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.
Estimate suggests that about 15.6 per cent 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, according to Pakistan Medical Association (PMA). Last year, the prevalence of hepatitis was just over 11 per cent, but it is increasing at an alarming speed.
A study by [the World Health Organization] revealed that 30 per cent of the cases of hepatitis B and C is because of reuse of syringes by unqualified medical practitioners. Unqualified doctors used the same syringe to inject several patients, to save money. No data were available from WHO about hepatitis levels in Pakistan. Nor does the government's health department have this information because of inadequate data collection.
Unqualified doctors, who can run health clinics by bribing health officials also used substandard and unsterilised syringes. 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. Safe Blood Transfusion Ordinance, introduced in 2002, has not yet been fully implemented, PMA sources said.
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's guidelines. It also says that the blood banks should posses equipment 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.
The ordinance was still deficient and called for inclusion of malaria and typhoid in it. A state-run campaign aimed at raising the level of awareness about preventive measures," is already under way. However, this campaign is not going to make any difference because the Pakistan Medical Association isn't involved in it, aver experts.
An institute of hepatology was being set up in Islamabad to raise health workers' awareness about hepatitis and prevention of the disorder. It is due to the campaign that people are getting vaccinated against hepatitis, but it will take time to deliver desired results because of Pakistan's illiteracy rate.
- BMJ