All types of hepatitis virus exist in Pakistan: IRIN report

* Media reports suggest one in every 10 Pakistanis suffers from hepatitis B or C
KARACHI: World Health Organisation (WHO) says all five types of hepatitis virus (A, B, C, D and E) exist in Pakistan, says a United Nations’ news agency IRIN report. Hepatitis is a viral infection spread through transfusion of blood and body fluids, sexual contact and use of improperly sterilised instruments.

A 2008 study on the prevalence of disease carried out by Pakistan Medical Research Council (PMRC), found that 12 million out of a population of 165 million were infected by hepatitis B or C. Mortality rates due to liver failure caused by hepatitis C were also among highest in the world, according to medical researchers who noted that “Pakistan carries one of the world’s highest burdens of chronic hepatitis and mortality due to liver failure and hepatocellular carcinomas.”

But what is especially alarming is the finding that healthcare practitioners themselves are responsible, in many cases, for the spread of virus due to unsafe techniques. These include re-use of syringes and needles. According to PMRC, nearly 15 percent of paramedics are themselves infected by the hepatitis virus, as are 7.3 percent of nurses, 6.8 percent of doctors and 5.2 percent of medical students based at hospitals.

The improper disposal of hospital waste adds to risks. “Sharp waste generated at hospitals and similar settings contribute to a minimum of 20 percent of all infections in the country,” PMRC deputy director Waqaruddin Ahmed said.

“The published literature on modes of transmission of hepatitis B and C in Pakistan implicates contaminated needle use in medical care, drug abuse, unsafe blood and blood product transfusion as the major causal factors,” researchers said.

Media reports suggested one in every 10 Pakistanis suffers from hepatitis B or C, and that failure to implement laws such as Safe Blood Transfusion Act of 2002, which puts in place rules for screening of donated blood, has exacerbated the situation.

“One of the problems is widespread belief among patients that injections are more effective than oral medications. People who come to clinics, such as one I practice at, frequently demand an injection even when pills are available.

This contributes to spread of diseases such as hepatitis, since needles are quite often re-used at some places,” Aziz Ahmed, a doctor in Lahore, told IRIN.

The theft and re-sale of hospital waste, quite often by hospital staff, makes matters worse. “There are people in this hospital, lab assistants, nurses, cleaners and others who take away used items, such as IV [intravenous] bags, and re-sell them in the market,” a doctor at a government hospital in Lahore, who asked not to be named, told IRIN. “Who knows what illnesses are spreading because of this?” he questioned.

http://www.dailytimes.com.pk/default.asp?page=2011%5C07%5C04%5Cstory_4-7-2011_pg7_4