Post by radovic on Jan 15, 2008 14:10:52 GMT -5
Hepatitis C Cases Alarm Bosnian Doctors
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Decrease text size15 January 2008 More than a decade after the end of the Bosnian war, there are increasing concerns about a rise in Hepatitis C cases, many of them caused by medical treatment of those injured in the conflict.
By Nidzara Ahmetasevic in Sarajevo
More than 50,000 people are estimated to be infected with the Hepatitis C virus in Bosnia and Herzegovina but doctors fear that number could be much higher. They say many patients may have been subjected to unsafe practices when they received blood transfusions or other medical treatment during the 1992-95 Bosnian war.
Testing blood samples for Hepatitis C has been standard practice in most developed regions of the world since 1990. It has been routine in the Herzegovina region in southern Bosnia since 1993, but in many other parts of country, blood has only been commonly screened for Hepatitis C since the end of the war.
Experts are concerned that in many cases, blood used for transfusions was not tested for the virus.
For example, data from hospitals in the city of Zenica show that out of the 63 patients treated for Hepatitis C infections in 2003, 90% had sustained injuries during the war.
Because the virus has a long incubation period, there could be a sudden increase in cases of the disease, many years after the war ended.
In December 2007, the Ministry for Veterans in the Sarajevo canton (one of the 10 cantons that make up the Bosnian Federation, one of the two autonomous entities, along with the Serb Republic) initiated a programme allowing all residents injured during the war, to be tested for viruses.
Hajrudin Ibrahimovic, a deputy in the Sarajevo canton, told Balkan Insight that since December 20, 2007, out of 460 war veterans tested for Hepatitis C, 32 were found infected with the disease.
“In Sarajevo canton, we have more than 10,000 veterans who were treated during the war in hospitals. We would like to test all of them. The final goal is to find out how many are infected so they can be treated. Sarajevo canton's Ministry of Health will pay for the whole treatment. We are expecting a huge number of such cases”, said Ibrahimovic.
Doctor Suzana Arapcic, from the Clinical Centre University in Sarajevo also warns of a high prevalence of cases.
“I do not have exact number at the moment but I can say that we have discovered many people with this virus. Of the 16 and 17 people we are able to test per week, one or two are found to be infected', she said.
Doctor Arapcic suggests that while some of those infected were drug addicts, a high proportion of those testing positive for Hepatitis C had received wartime medical treatment.
'During the war, doctors tried hard to get everything sterilised and made safe for patients. But we are well aware that some patients were infected through blood transfusions or with unclean surgical instruments', she said.
Doctors and government ministers caution that given the nature of the virus, it is difficult to say who was infected and when.
Every person who comes for testing at Sarajevo canton's hospitals is asked about their medical history, and whether they received medical treatment during the war. But more research will need to be carried out to establish the link between infections and the war.
“We ask doctors to ask patients as many questions as is possible, and we hope that the answers could provide us with some clues. For example, let's say we have ten people infected with the virus, all of them say they were wounded during the war, in the same period of time, and they received treatment, that will give us a clearer picture”, explains Ibrahimovic.
Doctor Jelena Ravlija, from the HIV and Hepatitis Centre in Bosnia's southern city of Mostar, told Balkan Insight that a study conducted in 2006 showed that there had been an increase in Hepatitis C infections. However she added the research did not investigate a link with wartime medical treatment.
“We have to do a thorough study on this problem and to explore a possible correlation. But I have to be very honest, even then, it will be hard to establish a link”, suggests Ravlija.
The answer may lie with the Institute of Transfusions which has offices across the country. But specialists have so far refused to comment.
Research from Europe shows that most of the people who are infected with the virus do not even know they have the disease. World Health Organisation, WHO, figures from 2006 show that Hepatitis C kills around 500,000 people a year.
The organisation's office in Sarajevo claims the people most vulnerable to the disease are those who received medical treatment during the war.
The WHO together with several other organisations, is calling for initiatives like the one in Sarajevo canton, to be introduced across Bosnia, with all individuals encouraged to be screened for Hepatitis C.
But this mammoth task is compounded even further by the fact that the number of people who received wartime medical treatment, or were indeed injured in the war, remains unknown.
