KARACHI: The prevalence of hepatitis C virus has increased in Sindh with several districts showing an alarming rise in the number of cases, with unsafe blood transfusion, poor infection control and unsterilised injections still standing out as major risk factors for the infection.

This was stated in a survey whose findings were recently shared in an official meeting, which was attended by provincial health minister Dr Azra Fazal Pechuho, health secretary Zulfiqar Shah, director general-health Dr Juman Bahoto, World Health Organisation representative Dr Palitha Gunarathna Mahipala and others.

The survey, presented by Dr Huma Qureshi, national focal point for hepatitis in Pakistan, was jointly conducted by the provincial health department and WHO-Pakistan from Nov 2019 till June 2020.

It gathered data from 1,153 households in 29 districts and screened more than 6,000 individuals for hepatitis B, hepatitis C and HIV.

Data gathered from 1,153 households in 29 districts; over 6,000 screened for hepatitis B, C, HIV

The survey showed that while the prevalence of hepatitis B virus had reduced from 2.5 per cent to one per cent over a decade, excluding one district, the cases of hepatitis C had increased from 5pc to 6.1pc with some districts showing very high prevalence.

A comparative analysis of 2008-2019 data of 12 districts showed that Sukkur was the only district where prevalence of hepatitis B had increased from 1.4pc to 4.6pc.

There was an overall increase in the prevalence of hepatitis C in Sindh in the same period with districts of Sanghar, Mirpurkhas, Shikarpur, Jacobabad, Khaipur, Sukkur and Thatta showing a very high prevalence.

Hepatitis was found to be more prevalent in men than women. In women, the hepatitis virus was often detected after marriage.

According to the survey, there are two million cases which need testing and treatment in the province. Sindh has been treating an average of 72,000 cases per year and needs to scale up treatment and treat 200,000 hepatitis C cases each year to achieve elimination by 2030.

The survey suggests that the only way to reach elimination of the hepatitis B virus is to increase coverage of its vaccination and administer a birth dose at the time of delivery. It’s the most efficient means to ensure that the incidents of adults with hepatitis are constantly on the decline.

“This is the only way to combat hepatitis B and the hepatitis D viruses in Pakistan. The hepatitis B birth dose should be available at all delivery units and with lady health workers. Electronic medical data reporting must be introduced at all levels,” it suggests.

It also recommends mass screening for hepatitis C and mass care for affected patients to manage the epidemic.

“All district focal persons should work on controlling the risk factors of infection and report their actions and success on the dashboard,” it says.

Published in Dawn, June 20th, 2022