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Manpower Deficit Threatening Efforts To Eradicate Hepatitis B



Eradication of the deadly viral disease, Hepatitis B, may not be feasible in Nigeria in the near future as inadequate manpower remains a challenge in the health sector, PATIENCE IVIE IHEJIRIIKA writes.

Lack of adequate manpower in the health sector places the lives of about 20 million Nigerians who are estimated to have contracted Hepatitis B Virus (HBV) at risk of dying.
This is because Hepatitis B patients go through vigorous processes and queue for about three months before they are able to secure an appointment with a physician.
According to a recent report, Nigeria is one of the countries with the highest cases of hepatitis B, with a prevalence of 10-15 per cent.
The report revealed that HBV is the commonest cause of chronic liver disease in the country with many people being at risk of contracting it, as it emphasised the urgent need for vaccination of the entire population.
The United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) had estimated that only 41 per cent of Nigerians were vaccinated against HBV in 2013.
The former President of the Nigeria Medical Association (NMA), Prof. Mike Ogirima, submitted that there are no enough gastroenterologists in the country.

He regretted that there are just about 100 of them in Nigeria, a county with about 200 million population, whereas the World Health Organisation (WHO) recommended one doctor to 600 people.
“We have the physicians we call gastroenterologists, under that, we have the hepatologists; people who take care of the liver.
“In Nigeria, we have one doctor to 2000 population. Gastroenterologists may not be more than hundred. WHO recommended that there should be one doctor to 600 people not patients but we have one doctor to 2000 patients in Nigeria, so where are we going to get many herpetologists or gastroenterologists together,” he lamented.
Speaking on the plight of patients, Prof. Ogiri blamed inadequate manpower for the delay involved in appointment, saying “if you have hepatitis in Abuja, for you to get a treatment, you have to queue.”
He however noted that the situation is not restricted to Nigeria, adding that the referral system is even more vigorous in some other countries.

“It is even better in Abuja, the referral system in the UK; if you want an elective consultation, not emergency, it takes 13 weeks, you can’t just work in and see your specialists, you must see the family physicians, they are what we call the general practitioners who will treat you and put an appointment with the specialist and base on the appointments the specialists has in his diary, he can give you an appointment date,” he explained.
Speaking on the way forward, Ogirima tasked government on more trainings and establishment of more medical universities in the country.
According to him, “government needs to train more, retain more and motivate more. What I mean by training more, government needs to establish more medical universities. By retaining more, it means government have to prevent them from going out of the country, engage them as you train them by motivating them and give them good working environment”, he explained.

Also speaking on the prevalence of the disease, the Director, Labouratory Services, Dr. Hassan’s Hospital & Diagnostic Centre, Abuja, and Chairman, West African Postgraduate College of Medical Laboratory Science, Dr. Godswill Okara, said “it is quite high, according to a survey done in some years ago, it was speculated at about 20million Nigerians infected with the virus.
In fact, we have done a survey in Dr. Hassan’s Hospital, we have an abstract and the research work we have done on it which we are presenting at the 33rd World Congress on the Medical Laboratory Science in Italy by September.”
According to him, “from our study, the prevalence rate is 7.72 per cent, which if you calculate by the Nigerian population, it comes to about 13million people who are infected by statistical projection and which is quite a high burden.”
He therefore stressed the need for public enlightenment especially since most people who are infected don’t show any symptoms or signs of infection, making it a very dangerous situation.

Speaking further, Dr. Okara noted that a research study has shown that HBV infection is even more infectious than HIV, thus the need for public enlightenment about the prevention, testing and vaccination.
He also urged government to be on the driving seat as it remains a critical stakeholder as far as public health is concerned and also considering the economic consequence of the disease.
“When you talk about public health, government is very centre and key to it. This is because when you look at the large group of people that are chronically infected, it has very adverse economic and public health consequences. From our study, we noticed that the age rate of 20-50 have the highest prevalence rate and this is the productive workforce.

“By the time the infection progresses to an acute condition and people coming down with liver cancer and all the complications resulting from the infection, it will have a consequence on our economy so government should be alive to its duty an d responsibilities, he explained.
Meanwhile, the federal government is set to carry out a national household survey that will determine the distribution of HIV and Hepatitis B and C in the country. The minister of Health, Prof. Isaac Adewole said the survey which will begin in June this year and last for a period of about six months across the 33 states and the FCT is being conducted by the Federal Ministry of Health and National Agency for the Control of AIDS (NACA).
According to him, the result of the survey will provide key information that will guide the government to plan and develop more effective programmes to control HIV and Hepatitis in the country.