4 Pakistanis die of Hepatitis every single hour: Dr Nusrat Shah

KARACHI: In every 16th minute, a Pakistani dies of hepatitis and in every 31st minute, a woman loses her life during childbirth. These lives can be saved as these diseases are treatable. These precious lives are slipping through our hands like sand. We are helpless.   

Prof Nusrat Shah, Pro-Vice Chancellor, Dow University of Health Sciences, shared her views while addressing the seminar organized concerning World Hepatitis Day at Muin Auditorium of Dow Medical College as a chief guest. 

The Pakistan Society of Gastroenterology organized the seminar in collaboration with World Gastroenterology Organization. Prof Saad Khalid Niaz and Prof Khalid Mahmood acted as session chairs in the seminar. At the same time, Prof Amanullah Abbasi, Prof Bader Faiyaz Zuberi, Dr Huma Qureshi, Dr Sajjad Jameel, Dr Abdul Qadir Memon, and Dr Majid presented their papers. 

While Addressing the seminar, Prof Nusrat Shah said that these tragedies are occurring silently in our society, every day, 50 women die during childbirth, and around 96 people die silently due to various types of hepatitis. There is neither any news nor government institutions paying attention to it. We are going behind our neighbouring countries, India, Iran and Bangladesh, and we have to think about it and do something. We are counted among the underdeveloped countries of Africa. 

Speaking to the audience, Dr Sajjad Jameel said that according to the World Health Organization's estimates, 100,000 people die from hepatitis A and 60,000 people from hepatitis E. The death rate is much higher in pregnant women. Hepatitis A accounts for 50 to 60% of acute viral hepatitis in children of Pakistan. 

Attributed to early exposure, almost 96% of individuals are found to be exposed to Hepatitis A by the age of 5 years. On the other hand, Hepatitis A leads to acute hepatitis in 3.5 to 4% of adults and approximately 98 to 100% of adults are exposed to Hepatitis A in adulthood. 

Hepatitis A is common in young adults. Symptoms of hepatitis A include fever, jaundice, indigestion, severe yellow urine, weakness, vomiting, right-sided abdominal pain, nausea, and dizziness. 

Regarding the ways to prevent hepatitis, he said vaccinations, eating fruits and vegetables after washing, eating well-cooked food, using medicines according to the doctor's instructions, and using washed dishes are included. He further said that giving children six times vaccination till the age of 15 months can protect them from 10 deadly diseases. 

The overall mortality rate due to acute hepatitis E ranges from 0.4 to 4.0%; however, the mortality rate gets much higher in the presence of pregnancy (16-33%) and the case of acute liver failure with HEV in the presence of chronic liver disease. The spread of Hepatitis E is intensifying in Pakistan due to dirty sewage water. 

According to a survey, Sindh, especially Karachi, Hyderabad, Larkana, Sukkur, and Mirpurkhas, are most at risk of hepatitis A and E due to dirty and contaminated water supply. 

Dr Huma Qureshi said that China is among the most affected countries by hepatitis C.  Pakistan is listed as the second most affected country. According to a 2019 report, the risk of getting hepatitis C from blood transfusions is the highest, with a rate of 14.8 per cent. Second place includes syringe or injection use, hospital history, dental treatment, surgical history etc. According to a recent survey of 2020, 164000 new cases of hepatitis C were reported in Pakistan. Eradication of hepatitis C appears impossible at the current rate. 

Prof Bader Faiyaz Zuberi said WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year. According to the above data, 820 thousand deaths occurred as a result of Hepatitis B in 2019. Most of the deaths were due to cirrhosis and hepatocellular carcinoma.   

He said that family history also plays an important role in its spread. Family history should not be ignored during the assessment of the patient. Globally, an estimated 51 million people have chronic hepatitis C infection, with approximately half a million new infections occurring yearly, including an estimated 3.2 million adolescents and children with chronic hepatitis C infection.   

Dr Abdul Qadir Memon said that in combination with the hepatitis B virus, hepatitis D has the highest fatality rate of all hepatitis infections, at 20%. It is the highest among all types. Forty-eight million people are suffering from this virus. Unfortunately, there are challenges in treating hepatitis delta. Hepatitis delta has remained a neglected disease in the past decades mainly due to the lack of an effective and widely applicable antiviral treatment.