Email a friend
Save article
Print article
Increase text size
Decrease text size15 January 2008 More than a decade after the end of the Bosnian war, there are increasing concerns about a rise in Hepatitis C cases, many of them caused by medical treatment of those injured in the conflict.
By Nidzara Ahmetasevic in Sarajevo
More than 50,000 people are estimated to be infected with the Hepatitis C virus in Bosnia and Herzegovina but doctors fear that number could be much higher. They say many patients may have been subjected to unsafe practices when they received blood transfusions or other medical treatment during the 1992-95 Bosnian war.
Testing blood samples for Hepatitis C has been standard practice in most developed regions of the world since 1990. It has been routine in the Herzegovina region in southern Bosnia since 1993, but in many other parts of country, blood has only been commonly screened for Hepatitis C since the end of the war.
Experts are concerned that in many cases, blood used for transfusions was not tested for the virus.
For example, data from hospitals in the city of Zenica show that out of the 63 patients treated for Hepatitis C infections in 2003, 90% had sustained injuries during the war.
Because the virus has a long incubation period, there could be a sudden increase in cases of the disease, many years after the war ended.
In December 2007, the Ministry for Veterans in the Sarajevo canton (one of the 10 cantons that make up the Bosnian Federation, one of the two autonomous entities, along with the Serb Republic) initiated a programme allowing all residents injured during the war, to be tested for viruses.
Hajrudin Ibrahimovic, a deputy in the Sarajevo canton, told Balkan Insight that since December 20, 2007, out of 460 war veterans tested for Hepatitis C, 32 were found infected with the disease.
“In Sarajevo canton, we have more than 10,000 veterans who were treated during the war in hospitals. We would like to test all of them. The final goal is to find out how many are infected so they can be treated. Sarajevo canton's Ministry of Health will pay for the whole treatment. We are expecting a huge number of such cases”, said Ibrahimovic.
Doctor Suzana Arapcic, from the Clinical Centre University in Sarajevo also warns of a high prevalence of cases.
“I do not have exact number at the moment but I can say that we have discovered many people with this virus. Of the 16 and 17 people we are able to test per week, one or two are found to be infected', she said.
Doctor Arapcic suggests that while some of those infected were drug addicts, a high proportion of those testing positive for Hepatitis C had received wartime medical treatment.
'During the war, doctors tried hard to get everything sterilised and made safe for patients. But we are well aware that some patients were infected through blood transfusions or with unclean surgical instruments', she said.
Doctors and government ministers caution that given the nature of the virus, it is difficult to say who was infected and when.
Every person who comes for testing at Sarajevo canton's hospitals is asked about their medical history, and whether they received medical treatment during the war. But more research will need to be carried out to establish the link between infections and the war.
“We ask doctors to ask patients as many questions as is possible, and we hope that the answers could provide us with some clues. For example, let's say we have ten people infected with the virus, all of them say they were wounded during the war, in the same period of time, and they received treatment, that will give us a clearer picture”, explains Ibrahimovic.
Doctor Jelena Ravlija, from the HIV and Hepatitis Centre in Bosnia's southern city of Mostar, told Balkan Insight that a study conducted in 2006 showed that there had been an increase in Hepatitis C infections. However she added the research did not investigate a link with wartime medical treatment.
“We have to do a thorough study on this problem and to explore a possible correlation. But I have to be very honest, even then, it will be hard to establish a link”, suggests Ravlija.
The answer may lie with the Institute of Transfusions which has offices across the country. But specialists have so far refused to comment.
Research from Europe shows that most of the people who are infected with the virus do not even know they have the disease. World Health Organisation, WHO, figures from 2006 show that Hepatitis C kills around 500,000 people a year.
The organisation's office in Sarajevo claims the people most vulnerable to the disease are those who received medical treatment during the war.
The WHO together with several other organisations, is calling for initiatives like the one in Sarajevo canton, to be introduced across Bosnia, with all individuals encouraged to be screened for Hepatitis C.
But this mammoth task is compounded even further by the fact that the number of people who received wartime medical treatment, or were indeed injured in the war, remains unknown.