KAMPALA - Hepatitis B is highly endemic in Uganda with a prevalence of 4.5% among the 15-64-year-old age group. No wonder, Uganda is one of the countries spearheading the campaign against Hepatitis B.
According to the health ministry permanent secretary Diana Atwine, Uganda was due to hold the first African Hepatitis Summit 2019 today at Speke Resort Munyonyo.
The summit, she said will bring together patient representatives, ministers of health, policymakers, civil society, international organizations, global funders and public health specialists under one roof to provide regional effects to tackle viral hepatitis.
The theme for this summit is: “Eliminating Viral Hepatitis in Africa; Implementing the viral hepatitis strategy.”
At least 25 African countries are represented at the three-day summit, alongside experts from US and Europe.
Uganda’s hepatitis B status
The Uganda Population-based HIV impact assessment 2016 survey indicates that chronic Hepatitis B infection prevalence varies across the country with the highest rates in Northern region with 4.6% in mid-North, 4.4% in North East and 3.8% in West Nile.
Hepatitis B infection was lower in the rest of the country with a range of 0.8% in South West region to 2% in the Central region where Nakaseke district is located. The prevalence amongst men is 5.4% and 3% among females.
Globally, hepatitis is killing nearly 1.4 million people annually, and worldwide, nearly 300 million people live with viral Hepatitis, unaware.
In Africa, Atwine notes that out of the 1 billion population, 82miliion is infected.
“This corresponds to 6.7% of the total population of the continent. The prevalence in different countries ranges from 1 to 12%,” Atwine says.
About 3.5 million (10% of the population) are living with chronic hepatitis B infection. The highest infection rates are in Karamoja (23.9%), northern Uganda (20.7%), West Nile (18.5%) and western region (10.0%).
Strategies in place
“One of the key strategies we introduced is hepatitis B vaccination for all children. We introduced it 10 years ago,” Atwine says.
The vaccine was introduced to the adults as well, and they are vaccinated once they test negative they are immunized.
“We began with the most affected areas,” she says.
The vaccination exercise is being done in a phased manner due to financial challenges that cannot allow the rollout of the exercise in all districts at ago. The ministry will continue with sensitization programmes working with local governments and training health workers on the management of Hepatitis B cases.
What’s more, screening of blood for transfusion has been strengthened to minimize transmission, and as well as strict protocols have been put in place against reusable syringes and needles.
“We also designated specific places for those that need treatment, in regional referral hospitals. However, we shall scale down to health center IVs so that anyone who needs treatment for hepatitis can access it,” she says.
Furthermore, the laboratory capacity was a prohibitive factor, as samples to test viral hepatitis B had to be sent to South Africa.
“We strengthened our laboratory capacity and now we are able to carry out the tests within the country. We have also strengthened sample transportation countrywide so that samples are delivered centrally and the viral load of hepatitis b is done,” she explains.
Atwine notes that awareness of the population regarding hepatitis B is still low. Consequently, there is a lack of vigilance to take up or complete the full dose of vaccination. After the first vaccination dose, another is given after four weeks, then the last after three months. It gives lifetime immunity. However, a number of people do not turn up after the first dose.
“We need to increase the sensitization of the public to appreciate the importance of getting immunized once they are found negative,” Atwine says.
What’s more, health workers at the lower units did not have much knowledge about hepatitis B, but the ministry is carrying out training of all health workers at all levels to learn how to deal with it.
Signs and symptoms
Hepatitis is an inflammatory condition of the liver. The condition can be self-limiting or can progress to liver fibrosis (scarring), cirrhosis or liver cancer.
The disease is caused by a viral infection though there could be other causes of hepatitis. For instance, a condition described as autoimmune Hepatitis results from medications, drugs, toxins, and alcohol.
Acute Hepatitis B is a newly acquired infection and individuals affected by the infection notice symptoms between one and four months after exposure to the virus.
A small number of people can develop a life-threatening form of acute hepatitis called fulminant hepatitis. Chronic hepatitis B lasts longer than six months and is usually an infection that has to be dealt with in the longer-term.
“The majority do not exhibit signs and are not aware of their condition until they test positive. Others get mild on and off fevers, and body weakness,” she says.
However, when the liver is damaged, patients develop yellow eyes, swollen abdomen and may later present will cancer of the liver.
The hepatitis B virus is a blood-borne virus. It is transmitted from person to person via blood or fluids contaminated with blood.
The common symptoms include liver pain, jaundice, dark urine, pale-coloured stools, appetite loss, feeling tired, nausea and itching all over the body.
Hepatitis B infection is diagnosed based on the above symptoms and blood tests, which indicate abnormal liver function.
“Those with hepatitis B should not be stigmatized. They can live a normal life. However, they should ensure to have regular checkups to know whether to start medication or not. Chronic hepatitis B requires one to start medication. Medication makes the virus go down, and protects the liver,” Atwine says.
• Razor, toothbrush, fingernail clippers, should not be shared.
• Think about health risks if you are planning to get a tattoo or body piercing. You can become infected if sterilized needles and equipment and disposable gloves are not used.
• Practice safe sex. Latex condoms have to be used when multiple partners are involved to prevent HBV transmission.
• Don't share needles or other equipment.