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Health Minister Dr Laxma Reddy announces hosting of mass Hepatitis screening camps, across the state!

Mass Hepatitis Awareness and screening camps across twenty nine centers in Telangana, Andhra Pradesh and Karnataka is being organised on Sunday 19th June, 2016 with the support of Apollo Hospitals and Grace Foundation. Dr C. Laxma Reddy, Hon'ble Minister for Health & Medical, Telangana, joined by Consultant Gastroenterologist at Apollo Hospitals - Dr K. Somasekhar, Dr Naveen Polavarapu & Dr. C. Suman announced the locations at which this mega camp is being held and appealed to public to avail the opportunity.

These camps are being conducted as part of an initiative by Apollo Hospitals Group to raise awareness levels about Hepatitis virus and work towards eradicating the disease through education and screening. The locations at which these camps are being organised are:

Telangana : Apollo Hospitals at Hyderugada, Secunderbad, DRDO, Kukatpally, Manikonda, A.S.Rao Nagar and Chandanagar in Hyderabad; Apollo Reach Hospital, Railway Station Road, Karimnagar; Sri Gajanan Hospital, Sree Raghavendra Nursing Home & Jeevan Jyothi Hospital in Adilabad; Dr.Damoder Reddy Hospital, Bhainsa, Adilabad; Ashok Nursing Home, Sathupally, Khammam; Area Hospital, Jagithyal; Waddepally (Mandal), Satherla & Vavilala, Mahaboob Nagar & Sri Sai Srinivasa Nursing Home, Mahabubabad, Warangal.

Andhra Pradesh : Apollo Hospitals at Kakinada & Nellore; BGR Hospitals, Proddatur, Cuddapah; Sita Rama Nursing Home, Sakkinetipally, Amalapuram; Paruchuru Town, Guntur; Shivanta Medical Diagnostics, Kurnool; Sangamitra Hospital, Ongole; Vivek Hospital, Palasa, Srikakulam; Lions Community Hall, Vijayanagaram & Govt. High School, Payakarao Peta, Viskhapatnam.

Karnataka : Gangavathi, Raichur.

Speaking on the occasion Dr C. Laxma Reddy said, there is a great need to create awareness about diseases and their prevention. We are aggressively doing this from the Government side. This Awareness and screening drive on hepatitis will be hosted at 18 centers in Telangana and he appealed to people in the state to come forward and avail the opportunity. He said, by creating awareness in the public, they will be alert and take measures to prevent from being afflicted of diseases, as prevention and early diagnosis is easy to cure an ailment and treating disease becomes difficult at late stage. Prevalence of hepatitis is high in some pockets of the state, we are working towards creating awareness amongst the people of these areas and reduce the incidence. One of the reasons for spread of Hepatitis virus is contaminated drinking water and food, besides creating awareness on this aspect, the Government of Telangana has taken up Mission Bhagiratha to provide potable water to the people of the state. The other measures to prevent spread of Hepatitis virus being undertaken are supply of vaccination for Hepatitis 'B', all government hospitals are stocking the vaccine. Dialysis centers are being asked to restrict the usage of filters for not more than one time, the forty dialysis centers being established by Government, twelve of which are already functional, will strictly follow the rule of single usage of filters, accordingly tenders have been floated, he said. This Government is laying emphasis on awareness and prevention, currently 8000 patients are undergoing dialysis in the state due to kidney failure, if they were aware in the initial stage they wouldn't have reached the state of kidney failure. The Government is going to make an announcement regarding establishing of Cancer screening centers in all District hospitals in a week to ten days time, which will have infrastructure to screen and treat cancer patients and they need not come to M & J hospital, unless that level of care is required. We are also going to implement change of bed linen on a daily basis in Government hospitals by having different color linen for each day of the week. We have made all arrangements for the WHO and Central government initiative of polio vaccine booster dose to be injected to kids between June 20 and 26, 2016, he added.

Dr Somasekhar said, Hepatitis A & E can cause acute liver failure and Hepatitis B & C can lead to chronic liver failure. While Hepatitis A & E spread through contaminated food and water, Hepatitis B & C come through injecting of intravenous drugs, through transmission of contaminated blood and transfer from mother to child during birth. Hepatitis virus can be completely eradicated and this exercise is the first step towards that objective. Initially we need to tackle by addressing the pool of patients inflicted of the virus, who can spread it to others, this way the transmission rate will come down and generations to come will be free of the disease. Simultaneously, educate people to source blood only from safe blood banks, screen all pregnant mothers and those with hepatitis need to be treated so that the baby doesn't get the virus. Hepatitis B has a vaccine and people should get vaccinated, Hepatitis C doesn't have vaccine but can be cured with drugs to an extent of 95% to 99%. Also health workers like ANMs, paramedical staff need to be educated on Hepatitis virus for them to create awareness amongst public. He said the prevalence of Hepatitis virus is less than 1% in Hyderabad but alarmingly high in Mahaboobnagar district, which is well above the national average.

