Around 10 million people in the country have hepatitis, but 9 million of them are not even aware that they have this ailment. It is important to identify these persons in order to bring hepatitis under control. And hepatitis must be eliminated in order to meet the Sustainable Development Goals (SDG) by 2030. It is important to initiate free tests to detect hepatitis cases. It is also important for the government as well as quarters related to public health to immediately prepare a hepatitis prevention strategy paper.
These observations were made on Monday at a virtual roundtable on ‘Eliminating hepatitis by finding the missing millions’. The roundtable was oganised by Prothom Alo and the Hepatology Society, Dhaka, Bangladesh.
Today, 28 July, marks World Hepatitis Day. The virtual meeting was held to observe the day. The theme of Hepatitis Day this year is ‘Find the Missing Millions’ to eliminate hepatitis.
The meeting was presided over by the founder chairman of Bangabandhu Sheikh Mujibur Rahman Medical University (BSMMU)’s hepatology department and president of the hepatology society, Professor Mobin Khan. Professor Khan said that nine out ten persons in the world were not aware that they were afflicted by the hepatitis virus. It was imperative to find these persons in order to eliminate hepatitis. There is a crisis of physicians for treatment of ailments in the country. Government and non-government quarters must make integrated efforts against hepatitis.
Former vice chancellor of BSMMU, virologist Professor Nazrul Islam said presently there existed Hepatitis A, B, C and D and it is thought that there were more hepatitis viruses in existence. Hepatitis D cannot be propagated without the presence of Hepatitis B in the liver cells. However, Hepatitis D can make Hepatitis B extremely dangerous.
General secretary of the Hepatology Society, Md Shahinul Alam, said there are only 100 liver specialists in the country for around 50 million liver patients. Tests for hepatitis should be taken during pregnancy, before surgeries, dialysis and also before transfusion of blood or blood substances. Infants must be administered Hepatitis B vaccines immediately after birth.
Former adviser (South East Asia) to the World Health Organisation, Professor Muzaherul Huq, said people’s participation must be ensured otherwise hepatitis cannot be eliminated. The government and public health experts together must draw up a strategy paper to eliminate it. And hepatitis vaccines must be made more affordable.
Senior director of icddr,b Professor Tahmeed Ahmed said Hepatitis B vaccines have been given since 2004 through the Expanded Programme of Immunisation (EPI). Those who did not receive this vaccine, that is, those over the age of 16 or 17, are more at risk. The elimination of hepatitis is included in 17 of the SDGs. Specific planning is required to achieve this target.
The roundtable began with an opening presentation by Prothom Alo associate editor Abdul Quayum.
The Hepatology Society’s secretary of scientific affairs, Md Golam Azam, said that hepatitis or liver diseases in the country were mostly spread by virus. Hepatitis can also be caused by drinking alcohol. However, Hepatitis B and C virus can be brought under control though public awareness and vaccines.
Head of the gynaecology department at Ibrahim Medical College and BIRDEM Hospital, Professor Ferdousi Begum, said that in 90 percent of the cases, an expectant mother can transfer the Hepatitis virus to the newborn. She said it is important to keep expectant mothers safe in order to eliminate hepatitis. There is a lack of public awareness concerning hepatitis.
Liver specialist Md Saiful Islam said that in most cases Hepatitis B was responsible for acute and chronic hepatitis, liver cirrhosis and liver cancer. In 2007, around 7 percent of the country’s population was affected by hepatitis. That has now dwindled to half.
Associate professor of BSMMU’s department of hepatology, Golam Mustafa, said that the condition of a hepatitis patient depends on the patient’s age. In the case of children, the disease is mostly cured. However, 85 percent of those affected with Hepatitis C suffer from long-term liver ailments.
Liver disease consultant Motahar Hossain said the treatment of a large number of Hepatitis B and C patients starts and ends with primary healthcare givers. That is why it is not possible to eliminate hepatitis without the awareness and participation of primary healthcare givers. An integrated training programme is essential to include them in the treatment of Hepatitis B and C.
Vice president of the Hepatology Society, Prof Md Abu Sayeed, 80 to 85 percent of the Hepatitis B positive patients do not need treatment. Medication is only required in the case of liver disease. Many pharmaceutical companies in the country now produce oral tablets for Hepatitis B.
Assistant registrar(medicine) of Kurmitola General Hospital, Tanvir Ahmad, said unless the unidentified hepatitis patients are detected, very year millions of people will be infected by them. Those with liver complications are more at risk if they contract COVID-19.
Prothom Alo’s joint editor Mizanur Rahman Khan said that stress must be laid on health communication in order to eliminate hepatitis. Hepatitis causes long term suffering. Mainstream media must come forward to mobilise public awareness about hepatitis.
Assistant professor of Kishoreganj’s Shaheed Syed Nazrul Islam Medical College, SKM Nazmul Hasan, said hepatitis detection tests must be done for free. This must be taken to the grassroots and remote areas. The number of immunised children has increased manifold over the past 17 years after the hepatitis vaccine was included in the EPI.
The virtual roundtable was moderated by Prothom Alo assistant editor Firoz Choudhury.