Health

Hepatitis: Arresting a monster with screening, early diagnosis

Globally, viral hepatitis causes 80 per cent of deaths from liver cancer, which is diagnosed in more than 800,000 people annually. But hepatitis and liver cancer are largely preventable. However, medical experts said better awareness and understanding of Hepatitis’ preventive measures, could eliminate much of the life-threatening condition, reports APPOLONIA ADEYEMI

Uncle T as he was popularly called by his friends and neighbours in Wuse, Abuja where he lived until his demise a week ago, had been ill for over three months. He had been in and out of hospitals particularly since the lockdown arising from the coronavirus pandemic in the country. Neither he nor his relations knew that he actually battled hepatitis. Based on the general attitude to self-medicate, he initially depended on drugs that he bought from pharmacies around his neighbourhood. His belief was that he had malaria and typhoid because of the feverish symptoms he manifested and most of the drugs he got were malaria medications.

Sadly, after each bout of fever and medications, not too long afterwards he broke down again and the circle continued until two weeks into his demise when a laboratory test showed he suffered hepatitis. By that time, the doctors providing care for him at a private facility in Abuja, said the condition of his liver cancer was already advanced. By the following week, he collapsed at home and was rushed to the National Hospital in Abuja where he was pronounced as having been brought in dead (BID). Uncle T was not the only Nigerian that had died in Nigeria from Hepatitis. In Ojodu – Berger area of Lagos State, the case of the late Alhaji Saliu Haruna, a bar attendant along Wilmar Street, by Isheri, was similar to that of Uncle T.

He, too was persistently ill for over six months and had regularly selfmedicated, treating malaria and typhoid. His sudden death in June, last month revealed that what he had battled for over six months was hepatitis. Sadly, Haruna had died before this knowledge came to the fore. Although, his family lamented that the coronavirus pandemic and the lockdown did not make accessing health care in public hospitals where treatment was more affordable, easy for their brother, the case of Uncle T and Alhaji Haruna revealed that many people in the communities who suffer hepatitis were actually not aware of the true nature of their medical conditions. However, as the global community marked the 2020 World Hepatitis Day (WHD), it provided the opportunity to raise awareness about Hepatitis and its huge burden on citizens.

Every year, July 28 is marked as WHD. It is a day dedicated to increase the global awareness and understanding of viral hepatitis and the diseases that it causes. Viral hepatitis is inflammation of the liver caused by a group of viruses known as hepatitis A, B, C, D, and E virus. The liver is the largest internal organ and has several indispensible functions such as: removal of harmful substances from the blood, breakdown and storage of many of the nutrients absorbed from the intestines as well as production of the chemicals that prevent excessive bleeding from cuts or injuries.

Worldwide, 290 million people are living with viral hepatitis unaware. This lack of knowledge is the major problem which both Uncle T and Alhaji Harun in this report suffered, though, self-medication and difficulty accessing care early were at the root of their challenge.

Globally, infection with Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV) is the main cause of liver cancer, making hepatitis a target disease of the Big War Against Cancer. Globally, viral Hepatitis causes 80 per cent of deaths from liver cancer, which is diagnosed in more than 800,000 people annually. Liver cancer is also a leading cause of cancer deaths worldwide, accounting for over 700,000 deaths each year (over 1,900 deaths daily). In Nigeria, 14 people die of liver cancer every day.

Yet, hepatitis and liver cancer are largely preventable. A major contributor to the sad hepatitis/ liver cancer statistics is lack of awareness. According to a Medical Expert, Dr. Abia Nzelu with better awareness and understanding of its preventive measures, much of these life-threatening conditions could be eliminated. On his part, a Family Physician, Dr. Rotimi Adesanya who has certification in Hepatitis, lamented that the group that were most adversely affected by Hepatitis in Nigeria are newborn and infants. Many of the infants, according to him, missed out on vaccinations, a key preventive strategy for the protection of the children. He disclosed that based on the fear of their parents to avoid contracting coronavirus prevented most mothers from visiting facilities to access the Hepatitis B vaccinations for their babies.

“About 90 per cent of mothers get vaccinations for their babies at health centres. As a result a lot of the children that were born during the lockdown could not access the health centres. “The vaccinations for Hepatitis B starts at birth, followed by another shot at six weeks, 10 weeks and 14 weeks.” he said.

The theme of this year’s World Hepatitis Day (WHD) is “Find The Missing Millions,” a clarion call for everyone to take action and raise awareness to find the ignorant multitudes who are unaware of their hepatitis infection. In this case, ignorance is not bliss. Abia who is also a Fellow and Consultant of the West African College of Surgeons and the National Postgraduate Medical College of Nigeria, said it was important to let people know the mode of transmission, the symptoms and preventive measure of hepatitis.

Transmission

According to Nzelu, “Viral hepatitis is one of the most contagious diseases in the world. It is spread through contaminated blood, intravenous drug abuse and sexual contact with an infected person.” In highly endemic areas like sub-Saharan Africa and Asia, she said Hepatitis B was most commonly spread from mother to child at birth (perinatal transmission). In addition, Nzelu said, “Infection can occur during medical procedures, tattooing, or through the use of razors and other sharp objects that are contaminated with infected blood.”

Symptoms

Speaking further, she said, “Most cases of hepatitis are asymptomatic. When symptoms do occur, they may include yellow skin or eyes (jaundice), nausea, abdominal pain, fatigue and fever.”

Prevention

One of the most successful ways of preventing Hepatitis is vaccination against Hepatitis B. The first dose is now being given at birth, she said. “The vaccine is safe and effective, protecting from HBV infection for life and preventing the development of chronic disease and liver cancer due to HBV.

“Adults can also benefit from the vaccine. Although vaccination for HCV is currently unavailable, antiviral medicines can cure HCV infection.” Other preventive measures include: avoid sharing of sharp objects like needles, toothbrushes, razors or nail scissors and screening of blood donation products. Safer sex practices, including minimising the number of partners and using barrier protective measures (condoms), also protect against transmission. Screening and early diagnosis can prevent health problems that may result from viral hepatitis infection and prevent transmission of the virus. Similarly, treatment with drugs, including oral antiviral agents can decrease the risk of liver cancer.

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