Hep load test takes 1/2 months at Ukl
04-Feb-2025
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By Our Staff Reporter
IMPHAL, Feb 4 : Four years after a viral Hepatitis testing and treatment centre was opened at Ukhrul in 2020, the centre is yet to serve its purpose fully.
A Hepatitis viral load test at the centre takes about a month or two and this has put a question mark on the efficacy and practicality of the National Viral Hepatitis Control Programme (NVHCP) in the hill areas of Manipur.
A hepatitis viral load test measures the amount of Hepatitis B or C virus in the blood.
Viral Hepatitis is an infection that causes liver inflammation and damage.
Several different viruses cause hepatitis, including hepatitis A, B, C, D, and E.
Hepatitis A and E viruses typically cause acute infections.
Hepatitis B, C, and D viruses can cause acute and chronic infections.
The viral Hepatitis treatment centre at the new District Hospital Ukhrul was opened in 2020 under the National Viral Hepatitis Control Programme.
The National Viral Hepatitis Control Programme (NVHCP) was launched on July 28, 2018 and it aims to combat Hepatitis and achieve countrywide elimination of Hepatitis C by 2030.
As per records from the treatment centre at Ukhrul, it has detected as many as 1,348 Hepatitis C cases out of a total 8,153 tests conducted since 2020.
The centre has given treatment to a total of 472 patients, and 389 of them have completed treatment.
A total of 138 cases have been treated successfully.
Speaking to The Sangai Express, a patient who had tested positive for Hepatitis said he had to wait 2 months for a viral load test at the centre.
"After I tested positive for Hepatitis, further registration was done at the centre for a viral load test. They called me for the test after about 2 months," said the patient.
A more robust testing and treatment mechanism would help patients get timely attention and medicines. If not, the National Viral Hepatitis Control Programme (NVHCP) is bound to fail in the district, added the patient.
Ukhrul district's NVHCP Nodal Officer, Dr Phangreichon said screening for Hepatitis and testing in the district is done 24 hours a day.
However, the Hepatitis viral load test is done only on Tuesdays, she said.
Only 10 samples are tested in a week, she said, identifying lack of staff and "Truenat" at the New District Hospital at Hungpung as the reason for the limited number of tests.
A Truenat is a kit used for quantitative estimation of Hepatitis virus load.
"Only the Old District Hospital at Kamphasom has the Truenat. Therefore, for the viral load test, the staff of the New District Hospital at Hungpung have to travel 4/5 kilometres to the Old District Hospital in passenger vehicles," Dr Phangreichon said.
Simply put, the Hepatitis testing and treatment centre is at Hungpung and the Truenat which is essential for the viral load test is at Kamphasom, which is just 4/5 kilometres away.
The Nodal Officer further said, the Hepatitis testing and treatment centre at present has only two staff including her.
After a person is tested positive for Hepatitis, he or she is registered for a scheduled viral load test. Serial-wise, 10 patients are called on every Tuesday for taking blood samples and testing (viral load), she said.
"If the centre has the Truenat, the viral load test can be done daily, improving testing and easing inconveniences being faced by patients," Dr Phangreichon said.
On treatment, the Nodal Officer said, the centre provides treatment for Hepatitis C and Hepatitis B.
The treatment for HCV (Hepatitis C Virus) has been more successful, however, the number of people requiring "a second line" of treatment has increased, she said.
A "second line" of treatment for Hepatitis C Virus (HCV) is required when the initial treatment regimen is unsuccessful in eradicating the virus in a patient.
The centre at present is providing the second line of treatment for only "uncomplicated" cases. The centre is unable to provide treatment to complicated cases, she said.
Many who are requiring a second line of treatment are unable to travel to Imphal and receive the treatment, she added.
The Nodal Officer further informed that Kamjong district still lacks the testing and treatment facility for Hepatitis and is depending on the centre at Ukhrul.
The Ukhrul centre lacks the infrastructure and manpower for swift and efficient treatment. If the Government and authorities concerned intervene and provide the required infrastructure, the centre would be able to serve the clients better, she said.
A vast majority of the people are not aware of Hepatitis. There is still a need for more awareness programmes in rural areas especially in the hill region, she added.
Apam Horam, president of DOULOS, explained the inconveniences people seeking treatment are facing.
Since the opening of the Hepatitis testing and treatment centre at Ukhrul, it has provided a number of services which were not available before. However, the centre still is lacking required infrastructure and people are facing great inconveniences, Apam said.
The limited number of testing done at the centre and the window between registration and viral load test is a worrisome problem. The virus being contagious may spread without timely attention and treatment, Apam said.
Hepatitis A may spread through contaminated food or water, or close personal contact with an infected person.
Hepatitis B may spread through blood, semen, or other bodily fluids from an infected person. This can include sexual contact, sharing needles, or during medical procedures.
Hepatitis C may spread through blood from an infected person. This can include sexual contact, sharing needles, or during medical procedures.
While the centre at Ukhrul conducts 10 viral load tests on Tuesdays normally, it does the test on other days in case of emergency, Apam said.
"We know the centre lacks staff. But if it does improve its service and required manpower is given, the centre would run smoothly. If the centre stops its service, it would be a disaster for the people of Ukhrul and Kamjong," Apam said.
Apam further explained the trouble people of Kamjong are facing in getting the treatment at the Ukhrul centre.
Patients from Kamjong and Jessami would have to spend travel fare and visit the centre for the initial test. In case they are tested positive for Hepatitis, due to lack of viral load test the same day, they have to get registered and return home. Then, after a month or two they have to return to the centre again for sample collection for the viral load test.
For this reason, people from far off places often do not return for the viral load test, Apam said.
Moreover, the centre lacks counsellors who will give awareness to patients and people who visit it for testing, he added.
"Only the Nodal Officer and a staff can't run the centre properly. The centre needs dedicated staff who can handle positive cases and care for them properly," Apam said, appealing to the Government to fill the required staff and infrastructure.
Meanwhile, National Viral Hepatitis Control Programme's State Nodal Officer, Dr Rajkumari Rosie said steps are being taken up to open a Hepatitis testing and treatment centre for Kamjong district.
Related officials have been given the training for this, she added.