with HCV, demonstrating the need for strengthening safety measures during similar procedures to prevent viral transmission.

Influenza represents a major burden for public health.Healthcare workers (HCWs) are a priority target group for flu vaccination.During the COVID-19 pandemic, when SARS-CoV-2 vaccines were not yet available, susceptibility to influenza vaccination especially by HCWs increased.The aim of this study is to analyze the flu vaccination coverage among HCWs and to study which factors affected their adherence given the concomitant COVID-19 vaccination.The retrospective study was conducted in an Italian research hospital from October 2021 to January 2022.A total of 7,048 individuals was included.Age class, gender and job category variables were analyzed.Statistically significant differences among groups were tested through 2 test.Univariate and multivariate analyses (p < 0,005) were performed to assess differences towards vaccination attitude.The flu vaccination coverage rate was 24.6%.Among the selected job categories, 29.8% of physicians, 19.9% of nurses and 19.7% of other HCWs were vaccinated with a statistically significant decrease (p < 0.001) across all categories respect with the last campaign.The findings of the logistic regression depicted that the 40-59 years old age class, compared with the youngest age class (OR 1.30, 95% CI 1.12-1.43)as well as being physician (OR 2.79, with the respect to being nurses, had a higher adherence to vaccination.Interestingly, being male, is associated with a statistically significant reduction (OR 0.71, 95% CI 0.59-0.87) in vaccination uptake.Study findings showed a several decline in the flu vaccination coverage comparing with previous campaigns, probably due to the concomitant administration of the booster dose against SARS-CoV-2.This alarm should not be underestimated and requires timely and innovative organizational approaches (i.e., combined vaccine).Further studies are needed to analyze the reasons for this poor adhesion and the strategies to be adopted Background: Liver damage caused by hepatitis C virus (HCV) is common, especially in low-and middle-income countries.Chronic HCV infection is among the leading causes of chronic liver disease, cirrhosis and hepatocellular carcinoma.Data on prevalence and risk factors of HCV infection are important for planning effective interventions to fight the virus.This study investigated the prevalence of HCV, its genotypes and factors associated with chronic HCV infection in Armenia.

Methods:
The study included 3838 individuals 18 years and older selected via stratified two-stage cluster sampling from all regions of Armenia.Anti-HCV antibodies were detected using a third generation immunoassay.Those testing positive were further tested by Polymerase Chain Reaction and genotyping.Shortly after testing, the participants underwent a telephone survey.Logistic regression model was fitted to identify factors associated with chronic HCV infection.

Conclusions:
This study was the first attempt to measure the prevalence of HCV infection among the general population of Armenia,

Background:
Cervical cancer caused by human papillomavirus (HPV) is the most frequent cancer in women in many low-income countries.Tanzania implemented a national HPV vaccination program in 2018 using a two-dose quadrivalent HPV vaccine.This study aimed to (1) estimate financial and economic costs of a two-dose vaccination program based on experiences with the national vaccination program, (2) estimate costs of a one-dose vaccination schedule to enable future cost-effectiveness analyses, and (3) assess the effect of alternative assumptions for future vaccination coverage rates on estimated costs of vaccination.

Methods:
The WHO Cervical Cancer Prevention and Control Costing (C4P) tool was used to estimate the incremental costs of the national vaccination programme from the perspective of the Tanzanian government using data collected via surveys, workshops, and interviews with local stakeholders.Deterministic sensitivity analyses were performed to estimate the effect of alternative assumptions for coverage rates and delivery strategies and to assess the impact of a potential onedose vaccination schedule.

Results:
The total financial and economic costs were US$10,117,455 and US$45,683,204, respectively, at a financial cost of $5.17

Conclusions:
The overall cost of Tanzania's HPV vaccination program was lower per vaccinee than previous demonstration projects in the region suggest.These data provide important baseline data for Tanzania's HPV vaccination program to date and may serve as a guide for improving coverage going forward.The findings may also aid in the prioritization of funding for countries that have not yet added HPV vaccines to their routine immunizations.

Key messages:
If a single dose regimen were found to be as effective as a twodose series, it would result in significant cost savings as well as an increase in the number of girls that could be reached.School-based vaccinations resulted in the lowest price per fully immunized girl, but other settings are needed to achieve equitable high coverage of HPV vaccination in Tanzania.

Abstract citation ID: ckac131.394 Knowledge about HPV vaccination among Croatian university students
Ivan Miskulin

Background:
Studies have shown the low uptake of the human papillomavirus (HPV) vaccine among university students.Knowledge about the HPV virus and the vaccine can be a factor that may sway an individual's decision to receive the vaccine.This study aimed to investigate HPV vaccine uptake and knowledge about HPV vaccination among Croatian university students.

Methods:
This cross-sectional questionnaire study was conducted from February to May 2021 period.A validated, anonymous questionnaire that contained questions regarding demographic data, data about HPV vaccine uptake, and data regarding knowledge about the HPV virus and the vaccination was selfadministered to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia.

Results:
The study sample included 840 subjects with, median age of 20 years (interquartile range 20-21), 45.8% males, and 54.2% females.The prevalence of vaccination uptake in the studied population was 20.8%.The study revealed that there were 25.6% of students with a low level of knowledge and 74.4% of students with satisfactory levels of knowledge about the HPV virus and the vaccination.The excellent knowledge about the HPV virus and the vaccination was more frequently shown by students who studied in biomedicine and health area of science (p < 0.001) and students with an excellent average grade of study (p < 0.001).HPV vaccination uptake was higher among females (p < 0.001), students who studied within biomedicine and health area of science (p < 0.001), students with an excellent average grade of study (p < 0.001), and students who showed excellent knowledge about the HPV virus and the vaccination (p < 0.001).

Conclusions:
The majority of Croatian university students had a satisfactory level of knowledge about the HPV virus and the vaccination but the vaccination uptake is still very modest.Additional efforts are needed to organize more appropriate education and promotion of vaccine uptake in the studied population.

Key messages:
The HPV vaccination uptake among Croatian university students is very modest although the majority of students have a satisfactory level of knowledge about the HPV virus and the vaccination.Continuous examination of HPV knowledge gaps and identification of factors influencing vaccine uptake is key to increasing vaccination rates in the Croatian university student population.
per two-dose fully immunized girl (FIG), and an economic cost of $23.34 per FIG.Under the assumption of a one-dose vaccination schedule, costs per FIG would reduce to financial costs of $2.51 and economic costs of $12.18.