HEPATITIS B , THE SILENT KILLER

Losing a dear younger brother to the viral hepatitis B few years ago made any news or write-up about hepatitis B to always fascinate and attract my attention.

Thus, reading the World Health Organization (WHO) findings and submission in the Daily Telegraph of July 11th, 2016, page 7 that “viral hepatitis is one of the leading killers across the globe” compelled me to add my voice to the call for action to stem the scourge of this silent deadly disease which is claiming more life than HIV/AIDS and Tuberculosis according to WHO data made available.

In its report (WHO), it is estimated that 400 million people are living with hepatitis B or C worldwide. It is obvious that millions of people are not captured in this data. This is to say that the figure could be twice this number if many people voluntarily surrender themselves to hepatitis B screening.

Viral hepatitis according to Wikipedia is the liver inflammation due to viral infection. It may present in acute (recent infection, relatively rapid onset) or chronic forms.

This disease may be contracted from various causes both infectious (i.e. viral bacterial, fungal and parasitic organisms) and non-infectious (e.g. alcohol, drugs, autoimmune diseases, and metabolic diseases). Scientists have identified five forms of hepatitis called hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus Various stages of liver damage caused by Hepatitis B(HDV), and hepatitis E virus (HEV).

Other unsubstantiated causes of hepatitis according researchers are hepatitis F virus (HFV) and GB virus C. Of all the aforementioned forms of hepatitis, the most deadly are hepatitis B and C with incubation period of 45-160 days HBV and 15-150 days HCV.

Clinical analysis shows that 5-10% of patients infected with HBV and 70% of HCV patients experienced chronicity respectively. Hepatitis B is a contagious liver disease that ranges in severity from mild illness to serious disease such as liver damage, liver failure, liver cancer, or even death. There are three injections lifetime protection vaccines for hepatitis B, which is said to be most deadly of all the viral hepatitis.

Most victims hardly notice except at the terminal point of death. In other to create awareness World Health Organization has declared 28/7/ of every year as World Hepatitis Day.

Research analyses have shown that substantial numbers of hepatitis B career are from sub-Sahara Africa and Asia. Many innocent citizens are dying of this ailment because of lack of awareness and unsustainable health education promotion.

We cannot eradicate or prevent the spread of a disease among the teeming population without orchestrated campaign; continuous sustainable awareness creation and enlightenment.

This must be registered in the people conscious and sub-conscious realm, the way a sustainable campaign was maintained to combat the scourge of HIV/AIDS and Tuberculosis.

The viral hepatitis B is almost at zero level in both Europe and U.S. This necessitated zero allocation from the Western world to most health related NGOs who could have created maximum awareness about this deadly disease in Africa.

On daily basis, people are dying of hepatitis B despite the existence of vaccines and treatment.

One of the evergreen cases that came to mind was the late discovery of hepatitis B virus by my younger brother (Abdullateef Bello) few months before his demise that he had a chronic hepatitis B, which had reached the terminal stage.

Ignorance is another killing disease in Africa. The young man in question had resulted to self-treatment of fever and malaria without consulting physician. By the time we realized the enormity of the sickness, he had presented symptom of acute hepatitis, which is jaundice (yellow colour in the skin and the eyes).

The non-availability of specialist doctors in this field is another bane of this viral disease. Imagine a patient who went to a teaching hospital for treatment and medication and was Yellowing of the skin and dark urine are some of the symptoms of Hepatitis-Bgiven three months appointment visitation to see the specialist.

Prior to the schedule appointment date he had passed on. Three months after his demise I received a phone call from Gwagwalada Teaching Hospital that he should come for his appointment. I told the doctor that his patient was late.

He was shocked by my response, he consoled me and cut the phone.

This is just one out of the thousands of cases of viral hepatitis B.

On a serious note, much has not be done by the Federal Ministry of Health to sensitize members of the public and otherwise illiterate, semiilliterate and literate citizenry to go for status check and screening.

Available evidence from the hepatitis patients shows that management and treatment of HBV is cumbersome and expensive.

Treatment and consultation is quite expensive and may not be affordable to people of lesser income. A patient is expected to go through series of liver functioning test (LFT) and full blood count (FBC) at every stages of the treatment, which are expensive. A branded Trufada Tenofovir Disoproxil 30 tablet is thirty thousand naira (#30,000) per month or unbranded one, which goes for four thousand five hundred naira (#4,500).

According to specialist, a patient will be on this for the minimum of three years depends on the chronicity of the condition of the patient. Quantification of viral load to determine the amount of viral load in the body will be done from time to time before the final stage of application of interferon injection to bring the viral hepatitis B to barest minimum.

Series of test will be conducted before and during the process of interferon injection administration to observe patient reaction to the injection administration. With administrative charges from the physician Pegasyinterferon injection may not be less than thirty two thousand naira (#32,000) per week, and is expected to run for 48 weeks. Besides, patient will be taken branded Trufada or unbranded one to compliment the interferon injection to combat this scourge simultaneously.

This and many more made the treatment of viral hepatitis B out of the reach of average common man in the country. At this juncture, serious intervention is required from the Federal Government, Federal Ministry of Health, International Donor Agencies, State and Local Governments to curb the spread of this deadly disease.

Sustainable health promotion education is needed to sensitize ignorant member of the public about the hazardous nature of the disease.

The branded Trufada Tenofovir Disoproxil and interferon injection should be subsidized by the Federal Government the way the HIV/ AIDS and Tuberculosis treatment are being effectively managed and controlled. People should be encouraged and assisted to go for status test screening through continuous advertisement and jingles in the print and electronic media.

Finally, Diagnostic Centre should be well equipped in the public hospital to carry out subsidies series of test for the patient seeking for treatment.

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