PESHAWAR, Dec 10: The Prime Minister's Programme for Prevention and Control of Hepatitis has started preparing national guidelines for effectively implementing the five-year programme, an official of the provincial health department told Dawn.

"To ensure standardised implementation of the programme across the board, we are in the process of developing five national guidelines to stem the tide of hepatitis A, B, C, D and E," the health department official said. These include sterilisation guidelines for use of invasive devices and instruments which were used in surgical, medical and dental interventions, he said.

He said 250 hospital-based studies conducted in the country’s top health institutions had indicated prevalence of hepatitis B in 3.4 per cent cases and hepatitis C in 5-6 per cent cases. He said there was an urgent need to regulate medical practice in the country by putting in place certain guidelines.

Referring to common causes of Hepatitis B and C, he said these include unsterilised implements used by barbers and beauty parlours, use of un-sterilised surgical instruments, unsafe blood transfusion and multiple injections and drips. He said under the programme, the process to develop national guidelines on viral hepatitis case management and provision of counselling facilities to high-risk groups had also been started.

The official said that it was now an established fact that contaminated syringes were one of the causative agents of spread of hepatitis in the country and, therefore, efforts were under way to prepare national guidelines to ensure injection safety, devices control and hospital biological waste management.

According to the official, advocacy material for barbers, beauty parlours, invasive groups, dentists and quakes were part of the national guidelines. For this purpose, he said, a complete information package would also be put on the Internet.

He said during the five-year (2005-10) programme, a holistic approach had been adopted to utilise Rs2.59 billion to achieve the objective set forth by Prime Minister Shaukat Aziz.

Besides preventive measures, 48 incinerators were being installed in public sector hospitals under the programme, he said. Besides, he said, 50 water purification plants were being installed in different cities to prevent the spread of Hepatitis A and E.Apart from these, steps such as blood screening, hospital waste management plan, training of doctors and hospital staff were also in the pipeline, he said.

Unlike, Hepatitis B and C, which were caused by blood, Hepatitis A and E were caused by consumption of contaminated water, he said. Epidemic of Hepatitis A and E had been reported from all geographical settings but because of immunity system, it was self-limiting and could be treated through symptomatic treatment, he said. To stop water-borne hepatitis, guidelines were also being prepared to educate people about sanitation-related problems.