Today the world commemorates “World Hepatitis day” with the purpose to increase public awareness on viral hepatitis in order to increase its prevention, early detection, and treatment. This awareness is important even as the World Health Organization focusses on prevention in mothers as well as the mother to child transmission in this year’s theme, a “Hepatitis-free future”.
In Nigeria preventive efforts through the national program on immunization targeting newborns and children, address hepatitis B amongst other childhood illnesses. However, its success in enforcing prevention, in general, generates questions as recent full immunization coverage nationwide was reportedly 31.3%, according to the 2018 Nigeria Demographic and Health Survey.
Further, for pregnant women, and even higher prevalence of 14.1% was noted in a study done by Musa B and colleagues in 2015. This is within regional estimates reportedly ranging from 6% to 25% in Sub- Saharan Africa, according to a study done by Ott JJ and Colleagues in 2012. Both scenarios underscore the need to ramp up awareness and prevention of hepatitis even before women become pregnant, and a risk to their unborn children if infected.
Viral hepatitis is an infection of the liver caused by viral agents. Viral hepatitis is mainly caused by five strains of the hepatitis virus. Namely, hepatitis viruses A, B, C, D, E; and of which the hepatitis B and C are responsible for higher deaths according to the World Health Organization. In Nigeria, both hepatitis B and C have high prevalence rates in the population at 11.2% and 2.0%, respectively according to the Federal Ministry of Health. Consequently, both have a high burden not only within the Nigerian population but also on the health system with poor outcomes.
Both are transmitted through contact with infected blood, and other bodily fluids as occurs during childbirth and breastfeeding between mother and child; sexual intercourse; shared sharp objects and accidental spills or pricks that may occur in health care settings.
In general, people can be infected and yet be unaware of the infections until symptoms and signs of liver disease set in. These may include a yellow color seen in the normally white part of the eyes, passage of dark-colored urine, and abdominal pain. In some cases, the development of liver cancer is a risk.
For these reasons for viral hepatitis severity, over 190 countries including Nigeria became a signatory to the Global Health Sector Strategy in 2016, with targets set by the World Health Organization to eliminate viral hepatitis’s threat by 2030. However achieving this, also within the global context to end hepatitis amongst other diseases as a target (3.3) of the sustainable development goals may present as a herculean task.
More awareness and prevention are needed, particularly at the population level. At this time when COVID-19 is equally associated with worse outcomes in individuals with underlying illness, prevention of viral hepatitis is even more imperative. So, the Nigerian government as well as the private sector must rise to this challenge, if we are to create a “Hepatitis-free future”. Indeed the focus should turn to improve immunization coverage as well as population screening and prevention in mitigating the burden of viral hepatitis in Nigeria.