Dr Naveen Polavarapu said, the incidence of hepatitis virus in the country is 160 mn, which is 4 times of the population with HIV of 40 mn. Hepatitis can lead to liver cirrhosis and liver cancer.

Viral hepatitis, caused by hepatitis viruses A,B,C and E, still remains a major public health problem. India is prone to hepatitis B surface antigen (HBs Ag) and an estimated 40 million chronic HBV (Hepatitis B Virus) infected people, constituting approximately 11 per cent of the estimated global burden. Population prevalence of chronic HBV infection in India is around 3-4 per cent. There is a wide variation in HBsAg prevalence in different geographical regions in India. Chronic HBV infection accounts for 40-50 percent of Hepato Cellular Carcinoma (HCC) and 10-20 percent cases of cirrhosis in India.

Population prevalence of chronic HCV (Hepatitis C Virus) infection in India is around 1 percent. Prevalence of hepatitis C has been observed to be relatively higher in Andhra Pradesh & Telangana besides few other States. In addition the well known high risk groups like injecting drug users (IDUs), truckers, and attendees of sexually transmitted disease (STD) clinics, other disease conditions requiring blood products transfusion, different risk factors have been highlighted which are believed to have led to the relatively higher prevalence of the condition in particular areas. For example, history of surgery, dental treatment and unprotected sex (in Punjab), unscrupulous practices of healthcare providers in Ratia block of the Fatehabad district, Haryana, intra venous drug users (IVDU) in north-east India, cultural practices such as tattooing, traditional medicine (e.g. bloodletting), rituals among pilgrims (e.g. scarification) and body piercing (in Andhra Pradesh).
HAV and HEV are important causes of acute viral hepatitis and acute liver failure in India. A total of 315 outbreaks of viral hepatitis have been reported from 2010 to 2013 and 99 outbreaks in 2013 alone by Integrated Disease Surveillance Programme (IDSP) to National Centre for Disease Control (NCDC). HAV infection is responsible for 10-30 per cent of acute viral hepatitis and 5-15 per cent of acute liver failure (ALF) cases in India. HEV infection is responsible for 10-40 per cent of acute hepatitis and 15-45 per cent of ALF in India. Acute HEV has inordinately high mortality rate of 15 to 25 per cent in pregnant women in the third trimester.

Spread of viruses causing hepatitis has three components, an infectious source, a susceptible host and an established route of transmission. Various strategies for control of viruses causing hepatitis would include control of infectious source, immunization of the host (susceptible subjects) and interruption of all routes of transmission.

Control of infectious source can be achieved for hepatitis B and C by treating the existing subjects infected with HBV and HCV. However, the cost of treatment for chronic HBV and HCV infections is prohibitive for a large proportion of patients. There is a need to develop a mechanism to provide free drugs to needy patients, in similar lines to National AIDS Control Organization (NACO) providing free HIV drugs to patients infected with HIV, which is one of the most important ways to prevent their further transmission and needs to be implemented on priority.

For hepatitis A and E, there are no specific treatments having a bearing on the control of infectious source. However, safe water and food and awareness on public health measures need to be rapidly implemented.

The other effective strategy is to protect the susceptible host by immunization. Hepatitis B vaccination along with Hepatitis B Immunoglobulin should be administered to babies within 24 hours of birth when mother is hepatitis B infected.

Hepatitis A (HAV) is endemic in India and most of the population is infected asymptomatically in early childhood with lifelong immunity and in highly endemic countries large scale immunization efforts are not recommended.

HEV vaccine is likely to be available soon in India. Pregnant women and patients with cirrhosis would be priority groups for HEV vaccination.

Interruption of transmission of viral hepatitis can be achieved by education and increasing the awareness of the public and medical personnel; improved sanitation and safe drinking water (for HAV/HEV prevention); and emphasizing the importance of safe blood and injections.

Encouraging voluntary testing for Chronic hepatitis ( Hepatitis B and Hepatitis C) can be achieved by increasing the awareness about these viruses to the public.

With a clear plan and execution , eradication of Hepatitis ( Chronic Hepatitis) is possible in next 25 – 30 years.

We would like to do our part in spreading the awareness, Our Programmes would be

1. Emphasizing on improvement of sanitation and safe drinking water.
2. Free screening tests for Hepatitis B and Hepatitis C.
3. Free Counseling for patients with Hepatitis (Chronic Hepatitis).
4. Affordable Treatment initiatives to all patients.
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