As the world marked this year’s Hepatitis Day, the World Health Organisation (WHO) and health experts have said that 90 per cent of people infected with hepatitis in Nigeria have never been tested.
WHO country representative in Nigeria, Dr Walter Kazadi, who said nine out of 10 persons infected with hepatitis do not know their status, noted that though the birth dose and pentavalent hepatitis vaccine is provided free of charge for all under five children, the Nigerian health system is challenged with ensuring access and availability for infants and children and testing and treatment for pregnant women and mothers.
Hepatitis, which is an inflammation of the liver tissue, is caused by a virus known as viral hepatitis. The virus, according to them, may also be caused by drugs or alcohol use.
The experts worry that without appropriate diagnosis and treatment, around one- third of those chronically infected with viral hepatitis would die as a result of serious liver disease, including cirrhosis, liver cell cancer and liver failure while identifying adequate treatment of hepatitis B and C as a way out as it would prevent the development of major life- threatening complication of chronic liver disease of cirrhosis and liver cancer.
In 2019, 3.8 per cent of the world’s population was living with Chronic Hepatitis B Virus infection and 0.75 per cent with Hepatitis C infection.
According to the minister of health, Dr. Osagie Ehanire, 16 million Nigerians are estimated to be infected with Hepatitis B and 2.2 million with Hepatitis C, which represents estimated prevalence rates of 8.1per cent and 1.1per cent respectively.
He noted that viral Hepatitis remains a disease of public health importance as the mortality rate from both infections remains alarming despite limited global progress in addressing the scourge.
Experts have, however, blamed the prevalence of the disease on poor awareness among health care providers and the general public.
LEADERSHIP Weekend findings also revealed that Hepatitis A and E are transmitted through contaminated food and water and that some of the symptoms include fever, diarrhoea, abdominal pain and yellow eyes. The symptoms go on their own and do not stay in the body to cause further damage.
Findings further revealed that Hepatitis B, C and D, on the other hand, stay longer than six months in the body and grow into chronic form.
According to the WHO, more than 124,000 Africans die every year from the consequences of undetected and untreated hepatitis.
WHO regional director for Africa, Dr Matshidiso Moeti, added that more than 90 million people are living with hepatitis in the African region, accounting for 26 per cent of the global total.
Moeti said about 4.5 million African children under five years old are infected with chronic hepatitis B, reflecting an enormous 70 per cent of the global burden in this age group.
According to her, the global target of less than one per cent incidence of hepatitis B in children under 5 years has been reached, but the African Region is lagging behind at 2.5 per cent.
She noted that most of the cases could be prevented by eliminating mother-to-child transmission of the disease, during or shortly after birth and in early childhood, while identifying key interventions against hepatitis B as vaccination at birth and in early childhood, screening pregnant women, and providing timely treatment.
World Hepatitis Day is marked on 28 July, every year to increase awareness of the disease, which inflames the liver and can lead to liver cancer and cirrhosis.
This year’s theme is “hepatitis can’t wait”.
The global health body has tasked Nigeria and other African nations to develop national strategic plans to serve as roadmaps for elimination of viral hepatitis.
Meanwhile, observers, in their view, have blamed manpower deficit for the rising case of the disease in the country, saying that with lest 100 hepathologist in the country, it is difficult for those diagnosed with hepatitis to see a physician as HBV patients are usually meant to queue for three months before seeing a physician.
However, Dr. Ofem Egbe Enang, in an interview, told LEADERSHIP Weekend that though is it true that there are very hepathologists and gastroenterologists in the country, hepatitise prevalent is not so much tied to that fact.
He rather identified lack of awareness and ignorance as major factors while advocating for preventive care which according to him, is a better approach.
“when you align yourself completely to gastroenterologists or hepathologists as the case may be, you are dealing in the realm of treatment alone but it goes more than that, because this is about medical specialist and we have very few of them in the country. But the truth about it is that we need preventive care. The prevalence of hepatitis itself is on the rise because of the ignorance on the part of people.
“First, there are several types of hepatitis viruses; A, B, C, D and E. But for the purposes of this, the one that calls to mind easily and that has extensive impact on public health is usually hepatitis B and C at it were. Both of them have some relationship because they are usually transmitted through blood and other body fluids,” said Dr Enang.
According to him, “prior report suggested a prevalence of about 10-15 per cent risk in the Nigerian population, and 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, it is about 23 per cent then for infants, about 16 per cent.
“If you look at the very high prevalence we are having, a lot of them comes down to ignorance, but sometimes too, practices, how do we use sharp objects? When there is contact with blood and then blood screening.”
He therefore advocates for awareness for people to seek adequate medical attention for common symptoms, adding that the treatment is very expensive and it doesn’t even guarantee that a person will be wholly fit after the treatment as the patient may still come down with complications which are long lasting.
The warning signs according to him are Jaundice, constant fever, fatigue, abdominal pain, lack of appetite among others. “When you have all of these things staying for a long period of time, you do your usual treatment but it is not going, the point is you should see a doctor,” he said.
However, he urged that there should be training for health professionals at the primary healthcare level, using guidelines to recognise people who have such symptoms so that it goes through a proper channel. this he said would reduce the burden at the tertiary health facilities as people will not go there directly when they already have complications.
WHO has also urged that health care workers, non-governmental organisations, civil society and people living with viral hepatitis must play a vital role in raising awareness and promoting testing and treatment for Hepatitis B and C. while calling on researchers to work on simplifying testing and treatment, and find a cure for hepatitis B infection and a vaccine for hepatitis C.