M.A. Jabbar :
Bangladesh, like other member-countries of the United Nations will observe World Hepatitis Day on 28 July. Hepatitis is a silent killer, which affects millions of people worldwide that causes acute and chronic liver diseases, kills and disables millions of people every year globally. The day reminds the member-states of the United Nations, policy-makers, health personnel, NGOs, socialworkers, and infact everybody of the society of individual’s responsibility about preventing hepatitis from their own positions and fields.
The World Hepatitis Alliance first launched World Hepatitis Day in 2008. The UN declared official recognition of the event in 2010. The theme of the day this year is “Prevent Hepatitis: know the risks.” By knowing the risk factors of hepatitis, one can remain free from hepatitis, work for preventing hepatitis and can contribute in building hepatitis-free environment. Therefore, the theme of the day this year is very appropriate.
Viral hepatitis status globally: According to WHO, hepatitis kills around one million people every year while millions more suffer from immediate sickness or long-term ill health. Medical experts say that hepatitis viruses A, B, C, D and E can cause acute and chronic infections and inflammations of the liver leading to cirrhosis and liver cancer. These viruses constitute a major global health risk with around 240 million people being chronically inflected with hepatitis B and around150 million people being chronically infected with hepatitis C. Globally, there are an estimated 1.4 million of cases of Hepatitis A every year. About one core of people in Bangladesh is suffering from diseases caused by hepatitis B and C viruses.
According to medical experts, hepatitis A and E are transmitted through contaminated food and water, B through unsafe blood and other bodily fluids, C mostly through infectious blood and D from infection in the presence of hepatitis B which are characterized by fatigues, loss of appetite, fever and jaundice. Medical experts further say that hepatitis A virus from food borne infection can lead to significant economic and social consequences in communities taking weeks or months for recovery from the illness to return to work, school, or daily life. The risk factors of the disease are poor sanitation, lack of safe water, injecting drugs, living in a household with an infected person, being a sexual partner of someone with acute hepatitis A infection, travelling to areas of high endemic without being immunized.
There are frequent reports in the national dailies that foods are contaminated in various ways. As such, we are vulnerable to hepatitis A and E viruses. Reports also reveal that dairy, poultry and fish feed are produced from the wastage of tannery factories, which are contaminated with heavy metals like cadmium, chromium, lead and other harmful substances. Food-grains, vegetables, fruits, fish, meat, milk, bakery products, sweetmeats, ice creams, and soft drink are adulterated. When consumed, these harmful metals enter to our body, cause hepatitis virus, and destroy our vital organs namely liver, kidney, brain, respiratory tract, and causes cancer of the body.
There is no scope to deny that adulteration of food is equivalent to silently killing people, as people are the consumers of the contaminated foods. A reference is worth quoting here of a research report titled “Insecticides in food: Bangladesh perspective” of Bangladesh Agriculture Research Institute (BARI) that found harmful level of insecticides in vegetables, shrimps, and dried fishes based on its collection of 454 sample tests from different hats of 12 districts of the country during the period from 2011 to 2014. This is just one example among such frequent reports available in the newspapers. If such circumstances go unabated and appropriate steps are not taken to avert the situation, we remain in vulnerable health risks. Government of Bangladesh has adopted a number of food safety measures for the health and welfare of people and those measures be implemented in an earnest way for the healthcare of the people. Moreover, improved sanitation and immunization are the most effective ways to combat hepatitis A. The experts are of the opinion that any food, if cleaned well by fresh water, food risk could be minimized from 60 to 80 percent and thus different diseases including hepatitis can be prevented.
Medical experts say that hepatitis B is a potentially life-threatening liver infection caused by hepatitis B virus. It is a major global health problem and can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer. Major route of transmission of hepatitis B and C is through blood and blood products, use of infected syringe and needles; shaving in barbershop etc. Vaccine against hepatitis B is available and effective for the preventing B viruses.
