Hepatitis: A Growing Threat and Persistent Challenge

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Hepatitis

WHO Report 2024 says Pakistan grapples with highest Hepatitis Infection rate globally

WORLD HEPATITIS DAY 28 JULY

Dr. Mohammad Masood Khoso

A recent World Health Organization (WHO) report reveals a disturbing trend: Pakistan has surpassed other countries in Hepatitis C infections, with a staggering 8.8 million cases, contributing to 44% of new global infections. This surpasses Egypt, which previously held the top spot for Hepatitis B and C cases.

– Pakistan ranks fifth globally in combined Hepatitis B and C cases

– 44% of new infections are attributed to unsafe injections

– The majority (50%) of Hepatitis B and C cases affect individuals between 30-54 years old

– Children under 18 account for 12% of cases

– Men make up 58% of all Hepatitis cases in Pakistan

These statistics highlight the urgent need for awareness, education, and improved healthcare practices to combat the spread of Hepatitis in Pakistan

Considered as Silent infections HBV case be considered as fatal, as usual people affected are unaware that they have contracted. Infections with HBV leads to a broad spectrum of clinical presentations ranging from asymptomatic carrier state to acute fulminant Hepatic failure, chronic Hepatitis to cirrhosis and hepatocellular carcinoma. One in four people with chronic HBV infection are at risk of premature death from cirrhosis or liver cancer. Most patients have no symptoms because HBV develops slowly over decades.

HepatitisSimilarly, most patients with chronic hepatitis C report no symptoms however some patients may have nonspecific symptoms related to fatigue and discomfort at right side of abdomen. Often symptoms leads to diagnosis of HCV are noticeable only at the end stage liver diseases when the patient has developed liver cirrhosis and liver failure. Liver disease claims a life in Pakistan every 20 minutes.

Read: WHO sounds alarm on viral hepatitis infections claiming 3500 lives each day

The various challenges that hinder the control of Hepatitis B and C cases in Pakistan are due to unnecessary therapeutic injection use and prolonged hospital stay, along with reuse of syringes and using unsterilized equipment for dental of surgical procedures. The cases also keep rising due to unscreened blood transfusion, sharing of personal objects, razors shaving machines etc. and contact with contaminated blood and body fluids, getting tattoo or piercing and going to un hygienic saloons or barbers along with intimate relations with someone who has hepatitis. Lack of vaccination against HBV is also major disaster and lack of screening and antenatal care is one of the reasons for transmission of hepatitis. According to American academy of pediatrics if baby receives the first dose of vaccine is preventing Hepatitis B transmission from parent to infant is 75 to 95 percent.

Hepatitis B and C have been spreading rapidly across all provinces of Pakistan mainly due to lack of awareness about ways of transmission and reluctance of people to seek medical advice on time, imposing huge burden on the health care system. The unavailability of vaccine against HCV and lack of skill personnel to administer the existing vaccine for HBV are some pivotal reasons why these diseases are still widespread, specifically in places that have zero access to any secondary health care.

To curtail the transmission and thus to reduce the prevalence of Hepatitis B and C in Pakistan, it is essential to begin by educating people about risk behaviors. An effective method of raising the awareness can be workshops aimed at providing basic information regarding the disease and preventive strategies. Special attention should be given to local barbers, tattoo artists and syringe using individuals whether drug abusers or those requiring regular transfusions such as thalassemia patients and local dentists, as the main mode of transmission of these viruses is through introducing in the blood.

The important of vaccination against HBV given its 90 to 95 percent effectiveness against virus needs to be reiterated through regular information sessions and vaccination campaigns.

Hepatitis poses a substantial threat to global health we need to combat the threat to create a healthier future.

The WHO has developed a global health sector strategy to achieve hepatitis elimination by 2030 in collaboration with different countries and Pakistan is also cosignatory. The gradual decrease in disease burden can be due to awareness campaigns against viral infections by local government authorities which play important role in educating the population. Still there is big need to update the health care facilities in developing countries like Pakistan well Hepatitis is a significant threat and persistent challenge, requiring collective action to combat its spread and mitigate its impact.

Hepatitis: WHO targets can only be achieved by screening, diagnosis and treatment

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Dr MasoodDr. Mohammad Masood Khoso is Assistant Professor Gastroenterology at Jinnah Postgraduate Medical Center (JPMC) Karachi Sindh.

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