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Dealing with hepatitis B and C in Punjab: Government hospitals don’t have equipment for major blood tests

* Poor patients being referred to CEMB or Shaukat Khanum where tests expensive

By Muzaffar Ali

LAHORE: Public hospitals in the city do not have Polymerase Chain Reaction (PCR) equipment to conduct quality, quantity and genotype tests for patients suffering from hepatitis B and C and other deadly viral diseases.

PCR is a biochemistry and molecular biology technique for isolating and exponentially amplifying a fragment or sequence of interest of DNA, via enzymatic replication, without using a living organism (such as E. coli or yeast).

Hospitals collect samples from hepatitis patients and send them to the Punjab University’s Centre for Excellence, Molecular Biology (CEMB), for PCR tests. These hospitals also refer patients to Shaukat Khanum Hospital where patients pay thousands of rupees for PCR tests.

The federal government started the prime minister’s programme for the prevention and control of hepatitis costing Rs 2.5 billion in 2005. Under his programme 5,000 hepatitis patients are being treated in Punjab. Shahid Pervez Khan, health education and hepatitis additional director, told Daily times that there were 5,000 registered hepatitis patients in Punjab and that the government had referred them to CEMB for quality, quantity and genotype tests.

He said CEMB preferred private patients, as they paid more, and were putting patients referred by the federal government on waiting lists. He said patients were suffering unnecessarily because of the delay in the tests.

Shahid said that even if a patient were registered in Rahim Yar Khan, he would have to come to Lahore for a test at CEMB.

He said that in a majority of cases hepatitis patients were being treated without first conducting quality, quantity and genotype tests. He said the quality, quantity and genotype tests were important because they helped monitor the condition of the virus in the body.

CEMB spokesman Imran said the centre was providing PCR tests at rates lower than private labs. He said the centre charged about Rs 1,700 for the quantity, quality and genotype categories. He said CEMB was the only centre in Punjab conducting PCR tests for hepatitis patients. He said that because of the rush of patients, a one and half month waiting period was given to hepatitis patients for the tests.

Doctor Mohiuddin, Sir Ganga Ram Hospital senior medical officer, said there were 12 million hepatitis C cases and five million hepatitis B cases in Pakistan, which meant that about 12 percent of the total population was infected. He said that under such alarming conditions, PCR technology had become the need of the hour. Dr Imran Maqsood of a private hospital said PCR equipment, which included several machines, was very expensive and each cost more than Rs 10 million. He said that in Punjab only Shaukat Khanum Hospital and CEMB conducted PCR tests and that the former charged Rs 15,000 for the tests.

Dr Kamran Malik of Lahore General Hospital (LGH) said no teaching or public hospital in the province possessed the technology. He said CEMB and Shaukat Khanum Hospital were providing the facility, but both of them did not fall under the Health Department’s jurisdiction.

Umar Baloch, LGH medical superintendent (MS), said hundreds of patients visited the hospital where they gave in their blood samples, which were sent to CEMB for PCR tests. He said the hospital did not have PCR equipment and that it had to refer the samples to CEMB.

Prof Dr Tariq Rahim of Fatima Jinnah Medical College said PCR equipment had become an essential part of teaching hospitals and was very important for medical students. He said that with access to PCR technology, students would gain experience in extracting genomic DNA from a variety of sources; choosing primer pairs needed to amplify selected genes; compose experimental and control reactions; programme the DNA thermal cycler; and analyse reaction products with agarose gel electrophoresis.

Additional secretary Sohail Saqlain said the Health Department was doing its best to provide basic facilities to all major hospitals across Punjab. He said the Punjab government had focused on improving the health sector and that it was the duty of the heads of autonomous teaching hospitals to send requisitions for such equipment to the Health Department.

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