Chijioke Iremeka
A Professor of Public Health at the University of Ilorin, Kwara State, Tanimola Akande says a huge number of Nigerians are living with undiagnosed hepatitis.
Akande, who is a former National Chairman of the Association of Public Health Physicians of Nigeria, said this in an exclusive interview with PUNCH Healthwise to commemorate the 2024 World Hepatitis Day.
The WHD is observed every July 28 to raise awareness of viral hepatitis, an inflammation of the liver that causes severe liver disease and cancer.
The theme of this year’s celebration is ‘It’s time for action.’
According to the World Health Organisation, Hepatitis is caused by a viral infection or non-infectious agents such as drugs, toxins, or alcohol.
The WHO noted that there are five main strains of the hepatitis virus – A, B, C, D, and E, saying that together, hepatitis B and C are the most common infections.
The global health body added that hepatitis B and C result in 1.3 million deaths and 2.2 million new infections per year.
Also, Nigeria HIV-AIDS Indicator and Impact Survey, 2018, estimated that Nigeria has a prevalence rate of 8.1 and 1.1 per cent for Hepatitis B infection and Hepatitis C infection among adults aged 15 to 64 years respectively.
The survey added that over 20 million Nigerians are living with hepatitis B, C, or both; yet over 80 per cent of the people do not know their status.
Continuing, Akande, who at various times headed, the Department of Epidemiology and Community Health at the University of Ilorin, said, “A huge number of Nigerians are living with undiagnosed hepatitis.
“This is true because most of them are largely undiagnosed because some do not show symptoms and do not present to the hospital for testing.”
He noted that most symptoms only appear once the disease is advanced, with most people discovering they have hepatitis B or C when they develop serious liver disease or cancer.
Akande, a member of the Expert Review Committee on Poliomyelitis Eradication Initiative and Routine Immunisation in Nigeria, said, “In this part of the world, the practice of periodic medical examination is low. The global goal of eliminating hepatitis is highly desirable. “While some countries will be able to achieve this goal, others, particularly in developing nations, will not be able to achieve this goal.
“At the current pace of preventive measures in Nigeria, the likelihood of achieving the goal is low. Hepatitis is inflammation of the liver. There are several causes. In addition to common viral causes of hepatitis, alcohol, drugs, and toxins can also cause hepatitis.
“We need a massive increase in awareness of hepatitis. This will make people present for testing. Laboratory facilities need to be provided across health facilities in Nigeria to ensure access by people for testing.
“This will strengthen the diagnosis of the disease. There is also a need to build the capacity of health workers on testing, diagnosing, and treatment of hepatitis.”
Akande noted that many countries of the world have adopted policies, programmes, and strategies to control infectious diseases, but there are, however, challenges in their implementation.
According to him, these challenges vary from one country to the other even as some countries have programme implementation failures due to poor funding or dependency on donors.
He noted that Nigeria has already developed a programme to control the infection, including universal precautions in workplace like health facilities and policies on control of sexually transmitted infections.
Akande believes that early detection through screening, case management, and free treatment, are of great importance to addressing the burden of the disease.
On the risk factors, he noted, “The risk factors include risky sexual behaviours, substance use, improper use and disposal of sharps and needles, use of contaminated blood for transfusion, mother to child transmission, scarification among others.
“The government needs to implement policies and guidelines for the control of Hepatitis. The control measures should be well-funded at all levels.
“Awareness through health education and sensitisation of citizens need to be increased at all levels of government. There is a need for improved awareness on preventive measures to drive behavioural change among Nigerians.”
Akande noted that the implementation of control programmes targeting the disease is heavily donor-dependent, insisting that the government should aim at improving funding for the control programmes.
“Nigerians should change risky sexual behaviours, and ensure blood donors are well screened. Nigerians should also ensure they take advantage of screening for the infection for early detection and treatment,” he added.
He added that hepatitis-related deaths can be prevented and eliminated with simplified care services for viral hepatitis by ensuring that all pregnant women living with chronic hepatitis B have access to treatment and their infants have access to hepatitis B birth vaccines to prevent infection.
At least, he noted, 90 per cent of people living with hepatitis B and/or hepatitis C are diagnosed; and 80 per cent of diagnosed people are cured of hepatitis C or treated according to newer hepatitis B expanded eligibility criteria.
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