May 19th was recently celebrated worldwide as World Hepatitis Day – although from next year the day has been shifted to July 28th. The day is aimed at raising global awareness of Hepatitis-B and Hepatitis,-C and to encourage prevention, diagnosis and treatment. But what does it really mean in a country like Pakistan, a country that carries one of the world’s highest burden of chronic hepatitis and mortality due to liver failure and hepatocellular carcinomas? It must be noted that national level estimates of the prevalence of and risk factors for Hepatitis-B and Hepatitis-C are currently not available.
It was only til a legend of the Punjabi stage, Mastana, passed away after losing his war against Hepatitis-C that hepatitis came back as a disease that we could not ignore. Ignorance, in most cases, is indeed bliss, but when it comes to hepatitis, the bliss more often than not comes at too steep a cost.
Dr Ghazanfar Mehdi, an expert on the issue and a consultant gastroenterologist at Al Razi Healthcare, revealed that the main reasons for hepatitis in the country are polluted water, illegal industrial poisonous water discharge and environmental pollution. “This was reason that the World Health Organisation (WHO) has estimated that 10 million people are suffering from hepatitis in Pakistan, he said.
The WHO country representative told the international media some months ago that there were five types of hepatitis, namely A, B, C, D and E. The A and E types are transmitted because of water problems and C, B, and D are blood-related diseases.
A review of the medical and public health literature over a 13-year period (January 1994-September 2007) provided by the Pakistan Medical Association, and aimed at estimating the prevalence of active Hepatitis-B and chronic Hepatitis-C in Pakistan, revealed that a weighted average of Hepatitis-B antigen prevalence in pediatric populations was 2.4% (range 1.7-5.5%) and for Hepatitis-C antibody was 2.1% (range 0.4-5.4%). A weighted average of Hepatitis-B antigen prevalence among healthy adults (blood donors and non-donors) was 2.4% (range 1.4-11.0%) and for Hepatitis-C antibody was 3.0% (range 0.3-31.9%). Rates in the high-risk subgroups were far higher.
Data suggests a moderate to high prevalence of Hepatitis-B and Hepatitis-C in different areas of Pakistan, the reasons for which have been identified as contaminated needle use in medical care and drug abuse and unsafe blood and blood product transfusion as the major causal factors.
“Hepatitis is quickly spreading in Pakistan, which is a very alarming situation. There are very few centres in Punjab that have the appropriate machinery needed to properly test for hepatitis. There is simply no way to test for hepatitis in most rural areas in the province as well as the country. This greatly hampers any movement aimed at reducing the amount of hepatitis cases in the country or spread awareness about the disease.
“I would encourage medical experts and relevant stakeholders to actively engage in a national drive that is aimed at reaching these rural areas and raising awareness on how deadly hepatitis actually is. Also, I would ask that the government and the private sector join hands and ensure that less-developed areas have health centres and the equipment needed to properly test for hepatitis,” Dr Mehdi said.
The time is now; we are the ones whose lives are at risk from hepatitis. No outsider will come and help us solve our issues, even such important ones. The nation, as a whole, needs to stand together on this vital issue and build a consensus, which would be followed by a nation-wide campaign that sees us slowly but surely winning our war against Hepatitis, lest we lose a war we can simple not afford to lose.
