More action needed to curb surging hepatitis

World Hepatitis Day 2016

On July 28, Uganda joined the rest of the world to commerate World Hepatitis Day. Alex Taremwa examines the country’s efforts to counter the epidemic so far.

Kenneth Akampwera fell sick on April 22, 2016. He retired from work at Dada Digital Photo Lab in Mbarara and did not return until early July, following a seemingly endless battle with strange illness that would later be discovered as hepatitis B.

His mother Juliet Tugume watched life drain out of his previously strong, resilient son.

Akampwera is one of the 240 million people globally estimated to be infected with hepatitis. According to the World Health Organisation (WHO), 686,000 people die annually from hepatitis B related complications.

Hepatitis is the inflammation of the liver. Viral hepatitis is the most common cause of liver cancer all over the world, constituting 83 per cent of liver cancer cases. 

It is one of the most infectious diseases although many people remain unaware of its toll on global health. This makes viral hepatitis a silent killer.

It should be stressed that viral hepatitis is a group of infectious diseases classified as A, B, C, D and E.

Hepatitis B virus is the most prevalent in Uganda and can be transmitted through sharing of needles with an infected person, sexual intercourse, mother to child, and blood transfusions. Experts have noted that hepatitis is thrice as infectious as HIV/AIDS.

Hepatitis Facts_Infographic Online_v2_1July2015

It is estimated that at least 3.5 million people are living with hepatitis B in Uganda, accounting for 10 per cent of the population. The regional prevalence of hepatitis B in Uganda is as follows: Northeast 21.7 per cent, Northcentral 19.4 per cent, West Nile 18.7 per cent, Western 10 per cent, Kampala 5.8 per cent, Central 5.5 per cent while Southwest has 2.9 per cent.

Unfortunately, the WHO reports that only 5 per cent of the people with chronic hepatitis know their status and less than one per cent have access to treatment. 

This situation is worsened by the complexity of hepatitis tests that are costly, and the lack of laboratory capacity in many countries. Independent investigations show that a single dose of the hepatitis B anti-viral drug costs between Shs60,000 and Shs90,000 in private clinics since the supply of the test kits and vaccines in public hospitals has been disappointing.

Government intervention 

On a similar day last year, the government launched yet another initiative to vaccinate eligible adolescents and adults against Hepatitis B in Uganda but this has not altered the standings much.

On July 26, The New Vision ran a story in which they quoted the Commisioner Clinical Services in the Ministry of Health as saying that “there is no concrete explanation as to why there is a high hepatitis B prevalence in the northern and West Nile regions.” She added that plans were underway to investigate this phenomenon.

In 2002 the Ministry of Health introduced the pentavalent vaccine along with routine immunisation schedules of the Uganda Expanded Programme on Immunisation (UNEPI).

This effectively means that if the UNEPI schedules are followed and adhered to, over 8 million children up to 13 years would have been fully immunised against hepatitis B. 

This year, the theme for the World Hepatitis Day is Know Hepatitis, Get Tested . The new strategies will be to expand vaccination programmes for hepatitis B, focus on preventing mother-to-child transmission of Hepatitis B; improve injection, blood and surgical safety, ‘harm reduction’ services for people who inject drugs; and increase access to diagnosis and treatment for hepatitis B and C.

The public is urged to learn about the infection, take positive action to know their status by getting tested, and finally seek treatment to reduce needless deaths.