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HCV in Pakistan....US based Pakistan doctors mark Hepatitis C Day....2-8% prevalence....9 mill with HCV ....5.6 mill with HBV
Our Correspondent
Thursday, November 28, 2013
From Print Edition
THE All Pakistan-descent Physicians of North America (APPNA) is marking the Second Annual Pakistan Hepatitis C Awareness Day throughout Pakistan. According to a press release on Wednesday, Daniyal Arif, Coordinator APPNA Hepatitis C Initiative in a press statement said that in the last three months, 25,000 people have died in Pakistan due to Hepatitis B and C while the number of deaths in Punjab for the last three months is 9,000. Death toll is rising with every passing day.
It is worth mentioning that more than 10 million Pakistani population is infected with Hepatitis C. For the past many years, more than 100,000 individuals die in Pakistan due to hepatitis C annually. Only five percent are infected with Hepatitis C virus. In reality, every 1 in 10 individuals is affected by Hepatitis C. The American based Pakistani doctors under the banner of the APPNA organisation have appealed the masses to have an annual Hepatitis C checkup from public hospitals free of cost so that timely treatment can save lives. A special focus is on the preventive measures to eradicate the disease from Pakistani population.
hepatitis C virus epidemiology in Asia, Australia and Egypt........
"Pakistan has one of the highest HCV infection prevalence rates in the world......The predominance of genotype 3 and the overwhelming role IV injections play in society leaves open the possibility of continued transmission.....Pakistan has one of the highest rates of injections by providers in the world. One analysis included 3351 individuals from across the country and identified the following risk factors: reuse of needles or syringes for injections (61.45%), surgeries and dental procedures (10.62%), blood transfusion or blood products (4.26%) and other causes including razor sharing and circumcision by barbers (3.9%) (208). A separate study by the same lead author reported reuse of syringes for antibiotics, vitamins and drugs as the factor most strongly associated with HCV infection in a large study (n=6817) based in Punjab province (209). More than 50% of the cases were acquired in hospitals, pointing to nosocomial infections as the primary source of transmission. Additionally, there was the possibility that public shaving in the male population was a significant transmission route. A large proportion of cases were identified as sporadic, or because of unidentified sources of contamination (209).".......A meta-analysis which pooled data from 132 published studies from 1992 to 2008 found prevalence of 3% among blood donors and 4.7% in the general population.....Prevalence among blood donors ranged from 0.5 to 8.9%. The largest blood donor study with a sample size of 103 858 was published in 2002 and showed an overall prevalence of 4%.....A 2008 review reported the countrywide prevalence estimate between 2.4 and 6.5%......Genotype distribution information was derived from three studies, which agreed that genotype 3 is the most prevalent genotype (208, 225, 245). The largest study included 3351 individuals from across the county and found the following genotypes: 1 [11.5% with 1a (8.3%) and 1b (3.0%)], 2 [8.4% with 2a (7.5%) and 2b (0.8%)], 3 [67.5% with 3a (49.1%) and 3b (17.7%)] (208). The smaller studies estimate genotype 3 at higher rates of 81.0-86.7% (225, 245), potentially because of the sampling. Similarly, however, genotype 1 was the next most prevalent, showing near agreement among all studies.
A review of hepatitis viral infections in Pakistan......http://www.natap.org/2012/HCV/050812_01.htm......"The HBV prevalence in general population ranged from 1.1-11.9% and the figures for HCV ranged from 2-13.5%"........."Sexual transmission of HCV was checked in few studies to see inter spousal transmission of the disease (Table-15)."......."The prevalence of HCV in Pakistan is 4-6%3 while a community based study in Hafizabad; Punjab revealed the figure to be 6.5%"......The most common routes of transmission of HCV in developed countries include intravenous drug use, blood transfusions, haemodialysis, needle-stick injuries, tattooing, sexual intercourse and peri-natal infections. In developing countries, therapeutic injections from reused needles and syringes and improper sterilization of invasive medical devices is the major vehicle for transmission of blood borne organisms including hepatitis B virus (HBV), HCV and HIV.7 Overuse and unsafe injection practices cause an estimated 8 to 16 million Hepatitis B virus infections, 2 to 5 million Hepatitis C virus infections and 80,000 to 160,000 HIV infections globally.....Pakistan's estimated population in 2011 is over 187 million making it the world's sixth most-populous country, behind Brazil and ahead of Bangladesh. During 1950-2011, Pakistan's urban population expanded over sevenfold, while the total population increased by over fourfold. The population growth rate now stands at 1.6%"
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