Private hospitals in Karachi lack cell separator, cryofuge machines

With almost all the city areas in the grip of dengue fever, malaria and typhoid, the Sindh health department has requested the Sindh Health Care Commission (SHCC) to ensure that cell separator and platelet cryofuge machines are available at most of the private hospitals in Karachi.

It says private hospitals are admitting patients but when their platelets count reduces below 20,000, they shift them to tertiary-care hospitals, which is resulting in deaths of dengue patients.

“Only two tertiary-care public and a private hospital has cell separator and cryofuge machines, while the remaining most of the private hospitals are without these important life-saving equipment. You are requested to ensure that private hospitals acquire these machines so that patients requiring transfusion platelets are not shifted to other health facilities in a critical condition,” the health department said in a letter to the SHCC Chief Executive Officer (CEO) Dr Minhaj Qidwai.

“It is to bring to your attention that the number of dengue cases is increasing day by day specially in Karachi division. Only two public and a private hospital have cell separator and platelet cryofuge machines. It has been observed that in many private hospitals, the cell separator and platelet cryofuge machine is not available except for one leading facility.”

It further said dengue patients were being admitted to private hospitals, but when platelet levels deteriorated below 20,000, then these patients were referred to other hospitals, which was the leading cause of increasing mortality due to dengue fever.

“In this context, you are requested to direct private hospitals to ensure the availability of cell separator & platelet cryofuge machines; otherwise, timely referral of the dengue patients to public hospitals for active management of the patients to save their lives,” the health department letter said.

But experts of blood diseases rejected the information of Sindh health department, saying at least six to seven leading private hospitals in the city had cell separator and cryofuge machines available with them and they were using them to prepare blood products and transfusing them to patients but added that only 10 to 12 percent patients were in the need of platelets as part of their treatment.

“Entire Pakistan, including Karachi, is currently in the grip of dengue fever, which has so far affected 50,000 people while 250 people have died due to the complications of the vector-borne disease in the country. But the majority of patients are not facing any complication and don’t require hospitalisation,” said Prof Dr Tahir Shamsi, a leading expert of blood and tropical diseases in Pakistan.

He said the current epidemic of dengue fever had returned after five years in Pakistan, but the majority of patients were recovering with simple painkillers and keeping them hydrated. Only 10-12 percent of patients whose fever persists or they have symptoms of hemorrhage should approach hospital for admission and proper treatment, he added.

“Patients with fever are coming with both dengue and malaria or even with typhoid also. They should consult health experts and follow their advice on medication and rest. Only if needed, their doctors would ask them to get admitted to any health facility,” he said and added that people having fever should get themselves tested for dengue fever (NS1 antigen) and malaria as well as CBC from some reputed lab so that their treatment could be started immediately.

If a person is diagnosed with dengue fever and he is eating and drinking well, is not having any complication, he or she should take painkillers, keep themselves hydrated and rest and they would recover on their own, Prof Tahir Shamsi said but added that such patients should regularly visit physicians in OPDs so that their condition could be monitored.