Tuesday, October 25, 2011

Infectious Diseases in Pakistan

Diseases which are caused by bacteria, viruses, fungi and other parasites become the main causes of death, disability, as well as social and economic disruption for millions of people. Despite the safe and effective interventions, many people are unable to follow the required prevention methods and treatment. Lack in productivity, missed educational opportunities and health care of high costs caused by infectious diseases directly affect families and communities.

Infections are more common in developing countries; the main reason behind it is the presence of co-infection. The unfavorable impact of infectious diseases is found to be most severe among the poorest people. These people have the fewest resources towards integrated health care, prevention tools and medications.
According to World health Organization (WHO), Pakistan ranks eighth on the list of 22 high-burden tuberculosis (TB) countries in the world. According to the researches, in 2007, an estimated 297,108 people in Pakistan (mostly adults in their productive years) developed TB. Besides that, the emergence of multidrug-resistant (MDR) TB and TB-HIV co-infection has become a growing concern in the country.
The Ministry of Health started to implement DOTS (the internationally recommended strategy for TB control) in 1995, where Baluchistan was selected as a pilot province. Much improvement has been made during the past five years. Pakistan’s case detection rate rose from 13 percent in the year 2002 to 67 percent in the year 2007, close to WHO’s target of 70 percent. According to the researches, DOTS coverage increased in Pakistan from 44 to 99 percent, during the year 2002 to 2007.
The sudden rise in case detection and the number of cases of TB reported every year since 2000 is the basic result of countrywide efforts to enhance the involvement of private practitioners and community volunteers to identify and refer TB suspects, as well as the common public who have helped with case finding. Since 2001, when TB was declared a national emergency by the Government, progress has been steady, with the support of USAID and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Regardless of improvements, the National TB Control Program (NTCP) still has to face challenges. As TB planning shifts from the national level to the district level, technical and managerial capacities at the provincial and district levels need strengthening. Furthermore, the private region might not be fully oriented to take care of patients using the DOTS approach.

Infectious diseases can be organized into the following exposure categories. Some are basically food or waterborne diseases which are acquired through eating or drinking on the local economy.

Hepatitis A
It is a viral disease that interferes with the functioning of the liver. It spreads through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea.

Hepatitis E
It is a water-borne viral disease that interferes with the functioning of the liver. It most commonly spreads through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine.

Typhoid fever
It is a bacterial disease that spreads through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated.

Others are vectorborne diseases acquired through the bite of an infected arthropod.

It is caused by single-cell parasitic protozoa Plasmodium that is transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats.

Dengue fever
It is a mosquito-borne viral disease. It is associated with urban environments; manifests as sudden onset of fever and severe headache.

Yellow fever
It is also a mosquito-borne viral disease. Its severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever.

It is a bacterial disease that is transmitted by fleas usually linked with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in the regions of Asia, Africa, and South America associated with rural areas or small towns and villages.
In Pakistan, there is the need of working out an unusual strategy for the challenges ahead in the year 2011, as it continued to witness double burden of infectious diseases, in 2010.

According to statistics, Pakistan had been unable to control the burden of communicable diseases like tuberculosis, malaria, dengue fever, typhoid, viral hepatitis, cholera and other infections which were caused due to floods in 2010.At the same time there had been a rising trend of non-communicable diseases like heart disease, stroke, diabetes, hypertension and cancer in the country.

Experts state that though Pakistan put efforts to develop primary healthcare across the country, a lot is yet to be done. Besides that, the change in climate, which continued to endanger health and food safety were among the foremost health issues that needs to be focused. According to the experts, Pakistan needs to invest a lot on research on most valuable measures in order to protect health from climate change, particularly in vulnerable populations such as women, children and elderly in the country.

It is also believed that the economic recession has affected health and society. Trauma centers need to be developed in all major cities of the country, .However; almost no attention has yet been paid to the subject. Social inequities and injustice still kills people on a grand scale.
The important infectious diseases, which especially hit Pakistan in 2010, were ‘gastro’, ‘dengue fever’, ‘Crimean-Congo Haemorrhagic Fever’. Thousands of cases of gastro and dengue fever were reported in various cities of Pakistan. However, the provincial government has allocated little budget for prevention and control of the said infections.

The global shift from infectious diseases to non-communicable diseases was observed with heart diseases and stroke as primary killers. Besides that, the increase in cancer that is tied to an aging population and the trend was witnessed in Pakistan too.

Likewise, majority of health experts want that media campaigns should be given more attention to control the outbreak of the use of tobacco especially in youth and prevention and control of both the communicable and non-communicable diseases in the year 2011.