Around 12 million people in Pakistan are suffering from hepatitis B and C, with Balochistan topping the list followed by Punjab, Sindh and Khyber Pakhtunkhwa. Pakistan has the highest therapeutic use of injections worldwide and researchers in the country have found that the increasing incidence of hepatitis, especially hepatitis C, is directly related to the higher use of injections and reuse of syringes.
The research published two years ago was the first national population-based study on hepatitis.As per findings of the previous studies largely based on hospital and clinical data, 16 million people in the country were suffering from hepatitis B and C. Over 300 local and international papers have been published on the subject and most of them are based on hospital or clinical data. The hospital data usually shows a higher rate of disease prevalence. The study showed that 7.4 per cent (11.84 million) population in the country was suffering from hepatitis (hepatitis B 2.5pc) and (hepatitis C 4.9pc).The prevalence of hepatitis B was found to be: Balochistan (4.3pc), Sindh (2.5), Punjab (2.4pc) and Khyber Pakhtunkhwa (1.3pc).The prevalence of hepatitis C: Sindh (5pc), Punjab (6.7pc), Balochistan (1.5pc) and Khyber Pakhtunkhwa (1.1pc).
The high risk districts for hepatitis B: Musakhel (14.7pc), Khairpur (6.3pc), Ghotki (5.9pc), D.G. Khan (5.7pc), Islamabad (5.6pc) and Upper Dir (5pc).The high risk districts for hepatitis C: Vehari (13.1pc), Hafizabad (12.9pc), Ghotki (12.7pc), Hangu (6.4pc), Musakhel (5.3pc) and Jaffarabad (5.2pc).About 7,000 households were visited in the study and the average number of individuals found in each household was 6.7pc.
It wasn’t an easy task as to go to every district of the four provinces. People were tested on the spot and handed over the reports. The positive cases were referred to the nearest government health facility.The teams visited the areas faced no problems accessing people in militancy-hit areas, including that of Balochistan. “In fact, people were very supportive when they were informed about the survey’s objectives.
One major factor contributing to the spread of infectious diseases, especially hepatitis, was a high use of injections and reuse of syringes in Pakistan.The World Health Organisation allows 3.5 injections per person per year. However, the therapeutic use of injections in Pakistan is very high –13.6 injections per person per year.The higher use of injections makes a person vulnerable to infection. This vulnerability further increased with the reuse of syringes.
Other risk factors for hepatitis,included needles, drips,multi-dose injection vials, improperly sterilised invasive medical devices such as thermometers, tongue depressors and surgical and dental equipment, unscreened blood transfusions, communal shaving and unsafe sex.
Balochistan,had the highest (4.3pc) prevalence rate for hepatitis B which was almost double of the national figures (2.5pc). Though the incidence of hepatitis B was falling due to vaccination, hepatitis was still within the previous range. The breakdown of provinces showed higher incidence of hepatitis C in Sindh and Punjab.
More active vaccination against hepatitis B was required, especially in high prevalence districts of Balochistan.For that the government needs to take help from all organisations, all stake holders including security forces in campaigns advocating judicious use of injections should also be launched.