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Nigeria, other African countries are slow in eliminating hepatitis -WHO

THE World Health Organisation has noted that Nigeria and 43 other African countries are lagging behind to eliminate viral hepatitis in the continent. 

Of the 47 countries in Africa only Rwanda, Uganda and Cabo Verde are on course to eliminate the disease that affects one in 15 persons in the region.

The information was contained in a press release of the WHO African region on Friday which gave some tips of a scorecard that examines hepatitis prevalence and response in Africa. The scorecard will be presented at the first African Hepatitis Summit to be held in Kampala, Uganda’s capital between June 18 and 20.

Dying of viral hepatitis in Africa is becoming a bigger threat than dying of AIDS, malaria or tuberculosis, said WHO. It said more than 200,000 people in Africa die from complications of hepatitis B and C annually. As it is a liver-related disease, complications include liver cancer, liver failure and scarring of the liver (cirrhosis).

The health agency estimated that 60 million people in the continent were living with chronic hepatitis B (HBV) infection in 2015, while about 4.8 million of them were children under five years old.  For hepatitis C, 10 million people are infected, “most likely due to unsafe injection practices within health facilities or by communities”.

Matshidiso Moeti, regional director, said the analysis was the first to track the countries and to access progress. “It was created as a guide for Member States on the implementation of the Global Health Sector Strategy on Viral Hepatitis, which calls for the elimination of the disease by 2030 (defined as a 90 percent reduction in new cases and 65 percent reduction in deaths),” she said

The analysis shows that only 7 of the 47 countries are leading prevention efforts with national coverage of both Hepatitis B birth dose and childhood pentavalent vaccination exceeding 90 per cent.

WHO said Rwanda is providing free treatment for both hepatitis B (HB) and C, Uganda only HB. “These two countries are championing the regional response and are on track to reach the 2020 Framework targets for testing and community awareness,” said WHO. 

“In Uganda, where more than 6 per cent of the population is infected, the commitment to end hepatitis infection was driven by civil society and strong political will with the result that it became one of the first African nations to fund domestic action against hepatitis B”.

Unlike HIV infection where there is no vaccine to prevent the disease, HB vaccination is available.

“Administration of the hepatitis B vaccination at birth and in early infancy is the most effective way to halt the transmission of the virus because 95 per cent of the burden of chronic disease is due to infections among children, acquired before their fifth birthday,” WHO reported.

But the health agency said only 11 countries could provide vaccination to children at a high rate. Only Cabo Verde was mentioned to have achieved 99 per cent vaccination coverage at birth.

High burden in Nigeria

According to WHO’s estimates, 11.2 per cent of the population is hepatitis B positive, while 2.0 per cent has the hepatitis C virus. The former figure indicates that 20 million Nigerians are living with viral infection.  And this represents that one in nine Nigerians has the disease.

Isaac Adewole, the former minister of health, had said during 2017 World Hepatitis Day that Nigeria is determined to eliminate hepatitis B infection by 2021.  Nigeria has also scheduled hepatitis B virus vaccination into the national immunisation for children since 2004.

However, WHO, in 2017, wrote that the screening and vaccination coverage among children and adults remains unsatisfactorily low in Nigeria due to a lack of awareness among the general populace.

A consultant gastroenterologist at the University of Abuja Teaching Hospital, Ojonugwa Ameh, told The ICIR in 2018 that the awareness of hepatitis B screening is not adequate in the country.

Most Nigerians do not know their status. Only when they come very sick, and most times at that stage, the damage has been done,” he said.

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