Spread of Hepatitis B – Nigerian Pilot

Not too long ago, Nigeria joined the rest of the world to mark the World Hepatitis Day, a day set aside by the United Nations and the World Health Organisation, WHO, to create awareness on the deadly effects of the disease. Worldwide, about 400million people are said to be living with Hepatitis B or C. Every year, 1.4million people die from the viral disease and yet all of these deaths could be prevented.
Health experts posit that with better awareness and understanding of how to prevent hepatitis, we can eliminate this disease and save 4,000 lives a day. That is why in 2010, the World Health Organization, WHO, made World Hepatitis Day one of only four official disease-specific world health days, to be celebrated each year on the 28th July.
Millions of people across the world now take part in World Hepatitis Day, to raise awareness about viral hepatitis, and to call for access to treatment, better prevention programs and government action. Hepatitis has A, B, C, D and E, categories.
However, Hepatitis B virus infection is a pandemic and chronic infection that often leads to chronic liver diseases which are often lethal. Records have it that it kills more Nigerians than the much dreaded HIV/ AIDS. Since over 30years when pioneer works were done in Nigeria to recent times, the prevalence of hepatitis B virus infection has remained very high.
In Nigeria, the transmission of hepatitis B virus occurs mainly during childhood and all the risk factors (like blood transfusion, sexual promiscuity, lower socioeconomic status etc) implicated elsewhere in the spread of the virus in the general population also play role in Nigeria.
Historically, hepatitis B surface antigen (HBsAg) was formerly called Australia antigen because it was first described in the serum of an Australian aborigine in 1963.In West Africa, it has been estimated that 40% of children will be infected by age two years and above 90% by age of ten years. Chronic carrier rate is 20% in these children. A chronic carrier rate above 7% in a population is classified as hyper endemic. Studies done in Nigeria showed HBV carriage rate in the range of 9 to 39%.
There are broadly three strategies for dealing with HBV infection in developed countries, immunization for at risk population, antiviral drugs (lamivudine, adeforvir and dipivoxil) and immunostimulatory therapy with alpha-interferon for those affected. Of all these, Immunization seems the most effective means of controlling HBV worldwide. The vaccine is said to have an outstanding record of safety and efficacy, and it is 95% effective in preventing development of the chronic carrier state.
Even when all blood donations are screened for HBsAg, donations from volunteered non-remunerated donors have been proved to be safest.
This is preferred to other methods for labile plasma derivatives. Where possible, only donations from immunized donors with a detectable amount of anti- HBs should be collected either for transfusion or for preparation of plasma derivative. Pasteurization of plasma derivatives like albumin, factors iii and viii at 60°C for at least 10 hours is essential for the elimination of HBV.
Because of risks of blood transfusions, it should be given only when it is absolutely necessary as it was said that most blood transfusions were not necessary.
Unfortunately and sadly enough, in Nigeria, most of these control measures are poorly observed and safe blood for transfusion are not easily accessible. Socioeconomic and living conditions of most Nigerians encourage transmission of HBV. Reduction in the hepatitis B virus infection could be achieved by public enlightenment campaigns, mass immunization of children and adults at risk while antiviral drugs and immune-stimulatory therapy should be provided for those already infected.