Saving Nigerians from Hepatitis as Nigeria joins the rest of the world to mark World Hepatitis Day, Martins Ifijeh writes on the role of stakeholders in addressing the silent killer in the country
While most countries, including Nigeria, put more premium on tackling the Human Immuno Virus and the Acquired Immune Deficiency Syndrome (HIV/AIDS) and other known global health concerns, little is being done to address Hepatitis, a relatively unknown disease, which infects 50 to 100 times more than HIV/AIDS and most other global health issues.
Statistics by the World Health Organisation (WHO) show that about 28 per cent of the 7.4 billion persons worldwide are infected with Hepatitis, which means almost two billion people are at one point or the other positive to the disease, while over a million persons die yearly from the scourge, with low and middle income countries, like Nigeria bearing the highest burden of the indices.
For instance, in Nigeria alone, the Society for Gastroenterology and Hepatology in Nigeria (SOGHIN), has reported that over 20 million persons were infected with Hepatitis in the country, while the death from it is also on a large scale, noting that at least one in every 10 Nigerians is chronically affected by the various types of Hepatitis, leading to liver disease, cancer or even death.
WHO says Hepatitis is an inflammatory disease of the liver which can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer, adding that it may start and get better quickly or may become a long lasting condition that could ultimately lead to death.Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause Hepatitis.
But with the increased prevalence of the scourge in Nigeria, experts believe the only way out of the high incidence level of the scourge in the country is if priority is given to its prevention and management by the stakeholders, various institutions and the Nigerian populace.
Speaking at this year’s World Hepatitis Day (WHD) organised by the Nigerian Military in partnership with Roche Products Limited, the Corps Commander Medical of the Nigerian Army, Major General Abimbola Amosun, said the prevalence of Hepatitis was increasingly becoming a national health emergency, hence the need for an institution like the Nigerian Army to take leadership in reducing the scourge through awareness campaigns.
She said if people were aware of the causes, prevention and management of the disease, it will go a long way in reducing its prevalence, as well as deaths. “As we are marking WHD here in Bonny camp, Lagos, same symposium is also taking place simultaneously in Enugu and Kaduna. We intend to continue this campaign until there is a drastic reduction of the disease in Nigeria,” Amosun added.
But why is Hepatitis common in Nigeria and how can it be managed, prevented, treated and possibly cured? Dr. Oluwadare Rotimi, a virologist with Roche provides a guide. He believes an awareness on personal hygiene, vaccination, treatment procedures and general management were keys to preventing and surviving Hepatitis.
While noting that there exist several types of Hepatitis viruses, ranging from A,B,C,D,E and CMV, he explained that Hepatitis B, a common type of the disease, is a silent killer, and could be deadly, as it does not show visible signs until it has spread to the organ. Adding, he said Hepatitis C, one of the strands of the disease, was referred to as the slow killer because infected persons could look healthy while the damage is being done to his or her organs.
According to him, the Hepatitis infectionis caused by acute illness; which resolves itself quickly without causing long term liver damages, and chronic illness; which lasts for more than six months, and in some cases can result in cirrhosis, (hardening of the liver), liver cancer, liver failure and ultimately death, adding that about 200,000 Nigerians die annually from Hepatitis B.
“Every hand must be on deck to tackle Hepatitis B virus as it is 100 times more infectious than HIV. It is also very dangerous because it contains carcinogens which leads to liver cancer. It also has the capacity to survive outside the human body for at least seven days.
“On mode of transmission, Hepatitis B can be transmitted from mother to baby at birth, child to child or through transfusion of contaminated blood products. It could also be transmitted through injection drug use that involves sharing of needles, as well as through contact with blood or open sores of an infected person,” he added.
For Hepatitis C, Rotimi explained that some of the easiest ways of transmission include blood transfusion, re-use of inadequately sterilised needles, syringes or other medical equipment, circumcision and tattooing with inadequately sterilised equipment, as well as through sexual transmission.
He called for increased awareness on vaccination, as it represents a strongwall against the scourge. Adding, he said Nigerians should be aware that viral Hepatitis was eminently preventable and by embracing the preventive strategies it would be easy to control it.
The Commander, 81 Division Garrison, Brigadier General Joseph Ejeh, while lending his voice to marking of the WHD, said the idea of bringing the campaign to the Nigerian Army was a welcomed one, adding that if a soldier, officer or any member of their family was down with the disease, it would in no small measure impact the productivity of such soldier or officer.
Ejeh, who represented the General Officer Commanding, 81 Division, Major General Isidor Edet, expressed optimism that if the awareness campaign on Hepatitis is decentralised to other members of the public, including the wider Nigerian Army community, it would help in reducing the scourge among the institution and by extension the country at large.
In a related commemoration of the WHD, organised by SOGHIN in Lagos, the President of the Society, Prof. Musa Borodo said the neglect of Hepatitis B and C could lead to complications like swollen organs, vomiting of blood, yellowing of the eye and tiredness, among others.
While advising patients to go for checkup and if positive,seek urgent medical attention, he said negligence and late presentation has stalled the intended progress against the health condition.
He stressed on the need for the country to adopt a comprehensive research presentation on Hepatitis and liver related health issues, adding that diseases associated with the liver were wide, hence requires detailed knowledge and skill for addressing them. “Globally, Africa has about 75 per cent of liver diseases and Nigeria has the largest population with over 23 million persons infected by the scourge,” he added.
He advised Nigerians to go for screening to know their status, adding that, “people should do screening at least once in a while, and if infected, they should get treated immediately. If not infected, they should get vaccinated against being infected,” he said.
Borodo also called on pregnant women to go for regular screening for Hepatitis so that if infected, mothers do not pass the virus to their unborn children.
Nigerians were also advised to stop the spread of the virus by avoiding the sharing of personal items such as razor, toothbrushes, needles, straws or other related objections to reduce the spread. Other notable acts to avoid are transfusion of unscreened blood, casual and unprotected sexual intercourse.
The WHO in one of its recommendations called for early vaccination, adding that this should be done as soon as possible after birth, preferably within 24 hours. It also said the birth dose should be followed by two or three doses to complete the vaccine series.
“Those who are at increased risk of Hepatitis should be vaccinated. These categories of people include those who frequently require blood or blood products (for example dialysis patients), healthcare workers, people who inject drugs, household and sexual contacts of people with chronic Hepatitis B, and people with multiple sexual partners,” WHO recommended.
Studies show that safe and effective vaccination can prevent Hepatitis B for life, as it can be taken by both infants, children and adults.
The health body also called on member countries, including Nigeria to educate the populace about Hepatitis B and C especially on the need for its prevention.
Unlike HIV/AIDS, tuberculosis and malaria are backed by donor funds, but control is not yet subsidised for Hepatitis, as patients have to bear the cost of their testing, vaccine and of course treatment for those who must be on treatment.