Pakistan medical association warns of potential rise in hepatitis
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《英国医生杂志》
Doctors in Pakistan are increasingly concerned that the reuse of syringes and use of unscreened blood products could fuel a rise in cases of hepatitis.
揙ur rough estimate suggests that about 15.6% of the population are carriers of hepatitis. About three million, who visited public sector hospitals have hepatitis B or C. The number might be catastrophic if the entire population was screened,?said Dr Umar Ayub Khan, president of the Pakistan Medical Association.
Last year, according to the association抯 data, the prevalence of hepatitis was just over 11%, but it is increasing at an alarming speed, said Dr Khan.
揂 study by revealed that 30% of the cases of hepatitis B and C is because of reuse of syringes by unqualified medical practitioners,?said WHO抯 operation medical officer, Dr Saeed Akbar.
Dr Akbar said that unqualified doctors used the same syringe to inject several patients, to save money.
He added that no data were available from WHO about hepatitis levels in Pakistan. Nor does the government抯 health department have this information because of inadequate data collection.
揟ransfusion of unscreened blood at official blood banks is also a reason for the spread of hepatitis,?said Dr Khan.
Unqualified doctors, who can run health clinics by bribing health officials also used substandard and unsterilised syringes, he said, adding that effective legislation on over use and unsafe use of injections is important. Patients go to unqualified doctors because the qualified ones charge a high fee, which many could not afford.
Dr Khan said that the locally manufactured substandard syringes used by the non-qualified doctors, especially in rural areas, are cheap, and 10 can be bought for the price of one high quality syringe.
He said the Safe Blood Transfusion Ordinance, introduced in 2002, has not yet been fully implemented.
The ordinance says that a five member Safe Blood Authority should be established under the director general health services to ensure that the blood banks are managed by qualified people and ensure biosafety measures in line with WHO抯 guidelines.
It also says that the blood banks should posses equipments for haemoglobin estimation, blood grouping, cross matching, antibody detection, and screening of infectious agents, including HIV and hepatitis. However, the authority has yet to be set up.
揟hree months ago, the chief editor of the Journal of Pakistan Medical Association, Dr Sarwar Jehan Zuberi, died after a blood transfusion at one of the leading hospitals in Karachi because the blood she received contained Plasmodium falciparum, which resulted in her developing malaria,?said Dr Khan.
He said that the ordinance was still deficient and called for inclusion of malaria and typhoid in it.
揥e want a state-run campaign aimed at raising the level of awareness about preventive measures,?he says. 揟he campaign already under way is not going to make any difference because the Pakistan Medical Association isn抰 involved in it.?
The health minister, Inayatullah Khan, said the government had launched an awareness campaign a year ago about preventive measures against hepatitis.
He said that an institute of hepatology was being set up in Islamabad to raise health workers?awareness about hepatitis and prevention of the disorder. 揑t is due to the campaign that people are getting vaccinated against hepatitis, but it will take time to deliver desired results because of Pakistan抯 illiteracy rate,?he said.(Peshawar Ashfaq Yusufzai)
揙ur rough estimate suggests that about 15.6% of the population are carriers of hepatitis. About three million, who visited public sector hospitals have hepatitis B or C. The number might be catastrophic if the entire population was screened,?said Dr Umar Ayub Khan, president of the Pakistan Medical Association.
Last year, according to the association抯 data, the prevalence of hepatitis was just over 11%, but it is increasing at an alarming speed, said Dr Khan.
揂 study by revealed that 30% of the cases of hepatitis B and C is because of reuse of syringes by unqualified medical practitioners,?said WHO抯 operation medical officer, Dr Saeed Akbar.
Dr Akbar said that unqualified doctors used the same syringe to inject several patients, to save money.
He added that no data were available from WHO about hepatitis levels in Pakistan. Nor does the government抯 health department have this information because of inadequate data collection.
揟ransfusion of unscreened blood at official blood banks is also a reason for the spread of hepatitis,?said Dr Khan.
Unqualified doctors, who can run health clinics by bribing health officials also used substandard and unsterilised syringes, he said, adding that effective legislation on over use and unsafe use of injections is important. Patients go to unqualified doctors because the qualified ones charge a high fee, which many could not afford.
Dr Khan said that the locally manufactured substandard syringes used by the non-qualified doctors, especially in rural areas, are cheap, and 10 can be bought for the price of one high quality syringe.
He said the Safe Blood Transfusion Ordinance, introduced in 2002, has not yet been fully implemented.
The ordinance says that a five member Safe Blood Authority should be established under the director general health services to ensure that the blood banks are managed by qualified people and ensure biosafety measures in line with WHO抯 guidelines.
It also says that the blood banks should posses equipments for haemoglobin estimation, blood grouping, cross matching, antibody detection, and screening of infectious agents, including HIV and hepatitis. However, the authority has yet to be set up.
揟hree months ago, the chief editor of the Journal of Pakistan Medical Association, Dr Sarwar Jehan Zuberi, died after a blood transfusion at one of the leading hospitals in Karachi because the blood she received contained Plasmodium falciparum, which resulted in her developing malaria,?said Dr Khan.
He said that the ordinance was still deficient and called for inclusion of malaria and typhoid in it.
揥e want a state-run campaign aimed at raising the level of awareness about preventive measures,?he says. 揟he campaign already under way is not going to make any difference because the Pakistan Medical Association isn抰 involved in it.?
The health minister, Inayatullah Khan, said the government had launched an awareness campaign a year ago about preventive measures against hepatitis.
He said that an institute of hepatology was being set up in Islamabad to raise health workers?awareness about hepatitis and prevention of the disorder. 揑t is due to the campaign that people are getting vaccinated against hepatitis, but it will take time to deliver desired results because of Pakistan抯 illiteracy rate,?he said.(Peshawar Ashfaq Yusufzai)