Tando Jam

Pakistan has no Prevention Plan against Thalassemia and as a result five thousand children are suffering from thalassemia every in the country.

Sindh, Khyber Pakhtunkhaw and Balochistan have done legislation for premarital screening but no implementation while the poverty and unawareness are major issues in prevention of this disease, said the speakers at a seminar on thalassemia for students at Dr. AM Shaikh Auditorium Hall organized by Sindh Agriculture University Tandojam and Sindh Sartyoon Welfare Organization on Wednesday.

Speaking at the seminar, Vice Chancellor of Sindh AgriculturE University Dr. Fateh Marri said that every year five thousand children are suffering from thalassemia in the country, The Sindh, Khyber Pakhtunkhwa and Balochistan assemblies have approved legislation for premarital screening, but implementation remains a major problem.

Dr. Marri said that due to the cooperation and conscious efforts of people in developed countries, diseases like thalassemia have decreased. “It is mandatory to get tested, being the only way to prevent Thalassemia.”

Dr. Muhammad Iqbal, a Social leader and chairman of Kashif Iqbal Thalassemia Care Center Karachi said that his organization has conducted thalassemia tests of thousands of students in 200 universities and colleges in the country.

He said that this disease is very painful but we are making efforts to prevent it for the health of affected children and youth. “Many young engineers and doctors are active in practical life despite suffering from this disease” he added.

Former Member of Assembly Ms. Rasheeda Panhwer said that the majority of the population of the province belongs to the lower socio-economic class, who cannot afford the expenses of treatment and management of children suffering from thalassemia due to household needs and economic problems.

Social leader Ms. Zahida Detho said that due to poverty in Sindh, common people are unaware of these types of diseases, especially in Thar and other areas. “Due to a lack of nearby health facilities and awareness programs, such diseases are increasing”.

Ms. Shahana Bhurgari, president of Sindh Sartiyoon Welfare Organization, said that there is no proper prevention program at the national level to deal with this disease in Pakistan including Sindh. However, some steps have been taken at the provincial level.

Dr. Muhammad Ismail Kumbhar, Director University Advancement and Financial Assistance, Ms. Zartaj Memon and Ms. Shabeela Talpur also spoke on the occasion. During the event, a camp was also organized for various blood tests including thalassemia of the students. (PR)

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By. Dr. M. Masood Khoso

HCV is a single stranded RNA virus, genus Hepacirus, family Flavi viradae having six genotypes. The credit of discovery of HCV goes to Michael Houghton, Harvey Alter and Charles Rice for which they are awarded 2020 Nobel Prize in Medicine. Their contribution has given better hope to mankind to cure HCV for the first time in history.

Global HCV prevalence declined from 63.7 million in beginning of 2015 to 56.9 million in beginning of 2020. In 2020, prevalence was highest in Eastern Europe and Central Asia. Greater than 50 % of infections were in China, Pakistan, India, and Russia. In Pakistan, overall prevalence of Hepatitis B and C is 2.5% and 4.8% respectively with combined infection rate of 7.6% in general population.

HCV is mainly transmitted via blood borne i.e. transfusion or intravenous drug abuse as high risk and needle sticks, body piercing, tattooing, and acupuncture with unsterilized needle as low risk transmission including from pregnant mother to child.

World Health Organization vision is to eliminate viral hepatitis as major health threat by 2030. That can be achieved either by preventive measure i.e. improve blood safety and infection control to diagnosis testing and treating.

US Preventive Services Task Force and AASLD recommends, one time, routine and opt out testing for all persons 18 years of age or older while prenatal testing as part of routine prenatal care recommended for each pregnancy.

Investigations include HCV antibody test followed by HCV RNA PCR, genotype if needed and also to exclude advance fibrosis or cirrhosis.

Treatment depends upon eligibility for simplified treatment or not i.e. adults with HCV infection, treatment naive or experienced and with or without cirrhosis.

Because of virological efficacy, ease of use, safety and tolerability, Interferron free, Ribavarin free, DAAs based must be used in HCV infected patients without cirrhosis or with compensated cirrhosis.

Treatment should be considered in advance or severe liver disease to avoid HCC, patients with post liver transplant recurrence should be considered for therapy.

Treatment must be given in renal impairment with careful monitoring as per guidelines and eGFR.

WHO elimination targets can only be achieved with effective screening, diagnosis and linkage to care.

Pangenotypic therapy allows simple algoirthms to effectively and safely provide treatment to large group of individuals with high SVR rates.

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Dr. M. Masood Khoso, FCPS, MACG (USA) is Consultant Gastroenterologist at Jinnah Postgraduate Medical Center (JPMC) Karachi, Sindh where a workshop on Hepatitis is being held today – July 29, 2022.

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