World Hepatitis Day, observed on July 28 every year, aims to raise awareness of the global burden of viral hepatitis. You! takes a look...
Health
When it comes to providing healthcare, Sindh suffers from a serious shortage of facilities for its people. The province is plagued with a number of health issues like the spread of HIV and AIDS in Larkana, deaths of children due to malnutrition in Tharparkar and the prevalence of Hepatitis B and C across Sindh especially in the suburbs of Karachi.
According to national and World Health Organization (WHO) reports, it is estimated that Pakistan, a country with a population of 200 million, has five million (2.5per cent) hepatitis B and 10 million (5 per cent) hepatitis C patients, 15 million (7.5 per cent) in total or seven out of every 100 Pakistanis. Pakistan needs 10,000 liver transplants yearly. It may be worse than estimated because data may not have been monitored in the right places.
Consultant Gastroenterologist Dr A. Shahid, in his presentation at a recent seminar said, “One of the goals of World Health Organization (WHO) is the elimination of hepatitis B and C from the world by 2030. But, the way this disease is becoming rampant among the population of Sindh, the situation seems bleak. There are some programmes at the government and NGO level but the general public is not aware of them. The government and private sector need make collaborative efforts in order to make a difference.”
World Hepatitis Day is an opportunity to step up national and international efforts on hepatitis, encourage actions and engagement by individuals, partners and the public and highlight the need for a greater global response.
Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue
According to Dr Talib at Taj Medical Complex, “A person infected by hepatitis doesn’t know if he has contracted the disease. By the time he finds out, the liver is massively affected. 80 per cent of infected people do not have any symptoms. Those who do, the symptoms don’t appear for 10-20 years, or even longer, after infection. A small number of people report flu-like symptoms during the early acute phase of the infection. However, they are not enough for the patients to know about their actual health. Symptoms that develop overtime include nausea, vomiting, diarrhoea, loss of appetite, loss of weight, restlessness (sleeplessness), fatigue and pain over liver side, dark-coloured urine and pale coloured stools.”
The major reason for the spread of this disease is lack of awareness, self medication, and illegal practice by unqualified medical practitioners who use unhygienic instruments and single syringe for multiple patients. “Prevalence of Hepatitis C among pregnant women in Sindh is quite high for which the main causes are surgeries, blood transfusion and injections, tells renowned obstetrician Dr Tasnim Sadiq at T S Shah Clinic Saddar. Quoting a study carried out by a group of medical students in Gadap area of Karachi, she informs, “Viral hepatitis has increase risk of maternal complications during pregnancy and it is a notable reason of maternal mortality. During the period of three months, 400 women in antenatal set up were screened for the disease and 27 per cent of them were found to be HCV positive. Majority of the patients had history of injections.”
The hepatitis A virus (HAV) is more common in areas of low socioeconomic status with a lack of adequate sanitation. It spreads through contaminated food and water or close person-to-person contact. Children often transmit it. Unlike hepatitis B or C, it does not lead to chronic liver disease, but it can result in significant loss of income and absence from work or school.
Prevention of such diseases depends on immunisation and good hygiene practices. For example: not sharing items of personal hygiene that may be contaminated such as razors, nail clippers, scissors, and tooth brushes. The second is the primary prevention by vaccination and so far it is only available for hepatitis A and B.
“Hepatitis B, C, D and are blood borne infections and are dangerous. Thus primary prevention of infection with hepatitis B viruses can be achieved through vaccination. As hepatitis C has no vaccine, transmission can be prevented through behavioural interventions only. For this, we need to monitor blood banks, public and private hospitals, dental clinics, nursing homes, clinics, labs, barber’s shops, street vendors performing body piercing and all those involved in blood related procedures,” shares Dr Ashraf Hussain, who holds a PhD and post-doc degrees on Hepatitis C virus and liver diseases.
While there was a programme launched in Sindh to provide free vaccination and screening, but it didn’t yield any desired results. Hepatitis Prevention & Control Program (HPCP) was the only health care programme in Sindh. In May last year, Sindh government announced a wind-down of HPCP and said it would now provide funds to Aga Khan University Hospital (AKUH) for the screening, diagnosis and treatment of hepatitis C patients, initially in two districts and later in the entire province.
“The free screening of hepatitis B and C is absolutely imperative. It would help treating the disease before it’s too late. Moreover, the screening will also give an insight to the magnitude of the problem and how prevalent the disease actually is,” concludes Dr Shahana Urooj Kazmi at Dadabhoy Univesity.
