Prevention and Control of Hepatitis

Hepatitis is a general term meaning inflammation of liver and can be caused by variety of different viruses such as Hepatitis A, B, C, D and E. Hepatitis A and E spread through fecal (sewage) contamination of food or drinking water, while B, C and D are transmitted through percutaneous or parenteral contact with infected blood, body fluids, and by sexual contact. spread through sex, blood and birth from infected mothers. Hepatitis C more particularly spread through blood transfusions and use of contaminated needles and equipments. Contaminated sharps also pose a serious risk of infection. HBV and HCV can cause acute Hepatitis followed by chronic Hepatitis, which results in severe liver diseases, such as liver cirrhosis and liver cancer.

Disease Burden

The National Hepatitis Prevalence survey by Pakistan Medical Research Council identifies (2007-80 12 Million people exposed to the Hepatitis B and C Infection in the country. Overall prevalence of HBsAg reactivity was found to be 2.5 % and Hepatitis C reactivity was 4.9%. Overall HBeAg positivity was 14.4% with 17% in Balochistan, 15.3% in Sindh, 14.1% in Punjab and 8.4% in KPK. For HCV prevalence within provinces showed 5% in Sindh, 6.7% in Punjab, 1.1. % in KPK and 1.5% in Balochistan. For HBV the figures were 2.5% in Sindh, 2.4% in Punjab, 1.3% in KPK  and 4.3% in Balochistan.

In Punjab high figures for HBV were seen in Dera Ghazi Khan (5.7%), Islamabad (5.6%), Rahim Yar Khan (4.7%) and Jhang (4.1%). The figures for HVC were very high in Vehari (13.1%), Hafizabad (12.9%), Pakpattan (10.6%)  and Bahawalnagar (10.1%).

For the prevention of Hepatitis B very effective vaccine is available globally and locally whose 3 doses produce lifelong immunity.  For Hepatitis C, globally no vaccine is available however treatment is available which is very costly and beyond the accessibility  of most of the people. Therefore preventive practices need to put in place both at individual level as well as social level.

Program Goal

The overall goal of the project is to reduce morbidity and mortality due to Hepatitis B&C

Objectives

  • To increase coverage of Hepatitis B immunization services especially of the target population sub-groups and high endemic regions of the province.
  • To improve hospital waste management, infection control and injection safety practices in public sector health facilities.
  • To improve access to quality diagnostic services and effective hepatitis B&C case management in the public sector health facilities.
  • To strengthen the existing infrastructure and support system at Provincial & District level for efficient and effective implementation of preventive program.