Growing Scourge of Hepatitis B in Nigeria
Martins Ifijeh writes that though, Hepatitis B has killed more Nigerians in recent time, little attention is paid to it by the government and the people
Going by the recent report of the World Health Organization (WHO), over 350 million people are chronic carriers of Hepatitis B Virus (HBV), while about 620,000 people die from the scourge every year, globally.
In Africa, according to the report, Nigeria tops the list of countries with high incidence rate of the scourge, with over 20 million Nigerians infected and thousands of people dying from the disease or liver-related diseases every year. This, no doubt makes it a health emergency that must be tackled seriously by the country.
Worried by its increased incidence level in the country, experts have said Nigeria is sitting on a keg of a gun powder, if nothing is done to tackle the relatively unknown disease that is capable of causing epidemic and 100 times more infectious than Human Immuno Virus (HIV).
In an interview with THISDAY, a virology expert and the Medical Director, The Saints Medical Centre, Benin, Dr. Nkem Nwokolo, said at least one in every nine Nigerian has Hepatitis B, but majority have little or no knowledge of the disease, making it one of the biggest silent killers in the country, with little awareness about its mode of infection and treatment.
According to Nwokolo, HBV is more dangerous than most common diseases because it is epidemic in nature, such that its rate of transmission from an infected person to a non-infected person is high and mostly through exchange of blood and body fluid.
“One unfortunate thing about this type of disease is that majority of people living with it are not aware that they have it because symptoms may not manifest for years, hence over time they gradually begin to develop chronic liver disease which often is a late presentation… late diagnosis hampers treatment of the virus and other viral diseases.
“These same people who are carriers of the virus unknowingly transmit it to other people around them, hence increasing the prevalence of the virus among other Nigerians,” he said.
Nwokolo, attributed the easy transmission of HBV among Nigerians to lack of awareness. He believed the attention given to other health issues like malaria, HIV/AIDs, tuberculosis, Ebola, among others is not given to HBV.
“What most health professionals and the government who should be involved in massive awareness of the disease fail to understand is that Hepatitis B or other liver diseases kill more Nigerians than most of the health issues been devoted hundreds of millions of naira to. It should as well be given priority so as to save thousands of Nigerians who die yearly from the disease.
“If Nigerians are knowledgeable about HBV, most of the people being treated for liver cancers and other liver infections will reduce drastically because anyone with HBV will visit the hospital and be treated for it before it progresses to acute liver infection or even chronic liver infection,” he added.
He said a disease that has infected about eight per cent of the Nigerian population definitely deserves to be given a high priority.
On the various mode of transmission of the disease, Nwokolo, said apart from transmission through blood and body fluid, other methods include, “transmission from an infected mother to a newborn child, which often occurs during or shortly after childbirth. There is also the transmission through use of unsterilised needles and other kits that has contact with the human blood.”
He also added that blood contaminated saliva as well as semen-which contains a significant amount of blood may also be sources of the virus.
Is Hepatitis B sexually transmitted? Nwokolo, said like the HIV, HBV is a sexually transmitted disease.
“Men or women who have multiple sex partners, especially if they don’t use condom are at a high risk of contracting the virus, or sharing same if they are already infected. Men who have sex with men are also at a higher risk of contracting the virus than men who have sex with the opposite sex,” he said.
On how the symptoms manifest, the virologist explained that about half of the people infected with the virus do not present symptoms and may never realise they have been infected.
However, he said that adults are more likely to develop symptoms than children. “For some people, symptoms may develop between one to four months after exposure to the virus. These symptoms may include, loss of appetite, jaundice (a condition in which the skin and the eyes become yellow in colour), nausea, vomiting, pain over the location of the liver, itching of the body, pale coloured stool, among others,” he explained.
According to him, the symptoms of Hepatitis A and C are distinguishable from Hepatitis B. “Though other form of hepatitis may exhibit symptoms of Hepatitis B, there are also other symptoms associated with them like weight gain due to ascites, mental disturbance, extreme sleepiness or hallucination, vomiting with blood, as well as bleeding from the nose.
“People must not wait for these symptoms to be exhibited before they go for testing. Early diagnosis of HBV can go a long way in saving lives. Most diseases presents symptoms of flu, but diagnosis will tell what type of health condition they are and how to be treated accordingly.
“In most cases, hepatitis B causes limited infection because usually, people manage to fight it off successfully within a few months, developing an immunity that lasts a lifetime. But some people don’t get rid of the infection. If you are infected with hepatitis B for more than six months, you are considered a carrier, even if you have no symptom,” he explained.
He called on public spirited individuals, non-governmental organisations, the government and the media to intensify awareness campaign against the disease.
“The truth is this, a disease that has infected about 20 million Nigerians and is killing thousands of people yearly is not to be taken for granted because it has the tendency to spread to the remaining 150 Nigerians if nothing is done about it.
“We are sitting on a keg of powder and we must not ignore the warnings. Attention given to Malaria, Ebola, HIV/AIDs and Pneumonia should as well be given to Hepatitis B (Hepatitis A and C inclusive). People should first know about the virus, as that is the first step in reducing the scourge in the country,” he said.
He specifically pleaded with the media to make it a front burner in their reportage as they are major stakeholders in the country. “I know when the media continue to make a particular issue a major front burner, people as well as the government and international donor agencies over time will begin to pay attention to such issues,” he stressed.
On treatment of the disease, he said people who are chronically infected but do not have any liver damage do not need treatment but need close monitoring with regular liver function tests at least once in 6 months.
“However, if a person has liver damage, they should consider having treatment for hepatitis B. It is also very important that people with chronic hepatitis B take their medications exactly as prescribed. Missing doses can cause HBV to become resistant to HBV medications,” he explained.
Also, in a recent interview, the Chairman, Society for Gastroenterology and Hepatology, SOGHIN, Lagos State chapter, Dr. Charles Onyekwere has raised the alarm that not many people know much about the disease which he described as a silent killer in the country.
Onyekwere who spoke at an event to raise awareness against Hepatitis, also called on the government and corporate organisations to focus on creating awareness about the disease. “Let us think about people who do not know what causes hepatitis and how it is managed and let us think again about what we need to do to ensure that our people get information on the killer disease,” Onyekwere added.