Ugandans should embrace vaccination Against Hepatitis B as first-line preventive measure

Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection. But, there are other possible causes which include, autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol.

Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue. Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. Each of these types is caused by a different virus.

Hepatitis A is caused by an infection with the hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A. Hepatitis C comes from the hepatitis C virus (HCV). It is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact.

Hepatitis D (Delta Hepatitis) is caused by the hepatitis D virus (HDV). HDV is contracted through direct contact with infected blood. This is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B. Hepatitis E is waterborne and caused by the hepatitis E virus (HEV). It is mainly found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply.

But in this article, my main focus is on Hepatitis B. This is a viral infection that attacks the liver and can cause both acute and chronic diseases. It is transmitted through contact with infectious body fluids, such as blood, vaginal secretions or semen containing HBV. The virus can also be transmitted from mother to child during birth and delivery, injection drug use and sharing razors with an infected person.

World Health Organization estimates that 257 million people were living with chronic hepatitis B infection and resulted in an estimated 887 000 deaths, mostly from cirrhosis and hepatocellular carcinoma in 2015. Of all people estimated to be living with hepatitis B, 27 million (10.5% were aware of their infection, while 4.5 million (16.7%) diagnosed were on treatment by 2016.

Newly infected people do not show any symptoms but some will develop acute illnesses with symptoms lasting several weeks. These include yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting, and abdominal pain. Acute hepatitis leads to liver failure, which may cause death.

In some other people, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer.

According to WHO, 80–90% of infants less than one year who get infected with Hepatitis B and 30–50% of children infected before the age of 6 years develop chronic infections. Less than 5% of healthy individuals who are infected as adults will develop chronic infections; and 20–30% of adults who are chronically infected will develop cirrhosis or liver cancer.

People infected with HIV are vulnerable to Hepatitis infections hence the need for early detection and treatment. The global prevalence of HBV infection in HIV-infected persons is around 7.4%. WHO recommends treatment for everyone diagnosed with HIV infection, regardless of the stage of the disease.

There is no specific treatment for acute hepatitis B except care and replacement of fluids lost from vomiting and diarrhea. Avoidance of unnecessary medications highly advised. Treatment of Chronic hepatitis B infection can slow the progression of cirrhosis, reduce the incidence of liver cancer and improve long term survival.

Therefore, vaccination of hepatitis B is the mainstay of prevention. In 2015, a low prevalence of chronic HBV infection in under 5year olds was recorded around the world and was attributed to the widespread use of hepatitis B vaccines.

With the prevalence of Hepatitis B infection among Ugandan adults at 4.3% (5.6% men and 3.1% women), it’s no wonder that Uganda recognizes Hepatitis B as a disease of public health concern.

According to the 2016 Uganda Population-based HIV Impact Assessment, Hepatitis B prevalence is highest in the Northern region at 4.6%, 4.4% in North East, 3.8% in West Nile, while lowest in South West region at 0.8%. The government commenced the mass vaccination campaign in 2015 so as to turn the tide against the pandemic.

Nearly 23 million adults and adolescents have been screened for the disease in Uganda while 17.6 million adults and adolescents have been successfully vaccinated. Ministry of Health’s statutory instrument on hepatitis B requires all health workers and students to be vaccinated against HBV within six months from commencement of clinical exposure to prevent infection.

However, there are challenges which include, low rate of follow up after first and second doses of vaccination, the disinterest of health workers in the exercise, counterfeit drugs and lack of timely provision of data from districts on implementation progress.

The government has been able to carry out vaccination in 69 districts of 127 amounting to 54.3% covered. All Ugandans are hereby encouraged to voluntarily report to health centers both government and private that are gazetted to offer Hepatitis B vaccination. Together we can kick HBV out of Uganda.

The Writer is a Communication Assistant at Government Citizen Interaction Centre (GCIC), Ministry of ICT and National Guidance.