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Preventive Care As Panacea For Eliminating Viral Hepatitis



Hepatitis remains one of the leading causes of death in Nigeria. More than ever before, the call for preventive care and awareness has been heightened. PATIENCE IVIE IHEJIRIKA, writes.

Nigeria’s running battle with viral hepatitis is well documented. Despite concerted efforts by government and other stakeholders to ensure its eradication, the disease, which is caused by an inflammation of the liver, has continue to claim many lives. Experts have said that Hepatitis is caused by the Hepatitis virus and that different types of the Hepatitis virus cause viral Hepatitis infection while the most common viral Hepatitis infections in Nigeria are caused by the Hepatitis B and C virus types. According to the Nigeria AIDS Indicator and Impact Survey (NAIIS), Hepatitis Brochure, Nigeria is among countries with the highest number of people infected with Hepatitis. It is estimated that about 11% and 2.2% of Nigerians have Hepatitis B and Hepatitis C virus infections respectively. This translates to between 20-24 million Nigerians living with either Hepatitis B or C virus infection. The report also revealed that in all cases, the infections are more among males than females and among people in early adulthood, those aged between 20 to 40 years. It said that more people in Nigeria are not aware of Hepatitis B and C, and how to prevent themselves or get treatment if infected. Most of the over 20 million Nigerians living with viral Hepatitis B or C are undiagnosed, increasing the likelihood of future transmission to others and placing them at greater risk for severe, even fatal health complications such as liver cancer.

The NAIIS, which is currently ongoing, is aimed at ascertaining the true state of HIV/AIDS and Hepatitis B and C in the country. Speaking on the prevalence of the disease, the Vice President, Nigeria Medical Association (NMA), Dr. Ofem Enang, said that Hepatitis is on the rise as a result of ignorance on the part of people. He also identified other factors including medical practice.
According to him, “the prior report suggested a prevalence of about 10-15 per cent risk in the Nigerian population. Some investigators have found high Hepatitis B prevalence among surgeons, as high as 26 per cent. These are from studies done in Nigeria, and again, among voluntary blood donors, about 23 percent then for infants, about 16 per cent. “If you look at the very high prevalence we are having, a lot of them are linked to ignorance but sometimes too, practices. How do we use sharp objects when there is contact with blood and then blood screening facilities are they available in our hospital? “So a lot of awareness has to be drawn up for people to seek adequate medical attention for common symptoms. If you’ve been having fever for a long while, abdominal pain, you need to visit a healthcare facility.”

Dr. Enang also said that the treatment is very expensive thus the call for prevention, adding that the treatment doesn’t even guarantee that a person will be wholly fit because eventually, the patient will still come down with complications which are long lasting.
He stated that the best way to prevent hepatitis B is for people to get vaccinated as a new hepatitis B vaccine was approved for adults. “It’s given in two doses, so we need health education programme, address the common causes of contracting hepatitis B and then eventually too, we need to carry out vaccination. So prevention is key,” he explained.
The doctor also said that there was need to train more manpower and then strengthen the primary healthcare facilities so that the community healthcare professionals and other healthcare professional can detect symptoms and be able to refer them properly for proper attention.
On how hepatitis B and C are contracted, he informed that it is spread when people come in contact with blood, fluid and so many others, he however said that some of the diseases can be fought by the body even as he insisted on testing. “If you have some of these condition like fever, abdominal pain and the rest, it will be good to have your doctor see you. Sharing of needles and so many things that people use, even these local tools used for cutting of nails should be avoided.
“If you are having hepatitis B, you cannot donate blood, it means you have to be sure that they have adequate facilities to screen it because like I said, they are all transmitted through infected blood and all that.
He also said that a pregnant women might pass the virus to her baby at birth saying that if a baby gets the virus and it is not treated, it could have long term liver problem. While urging that all new babies with infected mothers should get hepatitis B immunoglobulin and vaccine for hepatitis at birth and during their first layer of life.
According to him, other means of getting infected include unprotected sex, sharing of sharp objects like blades, sharing of chewing gums or pre-chew food with babies. unsteriilised needles, unscreened blood among others Meanwhile, the former Head of State, General Yakubu Gowon, in his remarks at the 2018 World Hepatitis Day event, urged that the federal and states budgetary allocation to health should be reviewed to a bench mark that can reduce the burden of viral hepatitis and inclusion into the National Health Insurance Scheme (NHIS), to improve the quality and access to medical facilities across the country.

Gowon, also urged the Federal Government to come up with a National Treatment Programme to tackle viral hepatitis and utilise the ongoing Nigeria AIDS Indicators and Impact Survey (NAIIS) to determine the viral hepatitis burden in the country. However, the Minister of Health, Prof. Isaac Adewole, said that with support from Partners and other stakeholders, Nigeria has made significant progress in the control of Viral Hepatitis. Some of the key achievements, according to him, include the inauguration of a Technical Working Group (TWG) in 2013, to provide technical guidance for the implementation of hepatitis control and support advocacy and resource mobilisation. “I must add that policy documents like the National Guideline for the Management of Viral Hepatitis and a five year National Strategic Plan (2016-2020) have been developed to give the national response the strategic direction it deserves. With support from WHO, the National Directory on Viral Hepatitis has been developed to further improve access to care,” he explained. Adewole informed that the Federal Ministry of Health has been working with Partners and Pharmaceutical companies to facilitate the provision of anti-viral drugs for the management of Hepatitis B and the treatment of Hepatitis C at the lowest possible price.

According to him, the ministry recently signed an MOU with Gilead Pharmaceutical to provide drugs for the treatment and cure for Hepatitis C and we will continue to significantly scale up over the next 12 months. “We must all know our status. Everyone must go to the nearby facility and get screened; it takes less than 15 minutes to do this. Save your Liver Today,” he urged.
The minister however regretted that the knowledge of VH remains low even though it is a leading cause of death. He said as a result, most Nigerians living with VH B or C are undiagnosed, increasing the likelihood of transmission to others. This, he said, also places the individual at the greater risk of severe, even fatal health complications such as liver cirrhosis and liver cancer (hepatocellular carcinoma). He thanked the former head of state for his leadership role over the years, particularly in driving advocacy and resource mobilisation for the control programme. “I also salute all our development partners, civil society organisations and every dedicated Nigerian health worker for their efforts and support towards the realisation of our set targets.”