Must Read: Taming Hepatitis B, the silent killer

Hepatitis B is 100 times more infectious than HIV/AIDS but only few Nigerians know their status. In this piece health experts highlight the risks of infection and what government should do to cage its spread in the country

Health enthusiasts are worried. Their concern bears on the high prevalent rate of Hepatitis B infection among Nigerians. Unfortunately, most Nigerians are ignorant of the deadly disease, which is 100 times more infectious than HIV/AIDS. The ailment, health experts say, can be contracted through body fluids such as sweat, tears, vaginal discharge, urine, blood and even
saliva. But what makes it more dangerous is that it has no symptoms. This makes it deadlier than HIV/AIDS. But a lot of Nigerians are unaware of its devastating effects; neither are they aware of what to do not to contract it. Due to this, medical experts say more Nigerians are becoming victims of the deadly virus. And those who are aware of its dangers do not know their Hepatitis B status because of poverty and inadequate medical facilities.

Hepatitis B is one of the six deadliest viruses in the world and in 2008, the World Health Organisation recognised the virus as a silent killer which had infected over two billion of the world’s population and left about 350 million with chronic liver complications.

In Nigeria, experts claim that over 20 million people are living with the infection while over five million lives have been lost to Hepatitis B across the country.

Stakeholders, who spoke with our correspondent during different Hepatitis B screening programme in Lagos as part of activities to mark the 2012 World Hepatitis Day titled, ‘This is Hepatitis: Closer than you think,’ warned that infection rates would continue to rise if more Nigerians do not know their status.

Speaking on the deadly nature of the virus, a consultant gastroenterologist at the College of Medicine, Lagos University Teaching Hospital, Idi- Araba, Dr. Olufunmilayo Lesi, said Hepatitis B virus which damages one of the most important organs of the body, the liver, could stay in body fluids for as long as 20 years without being detected.

Lesi said, “An infected person could live with the chronic infection without any symptoms. By the time you are seeing the first symptoms such as yellowing of the eyes, abdominal pain, coloured urine, it will be too late for any doctor or specialist to save, treat or manage the infection.

“Most of the patients we see know they have been infected when they already have liver cancer.”

She noted that Hepatitis B virus is one of the most infectious viruses in the world and could singularly lead to liver failure, cancer and untimely death in infected persons.

Lesi said, “It can stay on a surface it touches for at least seven days. HIV virus does not stay for more than an hour or so. It is 100 times more infectious than HIV. An infected person in a household would give it to the whole family, if they are not aware of it. That is why we are saying it is no more one in 12 persons that are infected in the world. It is closer than you think.”

According to her, some socio-cultural and unhygienic practices have also increased rates of infection in the country.

“Many Nigerians still go to hairdressing and barbing saloons without their manicure, pedicure or barbing kits. They share objects with people they do not even know.

“Some culture still give tribal marks to children with unsterilised needles, they remove belubelu and circumcise their children in herbalists’ homes. This is how infections spread and it is dangerous,” Lesi added.

Another consultant hepatologist with the General Hospital, Lagos Island, Dr. Oluremi Oluyemi, said a major factor for the prevalence in Nigeria is low testing.

According to him, to increase the population of Nigerians who know their status, schools, hospitals, and employers of labour should adopt more avenues to screen people.

He said, “If hospitals can insist that a patient must be tested for Hepatitis B as part of the registration process, we catch them early. Most of the patients referred to me did not know until they were above 30. It was even too late because they had started seeing the symptoms.

“If schools test their pupils for the virus as part of their enrolment process we can catch them very young, if employers include the screening as part of their medicals, then we can save our productive population from dying at a tender age.

“If not more mothers will continue to infect their children with the virus when they have not being tested. More members of the family will continue to be infected because they have not being tested. More personal items are going to be shared with infected individuals.”

However laudable this initiative may be, poverty and inadequate test centres in the country can prevent many Nigerians from undergoing the Hepatitis B test. For instance, it will cost an individual over N20,000 to undergo the test.

The Chief Medical Director, Benue State Teaching Hospital, Prof. Abraham Malu, who spoke at a symposium organised by the Nigerian Institute of Medical Research Yaba Lagos noted that this high cost of screening could frustrate early detection of the disease.

He added that only few centres were available in the country for Hepatitis B screening, and where they were provided, they were usually too expensive.

Malu said, “How many Nigerians in the rural areas have heard of Hepatitis B but they know of HIV which is not as infectious as HBV virus? Those in the cities who have the few screening centres do not have the money to pay for it. If we want people to know their status, so they can seek treatment early, then government must intervene by providing facilities for all its hospitals for free.”

The good news is that , Hepatitis B is a vaccine preventable disease. It has even been incorporated into the national routine immunisation programme in Nigeria for new born babies since 2004.

Stakeholders have called on government to increase HBV vaccination coverage across the country such that no child in Nigeria would be missed.

However, Lesi observed that the coverage rate for the HBV test in the country is low.

“Our coverage rate now is low compared to other vaccines available in the routine immunisation programmes. We are at 65 per cent and we must make 100 per cent,” she said.

She said as laudable as the provision of HBV vaccines for newborns in Nigeria is, the policy came a little too late which had left the adult population vulnerable to the infection.

Lesi stated, “The immunisation started in 2004, so adults that were born before then are still at risk of the infection. So, the adult population must still be catered for. Screening and provision of affordable treatment is the way to protect those that were missed.”

However, not all Hepatitis B infections would lead to liver failure or cancer, according to the President, Medical Women Association of Nigeria, Dr .Dumebi Owa. Like most viral infections, Owa said that the body’s immunity could clear the infections naturally, if they adopt healthy lifestyles.

Owa said, “This infection is connected with poor hygiene. It spreads faster in very dirty environments. If an infected person continues to live in a dirty environment, then the infection would not get cleared.”

She also called on the government to strengthen sanitation and awareness programmes on the virus to reduce the rate of infection.

Owa said, “Government must take their jobs seriously on awareness. It is funny that during election, politicians ensure that residents in the remotest areas are aware of the candidates to vote for. They should use the same means they use to create awareness for elections to educate Nigerians on how they can safeguard their health.

“We must key into prevention not treatment if we do not want to lose the fight. How many Nigerians can afford a liver transplant that can only be done abroad?”

-punch

...Now you know! Go check your self!