Imphal: Manipur a porous State situated along the Indo Myanmar border once known as The Golden Triangle, is now popularly known as the Death Triangle as all sorts of drugs are available in the State at an alarming stage and consequently the State has witnessed a sharp increase in the number of Injecting Drug Users (IDUs) creating a huge challenge to the health sector of the State.
Injecting Drug Users usually face various health issues including contraction of HIV and viral hepatitis and many others. Awareness on HIV has been widespread and preventive measures have been taken up at various levels. However, the general public is not sensitised enough on viral hepatitis and are not aware of their status.
Hepatitis B which is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV), is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. However, it can happen through sexual contact, sharing needles, syringes, or other drug-injection equipment, or during pregnancy or delivery. The route of transmission of viral hepatitis B is somewhat similar to HIV and is co-infectious.
Talking exclusively to The Morning Bell, Nodal Officer of National Viral Hepatitis Control Program (NVHCP), Dr RK Rosie stated that National Viral Hepatitis Control Program (NVHCP) is a new program launch in 2018 but it was implemented in the State in 2019, with an aim to combat viral hepatitis by 2030. She regretted the lack of collection of data and monitoring of data for viral hepatitis in the State started recently. Moreover, the number of people coming out to test for viral hepatitis is low, she added.
Conveying that the State has a high number of Hep C as compared to Hep B as there is a high number of IDUs, she said that India has 6-12 million Hep C infected persons while the number of Hep B is soaring to 40 million. The Northeast States and Punjab also have a high number of Hep C as compared to other States, she said.
She pointed out that health risking behaviour include sharing of needles, unprotected sex with an infected person and is mostly transmitted through blood related activities and high risk groups include IDUs, MSMs, FSWs and persons undergoing dialysis and advised to undergo viral load testing every six months to check their viral hepatitis status.
She highlighted that vertical transmission from a mother to child is one of the most common routes of transmission and if proper care is not taken the child may also get infected with viral hep B. She noted that 95 out of 100 children who are prone to Hep B are likely to develop chronic Hep B.
As a preventive measure to combat transmission from mother to child, it has been made compulsory for pregnant mothers to get tested for Hep B and as an intervention Hep B birth dose which is also called zero dose is given to the newborn child within 24 hours of birth. She also mentioned that Hep B vaccination has been included in routine immunisation since 2011, she elaborated.
Rosie asserted that viral Hepatitis does not show signs and symptoms at the early stage and often shows at later stages which often becomes chronic. She urged the people who have suspicion to get tested and start treatment at the earliest as early testing and treatment is the only way to combat viral hepatitis. She also urged the people to come out and get tested to know their status and get vaccinated to combat viral Hepatitis B.
She lamented that people often question the lack of awareness on viral hepatitis and often compares it to HIV but the fact is that the program for HIV/AIDs awareness was taken up at mass level as the number of lives claimed was huge in number and the stigma discrimination was also very high with no treatment methods.
Mass awareness has been widespread and people have become more aware of HIV. However, NVHCP is a new program and the full functioning of NVHCP was hindered for almost two to three years by the Covid pandemic. However, the department has been taking up various steps to meet the target set by NVHCP, she added.
Recalling that in the past there were only two modal treatment centres where viral load testing took place, she said that people from different districts faced huge problems in testing at the model treatment centres but now the problems will be eased as viral load testing facility has been launched in various district hospitals and health centres having proper infrastructure in Jiribam, Chandel, Thoubal, Ukhrul, Churachandpur and Tamenglong for Hep B and C. The same facility will also be made available soon in Bishnupur, Senapati and Moreh. Proper training will also be given to the staff, she added.
She also debunked the myth that “Hepatitis spread through sweat’, urging the people to understand the transmission route of Hep B instead of meting out stigma discrimination to those undergoing treatment for viral Hep B. She appealed to the people to get rid of myths and stop creating stigma discrimination among the people undergoing treatment for Hep B.
When asked whether the NVHCP will be able to combat viral Hepatitis by 2030, she replied that the department is trying its best to combat the disease but they are determined to meet the set target. She said that the program has been taken up in phase manner and with the existing manpower; the department will try to provide the facility to maximum people in the State.
Further appealing to the people to get tested for viral Hepatitis B and seek treatment at free of cost, said that vaccination is free for health care workers and high risk groups; however, vaccination is still not made free for the public but having said that everyone should get vaccinated without delay.