The Urgency to Mitigate the Spread of Hepatitis C in Pakistan Through Blood Transfusion Reform

Document Type : Perspective

Authors

1 Department of Public Administration and Policy, Rockefeller College, University at Albany, Albany, NY, USA

2 Global Institute for Health and Human Rights (GIHHR), University at Albany, Albany, NY, USA

3 Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, Albany, NY, USA

Abstract

Blood transfusions are contributing to a higher rate of hepatitis C virus (HCV) in Pakistan. Half of all blood transfusions in Pakistan are not screened for hepatitis C, hepatitis B or HIV. Family members donate blood that is likely not tested due to social stigma attached to HCV. Paid donations are also quite common in the country, especially by people who inject drugs (PWID), which increases the population’s exposure to HCV. Most of the population utilizes the private sector for their health needs; this sector has lax regulation due to the lack of oversight by the government or any other regulatory body. In addition, groups who are at most need for blood transfusions, such as hemophiliacs and those with thalassemia, have a higher rate of hepatitis C. This fact reinforces the need for blood transfusion reform in Pakistan, which includes improving oversight, upgrading infrastructure and promoting health literacy through cultural norms, according to the World Health Organization (WHO) recommendations. The lessons learned in Pakistan can be adapted to countries facing similar issues.

Keywords

Main Subjects

References

  1. Qureshi H.  Pakistan: Prevention & control of viral hepatitis. http://www.viralhepatitisaction.org/sites/default/files/AASLD%20Humas%20presentation%203%20Nov.pdf.  Accessed July 20, 2017. Published 2015.
  2. Alaei K, Sarwar M, Juan SC, Alaei A. Healthcare and the Preventable Silent Killer: The Growing Epidemic of Hepatitis C in Pakistan. Hepat Mon. 2016;16(11):e41262. doi:10.5812/hepatmon.41262
  3. 3.Rolling Stone Magazine. Nusrat Fateh Ali Khan Dead at 48. http://www.rollingstone.com/music/news/nusrat-fateh-ali-khan-dead-at-48-19970818.  Accessed July 20, 2017. Published 1997.
  4. Khan AA, Khan A. The HIV epidemic in Pakistan. J Pak Med Assoc. 2010;60(4):300-307.
  5. Ghani E, Rathore MA, Khan SA. Trends in human immunodeficiency virus seroprevalence in blood donors in northern Pakistan. Public Health. 2016;131:71-74. doi:10.1016/j.puhe.2015.10.010
  6. Bosan A, Qureshi H, Bile KM, Ahmad I, Hafiz R. A review of hepatitis viral infections in Pakistan. J Pak Med Assoc. 2010;60(12):1045-1058.
  7. Chaudhry M, Rizvi, F, Afzal M, Ashraf M, Niazi S, Beg A, & Kharal T.  Frequency of risk factors for Hepatitis B (HBV) and Hepatitis C Virus (HCV). Ann Pak Inst Med Sci. 2010;6(3):160-163.
  8. Ministry of Capital Administration & Development Government of Pakistan. National Baseline Survey Based on WHO Evaluation Framework/Tool for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan. Safe Blood Transfusion Programme. http://apps.who.int/bloodsafety/transfusion_services/PakistanMonitoringEvaluationBloodScreeningSystem.pdf. Accessed July 20, 2017. Published 2013.
  9. Amanullah A. Medical Law Regimen in Pakistan. Gomal Journal of Medical Sciences. 2011;9(1):1-2.
  10. Zaheer HA, Waheed U. Legislative reforms of the blood transfusion system in Pakistan. Transfus Med. 2014;24(2):117-119. doi:10.1111/tme.12107
  11. Zaheer HA, Waheed U. Blood safety system reforms in Pakistan. Blood Transfus. 2014;12(4):452-457. doi:10.2450/2014.0253-13
  12. World Health Organization. Blood Safety in Pakistan. http://www.emro.who.int/pak/programmes/blood-safety.html.  Accessed July 20, 2017.
  13. Jalal S, Inam ul H. Revisiting the three different tiers of the health system of Pakistan and their implications for the achievement of MDGs by Pakistan. J Pak Med Assoc. 2014;64(2):195-200.
  14. World Health Organization. Health System Strengthening. http://www.emro.who.int/pak/programmes/health-system-strengthening-hss.html.  Accessed July 20, 2017.
  15. Aslam L, Abdullah A,  Ayub R.  Analysis of Pakistan and Iran health care delivery system. International Journal of Innovative Research and Development. 2014;3(7):308-312
  16. SIAPS Program. Engaging Private Sector Pharmacies in Pakistan to Increase Early TB Case Detection. http://siapsprogram.org/wp-content/uploads/2016/03/Engaging-private-sector-pharmacies-in-Pakistan_Final.af_2.pdf.   Accessed July 20, 2017. Published 2016.
  17. Mumtaz Z, Bowen S, Mumtaz R. Meanings of blood, bleeding and blood donations in Pakistan: implications for national vs global safe blood supply policies. Health Policy Plan. 2012;27(2):147-155. doi:10.1093/heapol/czr016
  18. Ali SA, Donahue RM, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis. 2009;13(1):9-19. doi:10.1016/j.ijid.2008.06.019
  19. Ilyas M. Prevalence of hepatitis c among factory workers of Gujranwala (Punjab) Pakistan. Sci Int. 2015;27(3):47-52.
  20. Luby S, Khanani R, Zia M, et al. Evaluation of blood bank practices in Karachi, Pakistan, and the government’s response. Health Policy Plan. 2000;15(2):217-222.
  21. Saeed U, Manzoor S. Risk factors associated with transmission of hepatitis B and hepatitis C virus in Pakistan. Glob J Med Res. 2014;14(1):14-19.
  22. Altaf A, Pasha S, Vermund SH, Shah SA. A second major HIV outbreak in Larkana, Pakistan. J Pak Med Assoc. 2016;66(12):1510-1511.
  23. Zaheer HA, Waheed U. National baseline survey on monitoring and evaluation of blood screening systems in Pakistan. J Blood Disord Transfus. 2015;6(2):1-5. doi:10.4172/2155-9864.1000265
  24. Rafique I, Saqib MA, Siddiqui S, et al. Experiences of stigma among hepatitis B and C patients in Rawalpindi and Islamabad, Pakistan. East Mediterr Health J. 2015;20(12):796-803.
  25. Waheed Y, Shafi T, Safi SZ, Qadri I. Hepatitis C virus in Pakistan: a systematic review of prevalence, genotypes and risk factors. World J Gastroenterol. 2009;15(45):5647-5653.
  26. Butt AS. Epidemiology of Viral Hepatitis and Liver Diseases in Pakistan. Euroasian Journal of Hepato-Gastroenterology. 2015;5(1):43-48. doi:10.5005/jp-journals-10018-1129

Files

History

  • Receive Date: 07 April 2017
  • Revise Date: 29 September 2017
  • Accept Date: 02 October 2017
  • First Publish Date: 01 March 2018

Share

How to cite

Statistics