Appraisal of National Response to Chronic Hepatitis in Pakistan

Chronic hepatitis has emerged as a grave health crisis in Pakistan that is becoming increasingly difficult to control. The national response in the public and private sector is lacking realism, direction and strategy. The aim of the present review was to analyze the efforts directed towards elimination of this menace, outline the challenges and make pragmatic recommendations. We searched PubMed, Google Scholar and Google web search for relevant indexed literature in English using the Mesh terms ‘Chronic Hepatitis’, ‘Pakistan’, ‘Hepatitis B’, ‘Hepatitis C’, ‘Hepatitis prevention’, ‘National hepatitis control’, etc. Rigorous efforts to improve the capacity of the primary healthcare establishments are pivotal to contain further spread of hepatitis B and C infections. Combating quackery, regulating the use of medical sharps and making affordable hepatitis treatment accessible to the masses should be the principal focus of the government. Healthcare delivery units should be equipped to render complete coverage of essential quality hepatitis services in order to curb this menace

Severe Monkeypox in Hospitalized Patients - United States, August 10-October 10, 2022.

As of October 21, 2022, a total of 27,884 monkeypox cases (confirmed and probable) have been reported in the United States.§ Gay, bisexual, and other men who have sex with men have constituted a majority of cases, and persons with HIV infection and those from racial and ethnic minority groups have been disproportionately affected (1,2). During previous monkeypox outbreaks, severe manifestations of disease and poor outcomes have been reported among persons with HIV infection, particularly those with AIDS (3-5). This report summarizes findings from CDC clinical consultations provided for 57 patients aged ≥18 years who were hospitalized with severe manifestations of monkeypox¶ during August 10-October 10, 2022, and highlights three clinically representative cases. Overall, 47 (82%) patients had HIV infection, four (9%) of whom were receiving antiretroviral therapy (ART) before monkeypox diagnosis. Most patients were male (95%) and 68% were non-Hispanic Black (Black). Overall, 17 (30%) patients received intensive care unit (ICU)-level care, and 12 (21%) have died. As of this report, monkeypox was a cause of death or contributing factor in five of these deaths; six deaths remain under investigation to determine whether monkeypox was a causal or contributing factor; and in one death, monkeypox was not a cause or contributing factor.** Health care providers and public health professionals should be aware that severe morbidity and mortality associated with monkeypox have been observed during the current outbreak in the United States (6,7), particularly among highly immunocompromised persons. Providers should test all sexually active patients with suspected monkeypox for HIV at the time of monkeypox testing unless a patient is already known to have HIV infection. Providers should consider early commencement and extended duration of monkeypox-directed therapy†† in highly immunocompromised patients with suspected or laboratory-diagnosed monkeypox.§§ Engaging all persons with HIV in sustained care remains a critical public health priority