Sharp decline in Hepatitis cases
The country has reported a significant decrease in Hepatitis E cases, with the latest statistics indicating only eight cases were reported between 28 December 2020 and 10 January this year, while only one case was reported in the last two weeks.
According to the health ministry, between 11 January and 24 January this year, a single case was reported in the Otjozondjupa region, while no new cases were reported across the country during the period under review.
Since the outbreak in 2017, cases have been reported mainly from informal settlements, such as Havana and Goreangab in Windhoek, DRC in Swakopmund and Kuisebmond in Walvis Bay.
Similar settings in other regions, where access to potable water, sanitation and hygiene is limited, have also reported cases over the years. As of 24 January 2021, a cumulative number of 8 045 Hepatitis E cases were reported, with Khomas recording over 50% of the cases.
The Windhoek district alone reported a cumulative 4 954 cases, while the Erongo region has a cumulative 1 710 confirmed cases.
Other regions with a relatively high number of cumulative cases include Omusati (348), Ohangwena (166), the two Kavango regions (169) and Omaheke with 155 cases. The total due to Hepatitis E remains 66, representing 0.8% of the total confirmed cases.
Hepatitis E (HEV) is a viral infection, causing inflammation of the liver. It is primarily acquired by ingesting water contaminated with faecal matter.
The virus is also transmitted from person to person through the faecal-oral route as a result of poor body hygiene practices.
The health ministry has received N$4 million to support the outbreak response from the Japanese embassy through WHO up to June 2021. Some of the challenges of curbing the virus are access to sanitation and proper hygiene, especially in urban informal settlements. In addition, “Inadequate risk communication activities to facilitate behaviour change and enforce hygiene and sanitation practices, early health-seeking behaviour and sense of ownership among community members” are other challenges highlighted by the ministry.
“Due to Covid-19 pandemic, HEV response seems to have scaled-down, as the health ministry and partner organisations have repurposed their staff to focus entirely on the containment of Covid-19 and the National Health Emergency Management Committee meeting does not discuss HEV outbreak anymore.” The US Centre for Disease Control and Prevention (CDC) country director Dr Eric Dziuban told New Era yesterday that CDC has been a steadfast health development partner in Namibia for over 15 years, assisting with many disease outbreaks.
“CDC procured the first Rapid Diagnostic Tests for Hepatitis E available in the country back in October 2018. During December 2018, CDC Namibia partnered with the Ministry of Health to conduct a knowledge, attitudes and practices survey conducted in informal settlement areas of Katutura,” shared Dziuban.
He said they also supported laboratory confirmation of HEV in communal handwash water, which pointed to modes of transmission and that CDC has provided resources, technical assistance and funding for human resources to respond to this very prolonged outbreak. “There have been some small-scale improvements with total community-led sanitation, including in informal settlements in Windhoek. In areas where open defecation occurs globally, diseases spread is common; Namibia is no exception. To control Hepatitis E, Namibia must improve its sanitation infrastructure to finally beat this disease.”
He noticed that since Covid-19 emerged, less attention has been focused on HEV, including testing and tracking cases.
“For more than a year, the country has been challenged in testing capacity for HEV due to supplies, human resources and laboratory personnel prioritising Covid-19. This makes it harder to know right now what the true direction of the Hepatitis E outbreak has been,” he stated.
WHO suggests the implementation of general hygiene practices and other preventive measures should be sufficient to prevent the disease from spreading further.