Drug abuses in various forms pose a big threat to public health. These threats to public health have led the international community to call for a stronger and more coordinated response, compounding this public health risk is the fact that the supply chain for medicines operates at a global level, and therefore, a concerted effort at the international level is required to effectively detect and combat drug abuse as well as supply chain. This can help combat various diseases including hepatitis.
Hepatitis ignored in MDGs: It is unfortunate that viral hepatitis was not included in the Millennium Development Goals (MDGs) of the United Nations where the control of HIV/AIDs, malaria were included among the eight development goals by 2015 among 194 United Nations member states, consequently hepatitis was seriously ignored globally. All-out efforts should be made and a comprehensive development programme and action be taken and by all concerned for the prevention, control, and treatment of viral hepatitis can help prevent hepatitis for a hepatitis-free society.
World Hepatitis Day 28 July 2015: Observance of the day is an opportunity to draw attention and take action by the policy-makers, health workers, and the public to work to prevent infection and death from hepatitis. Health Assembly delegates from 194 countries adopted a resolution in 2014 to promote global action to prevent, diagnoses, and treats viral hepatitis. Various events will take place around the world focusing on preventing hepatitis.
Hepatitis status in our Bangladesh: The incidence of different kinds of liver diseases like hepatitis, cirrhosis, and liver cancers is common in our country. From various data, it is found that about 4-7 percent of our population has hepatitis B and 1-3 percent has hepatitis C virus. Patients admitted in medical college hospital with acute hepatitis and jaundice, 43 percent were suffering from hepatitis E, 22 percent from hepatitis B and 8 percent from hepatitis A and 3% by hepatitis C virus. About 3.5 percent of pregnant women have hepatitis B viral infection. They are potential source of transmission of hepatitis B virus to their newborn. Eminent experts National Prof Dr M R Khan said that people infected with hepatitis B and C would suffer from different chronic diseases including liver cirrhosis and liver failure. Former VC of BSMMU Prof Nazrul Islam said that 85 percent possibility of transmitting hepatitis B and C virus to the newborn are from the infected mothers. Eminent expert Prof. Mobin Khan emphasized on safe blood transfusion to prevent the disease.
The ways to combat hepatitis: Setting up of hospitals and research center for the treatment and research needed for long-term management of the disease. Students may be involved; seminar, survey, workshop, and class campaign media campaign via website, facebook, twitter, newspaper, online news portal, and radio can create awareness and help prevent the diseases. Liver clinic service, e-liver service, website liver service, postal service, screening, and vaccination service, mass media service, information service like issuance of free leaflets, seminars, and discussion meetings etc. will create awareness and help combat spread of hepatitis related diseases.
Observance of hepatitis day in Bangladesh: Government of Bangladesh is taking various programme to combat hepatitis. It has always upheld the United Nations’ policies and strategies towards health programme for the health benefits of the people. Health experts say that as multiple factors are responsible for the cause and spread of liver diseases, prevention well ahead and extending facilities to patients in time may help prevent many deaths. As welfare oriented country, Bangladesh will also observe the day in a befitting manner for the health benefit of the people of the country. In our country, World Hepatitis Day is observed with special messages given by the Hon’ble President, Hon’ble Prime Minister, Hon’ble Speaker, experts, WHO DG and Regional Director and other eminent persons of the subject on special emphasis on the significance of the day. Liver Foundation of Bangladesh, Bangladesh Hepatology Society, The Liver Clinic, and other organizations observe the day to create awareness. The event includes seminar, world hepatitis day souvenir, conference, and special programme on hepatitis, distribution of T-shirts, leaflets, posters, and publication of articles in the national dailies. We have to know the risk factors of hepatitis. For that, mass awareness is necessary. Let us know the risk factors of hepatitis and work for prevention.
(M.A.Jabbar writes on health and environment issues and is executive secretary of ADHUNIK, national anti-tobacco organization of Bangladesh.)
