NIGERIA– On World Hepatitis Day, the World Hepatitis Alliance (WHA), has called out Nigeria, noting the country is unlikely to reach net testing of 90% of her population before the 2023 benchmark set by the Global Health Sector Strategy (GHSS).

Global health sector strategies on, respectively, HIV, viral hepatitis, and sexually transmitted infections for the period 2022-2030.

GHSS guides the health sector in implementing strategically focused responses to achieve the goals of ending AIDS, viral hepatitis B and C, and sexually transmitted infections by 2030.

Nigeria is one of the most afflicted countries, and Hepatitis B has a prevalence rate of 8.1 percent and hepatitis C of 1.1 percent, according to the 2018 Nigeria AIDS Indicator and Impact Survey (NAIIS) report.

The theme for the 2023 World Hepatitis Day, “We Are Not Waiting” is a call to accelerate elimination efforts of viral hepatitis now and the urgent need for testing and treatment for the people who need it.

WHA noted that global funding inadequacy for viral hepatitis would be a contributory factor to achieving this feat.

President of WHA, Danjuma Adda, spoke weekend, in Jalingo, Taraba state capital, during the commemoration of World Hepatitis Day.

According to Dr. Adda, “Nigeria might achieve prevention if we scale up vaccination, but as for testing and treatment, by 2030 it might be a very tall dream to achieve. Nigeria has a population of about 200 million people, and we are looking at a 90% reduction in incidence and 65% in mortality.”

Dr. Adda noted that the government of Egypt had screened over 60 million of its population, and Rwanda and Uganda had screened almost everybody, and hence with political commitment, nothing was impossible.

He also urged the Nigerian government to announce a dedicated budget for hepatitis, adding the epidemic remains one of the fastest-killer diseases across the world, especially Liver damage.

World marks day to renew calls to end Hepatitis

The World Health Organisation (WHO) organizes the annual World Hepatitis Day campaign (as 1 of its 9 flagship annual health campaigns) to increase awareness and understanding of viral hepatitis.

For World Hepatitis Day 2022, WHO focuses on the theme “One life One liver” to highlight the importance of the liver for a healthy life and the need to scale up testing and treatment of viral hepatitis to prevent liver disease and achieve the 2030 elimination goals.

Hepatitis, a viral infection, is known as a major cause of liver disease, which leads to death if not promptly and properly managed.

A consultant gastroenterologist at the Lagos University Teaching Hospital, Dr. Emuobor Odeghe, said hepatitis B, one of the five strains of hepatitis virus, can infect the liver and cause liver damage, calling it the commonest cause of chronic liver disease and its complications in Nigeria.

Dr. Odeghe said hepatitis is an inflammation of the liver that can be self-limiting or can progress to cirrhosis or liver cancer.

WHO said approximately 296 million people were living with chronic hepatitis B in 2019, and that 1.5 million new infections are recorded each year.

The global health body also disclosed that hepatitis B resulted in an estimated 820,000 deaths in 2019, mostly from cirrhosis and primary liver cancer, also known as hepatocellular carcinoma.

Understanding the Epidemiological nature of Hepatitis

“Hepatitis B virus can be transmitted through contact with infected body fluids such as from mother to child, one child to another child through skin cuts or infections that get in contact with infected blood during play,” Dr. Odeghe shared.

She also informed that the sharing of sharps and personal items, unsafe sexual practices, using unsterilized instruments for surgeries and other medical procedures, unsafe blood and blood product transfusion, and needle stick injuries sustained by health care workers can put persons at risk of infection.

A consultant paediatrician, infectious diseases, at Barau Dikko Teaching Hospital, Kaduna State, Shuaibu Musa, also reiterated that hepatitis B and C viruses are transmitted through direct contact with infected blood or certain bodily fluids.

Dr. Musa said hepatitis is a silent epidemic because most people do not have symptoms when they are newly infected or chronically infected, hence they unknowingly spread the virus to others.

He said most patients with hepatitis B and C remain asymptomatic until the liver is significantly damaged.

According to WHO, only percent and 19 percent of patients with chronic HBV and HCV are aware of their status.

“Some symptoms of the viral infection include loss of appetite, stomach pain, dark-colored urine, nausea, yellowish eyes or skin, and vomiting,” Dr. Musa added.

Unlike its counterparts, hepatitis B has no cure but can be managed effectively.

Dr. Musa explained that the treatment options available for hepatitis B infection include focusing on controlling viral replication, reducing liver damage, and preventing the progression of the disease.

“For acute hepatitis B, supportive care is often sufficient. But chronic hepatitis B requires long-term management using drugs that can kill the virus which is prescribed to slow down the replication of the virus and reduce the liver damage,” he said.

Mr Musa, however, said the killer infection can be prevented with the use of approved vaccines which he said are highly effective and recommended for everyone especially those at high risk.

He said the vaccines provide long-lasting protection against the virus as some studies show that immunity will persist for at least 20 years.

“Some studies also indicate that complete doses last for a lifetime and also the duration of immunity can vary between individuals because of certain factors like the age the vaccine was administered, the dosage received, the individual’s immune response, and other underlying health issues of the individual,” Dr. Musa said.

The Executive Director of the National Primary Health Care Development Agency (NPHCDA), Faisal Shuaib, said the Hepatitis B vaccine is given under the Expanded Programme on Immunisation (EPI) schedule in Nigeria.

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