KARACHI, Sept 20: In order to ease the process of most effective interventions to curb hepatitis there is a need to determine the exact quantum and magnitude of the disease and its varied types among the local population through a base-line prevalence survey.

This was stated by Dr Shareef Ahmed Khan, Manager of the Prime Minister’s Programme for Prevention and Control of Hepatitis, while speaking at a seminar on hepatitis jointly organized by the Pakistan Ministry of Health and Abbot on Wednesday.

He said that institutions-based studies conducted by researchers reflected an estimated prevalence of three per cent to four per cent Hepatitis-B and five per cent to six per cent Hepatitis-C in Pakistan. However, he said that there was a need to have more broad-based studies with regard to incidence rate of all five distinct types of hepatitis virus prevalence among local population easing the process of most effective interventions.

The speaker also recommended feasibility studies for all specified preventive as well as curative projects for ailments as TB DOTS Control Programme and others mentioning that these are to substantiate and strengthen the existing health-care programmes and facilities available in the country. For the very purpose, the programme manager said the strategy had been evolved with the Pakistan Medical and Research Council taking a lead role along with CDC-Atlanta.

Equally and much more significant collaborations were being developed with provincial health departments local bodies and the ministry of environment with specific reference to potable water as well as safe disposal of hospital waste, he said.

Dr Shareef observed urgency to make locals, including many of the doctors and comparatively educated segments, realize that all five distinct types of hepatitis virus were prevalent in the country. “This is particularly needed to be realized by all that while Hepatitis B, C and D are blood-borne while Hepatitis A and E are water borne,” he explained.

“We have to particularly interrupt the unprecedented transmission of Hepatitis B and C through efficient control measures,” he stressed reminding that country needs national treatment guideline for hepatitis.

He said besides establishment of viral hepatitis surveillance system diagnostic, treatment and counselling strategies were being developed at public healthcare facilities up to district health units.

Provision for vaccination against Hepatitis-B had been included in the EPI Programme with all children under one year of age being compulsorily administered the same.

Other high risk groups including staffers serving at blood banks, clinics, hospitals as well as those already inflicted with Hepatitis-C, Thalassaemia and those on dialysis were further being targeted under the programme.

Dr Khalid Zafar of the Sindh Institute of Urology and Transplantation, who was the chief guest on the occasion, said that a large majority of people in the country was not aware of the significance of the disease and that how rapidly it was spreading. “It is mainly because of the HIV/AIDS scourge that attention has also be drawn towards Hepatitis Band C,” he observed.

He further said that while carrier rate for Hepatitis- B was three to four per cent among urban population yet most of the people were generally unconscious of their being carrier of any of the type of the virus which could be fatal. He registered with deep concern that large majority of Hepatitis B or C patients despite reaching the chronic stage of the disease fail to get proper treatment.

“There is dire and urgent need to understand the disease, ensure timely diagnosis followed by proper treatment,” Dr Khalid Zafar said.

Dr Mark W. Bruns said that more than two million people had been infected with Hepatitis-B at some time in their life. “The prevalence of HBV varies worldwide from as low as 0.01 per cent to 0.1 per cent in developed countries with good public health to as much as 20 per cent and even higher in many developing countries,” he said.

The speaker also mentioned that Hepatitis-B was 10 to 100 times more infectious than HIV. It was further mentioned that 70 per cent of acute HBV cases were asymptomatic (i.e. presenting with no signs or symptoms of infection) and there were 350 to 400 million chronically infected HBV carriers worldwide. “Immunization with hepatitis vaccine is the most effective means of preventing HBV infection and its consequences,” he said.

Dr Huma Qureishi, Director of the Pakistan Medical and Research Council-Islamabad, said that it took 10 years to 15 years for Hepatitis-C to develop into cirrhosis and that there was again a high chance for those on dialysis to be inflicted with Hepatitis-C.

The senior researcher clarified that healthy adults of the country when exposed to the virus might suffer from acute hepatitis (clinical and sub-clinical) and got recover within 12 weeks.

She also referred to factors causing Hepatitis B or C and identified sharing of syringes, improper sterilization of surgical/ dental equipments, inadequate provision for safe blood transfusion and sexual transmission.

Earlier, the welcome address was given by Ian Martin.—APP