The prevalence is related to contaminated water, open defecation, leading to need to stick to ‘Swachch Bharat Abhiyan’, show seriousness towards improving living standards
A major healthcare burden, viral hepatitis is standing at a pedestal with HIV/AIDS, malaria and tuberculosis. Hepatitis A virus (HAV) and Hepatitis E virus (HEV) cause both sporadic infections and epidemics of acute viral hepatitis (AVH). High attack rate of HAV is found in the age group of 15-24 years followed by 5-14 years. The prevalence is related to contaminated water and open defecation, leading to the need to stick to ‘Swachch Bharat Abhiyan’ and show seriousness towards improving the living standards. If you look into diagnostics or laboratories centre, today there are about four crore people suffering from hepatitis D and 80-90 lakh people are suffering from hepatitis C in India itself.
Goverment has planned a National Action Plan for Viral Hepatitis and in 2018 launched National Viral Hepatitis Control Programme (NVHCP) under National Health Mission. “In this plan the two important things that were implemented was that we have to provide free diagnostics to people who were suspicious of having hepatitis or suffering from hepatitis that will be followed by providing free of cost drugs lifelong. Along with that whatever preventive measures needs to be taken prevents it, promote it, for vaccination of pregnant women, to making public aware of how does it spread. Action needs to be taken in primary health centre, secondary centre and tertiary centre. I am sure by 2030, the aim is to eradicate with hepatitis C and reduce other hepatitis occurrences,” said Dr Ravi Gaur, COO, Oncquest Laboratories.
Hepatitis A and E are food borne, hygienic issue or water borne. Hepatitis D and C are a major challenge and leads to chronic disease, liver failure and cancer. HEV outbreak is particularly dangerous for pregnant women leading up to acute liver failure in 10-22 per cent of the cases. In HEV, the prevalence is dependent on living standards and requires maintaining hygienic conditions in the surroundings. HAV is responsible for 10-30 per cent of acute hepatitis and 5-15 per cent of acute liver failure cases in India. And, HEV is responsible for 10-40 per cent of acute hepatitis and 15-45 per cent of acute liver failure. “Viral Hepatitis A and E are predominantly because of poor hygiene, they are basically food and water borne diseases. That’s where Swachch Bharat Abhiyaan will help as it stops open defecation as stool is the carrier of infection. People get infected from there, they don’t wash their hands properly, scavengers are exposed to solid waste, sewage lines, contaminated water. These are the major causes of hepatitis A and E,” said Dr Gaur.
On the other hand, B and C is a challenge as it comes by IV fluids, needle pricks. “During surgery if a patient has hepatitis B and then blood gets exchanged with someone else or blood transfusion happens then they will get affected. It can be transmitted sexually also. It also get transferred from pregnant mother to infant. Wear gloves, wash your hands properly maintain proper hygiene,” added Dr Gaur. People should make sure that therapeutic injections that are being administered are safe. Unsafe injections in India lead to 21 million hepatitis B (HBV) infections (32 per cent of global burden) and two million hepatitis C (HCV) infections (40 per cent of global burden).
The role of laboratory services is a very critical component of any response to control viral hepatitis. After NVHCP, there is a guideline on laboratory services that are aimed at standardisation of protocols and algorithms. “There guidelines are for safety workers, lab workers that they should be vaccinated by hepatitis B and monitored regularly so that protection is adequate. Wearing gloves and masks so that infection is not transferred from staff to patient or the other way round. One should follow these steps to avoid spreading Hepatitis,” further added Dr Gaur.
Urban people are aware and know that it can be cured. But in certain rural areas and semi-urban areas people believe that you should keep away from people suffering from hepatitis B and C. “People in rural and semi-urban areas believe that hepatitis B and C is a lifelong thing and the person is ostracised. But the fact is that it is not a lifelong thing and if proper treatment is given it can be cured. That is why all health should be confidential. If you take the adequate treatment then there is 100 per cent cure of hepatitis B, which can become chronic if proper care is not taken. Whereas hepatitis A and E are curable within 4-5 weeks if you take rest and proper medication. All the viruses require adequate rest and infection can be cured by antiviral drugs which are easily available now. Hepatitis C is not very common and Hepatitis D is very rare in India,” explained Dr Gaur
Swachh Bharat Campaign is successful..