Ignorance of hepatitis, a disease of the liver, is fuelling its spread especially in northern Nigeria.
A high number of potential candidates seeking to join the armed forces but are rejected because of the infection is raising serious concern about the disease.
“People don’t present early, most people rush to traditional or normal conventional paracetamol before they come to us, by then the situation is already fulminant.
Fulminant means the liver has been damaged so much within a short time,” a consultant gastroenterologist and pathologist at the Aminu Kano Teaching Hospital (AKTH), Dr Yusuf Maisuna Abdulkadir, said.
The doctor added that “sometimes you see them vomiting, bleeding or having jaundice or becoming unconscious.”
Minister of Health, Professor Isaac Adewole said about 20 million Nigerians have hepatitis. He said that though many people may appear healthy physically, they could be walking around with the without knowing they were carriers.
He said most times, the disease does not manifest until it was too late, adding that it could cause chronic liver disease, liver cancer and death without any presentation of weighty symptoms.
Dr. Pantong Mark Davwar, a gastroenterologist, and hepatologist at the Jos University Teaching Hospital (JUTH) said hepatitis is four times bigger than the burden of HIV but unfortunately given less attention.
What to know about the disease
According to Dr Ganiyat Oyeleke, a consultant hepatologist and gastroenterologist at the Lagos University Teaching Hospital (LUTH), Idi Araba, there are five types of viral hepatitis: A, B, C, D, and E.
She said hepatitis A and E are transmitted by contaminated food and water and that some of the symptoms include: fever, diarrhoea, abdominal pain and yellow eyes. She said the symptoms go on their own and don’t stay in the body to cause further damage.
Hepatitis B, C and D on the other hand, she said stay longer than six months in the body and they grow into chronic form.
Dr Davwar said hepatitis E is not common in Nigeria, and that “hepatitis D cannot exist on its own, and only occurs in cases of hepatitis B.”
Patients experiences
Ibrahim Khalifa was ignorant about hepatitis until he was diagnosed with it during a medical examination into the Nigerian Air Force in 2015. Khalifa from Plateau State said he had undergone all the necessary exams and training at the Nigerian Air Force base in Kaduna but a simple medical exam had changed his life and shattered his dream of joining the air force.
“They told me that I needed to go and treat myself and then apply when next they were recruiting. Even after I got the necessary treatment, I applied again in 2017 and didn’t get in, I am going to keep trying,” he said.
Twenty-year-old Favour who came from Kaduna State to Abuja when she secured a job as a domestic staff lost her job as a result of hepatitis. Her employer told her that she couldn’t risk her working in her home because she could infect her children and the rest of the family with hepatitis.
On his part, Istifanus Mafeng said he tested positive to hepatitis B when he offered to donate blood to his then ill father in 2012. Mafeng said he was immediately treated in the hospital. He was however shocked when he tested positive this year during an awareness campaign on hepatitis.
Explaining Mafeng’s dilemma, Dr Davwar, said “hepatitis C is curable but hepatitis B is not curable but treatable. So, for B, if you take the right medication consistently it can prevent you from having liver cirrhosis and liver cancer but for it to disappear from the body, it is unlikely with the current drugs that are available.”
Prevalence and causes
Dr Oyeleke said Hepatitis B and C were the most common types of hepatitis in Nigeria, and that they could cause liver damage which results in liver cancer.
She said Lagos has a low prevalence rate compared to some other places. “There is about six to seven percent of people living with the disease in Lagos,” she said.
The average prevalence rate of hepatitis B virus in Nigeria is about 13 percent while that of hepatitis C virus is about two percent, said another consultant physician and gastroenterologist, at the Lagos University Teaching Hospital (LUTH), Idi Araba, Dr Emuobor Odeghe.
She said there was no reliable data for the other types of hepatitis viruses (Hepatitis A and E).
Nweke Prince, a medical laboratory scientist, and hepatologist said results of the tests he had conducted within the last three months in Abuja and other cities showed that hepatitis rate was high in the country.
He said two to three people test positive for hepatitis, adding that hepatitis B was the most prevalent in northern part of the country, while hepatitis C was very prevalent in Kwara State.
He said some cultural practices such as using unsterilized knives and other sharp objects for barbing hair and for pedicure and manicure in the north predisposes people to hepatitis B.
He said people with hepatitis were usually disqualified from they are because the army required to do strenuous activities, and the liver of people who have hepatitis couldn’t take it.
Data obtained from the Jos University Teaching Hospital (JUTH) showed that 17 persons were admitted for hepatitis B and one person for C between the months of July and August.
The data which was obtained from the Health Record officer, Mrs Nana Kuden of the Internal Medicine and Health Record Department indicated that 10 persons were admitted with hepatitis B in July, eight of which were male and nine of which were between the ages of 36 -61 with the last below 20 years.
Dr Abdulkadir said twenty percent of Kano state’s total population suffers from hepatitis B, saying the burden is much on the male population than in females.
He said on average three out of every ten men have the virus while 1 in 10 women is positive with the disease.
Dr Abdulkadir attributed the burden of the disease on male population to their early exposure to blood and other body fluids either through some cultural practices or wounds sustained from childhood play.
In Benue State, at least 586, 000 people are believed to be carriers of Hepatitis B in accordance with 2016 projection of over four million population in the state, Professor Godwin Achinge has said.
Achinge, a professor of Medicine and Consultant Gastroenterologist as well as Head of Infectious Diseases Centre at the Benue State University Teaching Hospital (BSUTH), said people who are infected with the virus become ill at the prime of their age such that those in their late 20s, early 30s, and early 40s come down with liver diseases caused by hepatitis.
A laboratory technician, Blessing Michael, at the Makurdi office of the Viral Hepatitis Association, said Hepatitis B and C are prevalent in the state, citing a 2016 report which ranked Taraba State at 34 percent and Benue 35 percent as being the highest around the northern states of the country.
In November 2013, the then Benue State Governor Gabriel Suswam said a report written to him by the Nigerian Army indicated that at least five out of every ten persons in the state are infected with the deadly disease.
Dr Adamu Alhassan Umar, State coordinator, and Principal Medical Officer, National Blood Transfusion Service, Yobe State said the centre, which covers institutions and communities in Yobe, Bauchi and Gombe has within the last 12 months collected 991 units of blood, a total of 113 units were found to be positive for the hepatitis B infection and 13 positive for hepatitis C.
He said when juxtaposed with the total percentage of all transfusion transmissible infections which stands at 16 percent (this include other infections such as HIV and syphilis), the hepatitis viral positivity is high in individuals in the region.
Prevention and treatment
Professor Achinge advised people to prevent the disease by adhering to safe health practices and to vaccinate themselves, especially, where one of the members of a family test positive for the virus.
Dr Odeghe said hepatitis C virus could be avoided by simple, regular hand washing.
He said people should avoid self- medication, and use of herbal/traditional drugs as some of them cause hepatitis.
Dr Oyeleke said for the disease to be reduced, every adult must be tested for hepatitis. She said those whose results are negative, should get the vaccine, while those who tested positive, should get treated.
She recommended that every child must be vaccinated during the routine immunization after birth.
Dr Biodun Ogungbo, a medical expert with Spine Fixed in Abuja said the vaccine for hepatitis B is available and relatively cheap. It cost about N10, 000 for three doses, she said. – Daily Trust.
