Hepatitis: a national health issue without accurate data

Karachi
Though health officials all over Pakistan are unanimous that the prevalence of Hepatitis is a “national issue”, no authority, official or professional is aware of the actual number of patients, given the fact when Hepatitis B and C, transmitted via blood, are lethal when detected in advanced stages.
The only credible survey to ascertain the actual number of Hepatitis B and C patients in Pakistan was conducted by Pakistan Medical Research Council (PMRC) in 2007. The survey was completed in 2008, and its findings revealed that the estimated number of Hepatitis B and C patients was 12 million, which mean that every 18th person in the country suffered from either Hepatitis B or C.
However, till today, health officials, hematologists and experts quote the same figures. Though some analysts believe that the number of Hepatitis patients has increased alarmingly in Pakistan, especially in rural, undeveloped and slum areas, where every second or third persons is infected with either Hepatitis B or C virus, or both.
But new estimates by government officials and physicians’ bodies associated with liver diseases reveal that Hepatitis has spread to an extent in Pakistan where every ninth or eighth person is infected with the either type of Hepatitis virus. This could mean that the total number of patients in the country exceeds well over 25 million.
The situation in Sindh is not that different as well. Nobody knows for sure the actual number of Hepatitis patients as officials and hepatologists still quote the years-old PMRC data when the number of Hepatitis B patients was 1.1 million and the number of Hepatitis C patients was about two million.
“In the absence of a new survey and updated data, we can’t speculate about the number of Hepatitis B and C patients in Sindh but we are sure that the burden of disease is increasing with every passing day,” said the project director of Sindh Hepatitis Control Program, Dr Abdul Hafeez Shaikh, while talking to The News.
He said the program had identified four districts in Sindh — Khairpur, Ghotki, Sanghar and Dadu —where the blood-transmitted hepatitis had become an endemic while there were pockets in the outskirts of Karachi — including Malir, Memon Goth, Ibrahim Hyderi, Sachal, Safoora Goth and Lyari — where thousands of people were infected.
“We have recently hired an epidemiologist and given him the task to research the prevalence of Hepatitis so we use the updated figures and chalk out a strategy to deal with the menace,” said Dr Shaikh.
Though Hepatitis is a curable disease, Dr Shaikh says it is impossible to treat each and every patient when nobody knows the actual number and how many more are infected with every passing day.
“Since it is transmitted by blood, prevention is the best course to limit its spread. Awareness is the only possible tool to prevent its spread and transmission to healthy persons,” he said.
However, a renowned hepatologist, Dr Shahid Ahmed, believed that the number of Hepatitis B and C patients in Pakistan was around four million, and it was the fastest-spreading health menace in the country where every fourth or fifth person was either infected or infecting others.
“Hepatitis B and C are viral diseases and cause major damage to the liver,” said Dr Ahmed, who is the associate professor of medicine and gastroenterology at Dar-ul-Sehat Hospital. “Both are major causes of liver diseases worldwide. A person may become infected if he or she receives unscreened blood.”
According to him, Hepatitis B and C are found everywhere in the world and the countries showing the highest rate of chronic infection were Egypt, Pakistan and China. He added that Hepatitis C Virus (HCV) infection was responsible for between 60 and 70 percent of the liver cancer cases.
Citing WHO, he said Pakistan was ranked second in the world in the highest prevalence of Hepatitis C with about four million patients.
“The major signs and symptoms of Hepatitis C infection are fatigue, nausea, vomiting, anorexia, yellow coloration of the skin and eyes, pain in abdomen, bright coloured stools, dark coloured urine, pain in joints and depression,” he said. “Fatigue is the most common symptom of hepatitis.”
However, he said, diagnoses cannot be made merely on the basis of symptoms and a blood test is required.
“Never share razor blades, nail files, toothbrushes or other personal items,” he said. “They can be contaminated with traces of the owner’s blood.”