Every year, on July 28th, the world comes together to observe World Hepatitis Day, aiming to raise awareness about this dangerous yet preventable viral disease that affects the liver, often leading to liver cancer.
In line with the global efforts, Uganda joined in to mark this significant day and encouraging everyone to undergo testing for hepatitis B and C. Timely testing and early treatment are emphasized to prevent the disease from progressing to a critical stage.
International experts who have been actively working on combating this chronic condition, especially in Africa, where awareness levels remain low, are advocating for people to get tested. In particular, they stress the importance of testing for hepatitis C and B, as these types can be treated with some antiretroviral drugs.
Pregnant women are being urged to undergo testing as well, and it is essential to ensure that newborn babies receive vaccination at birth.
Kenneth Kabagambe, the Founder and Executive Director of the National Organization for People Living with Hepatitis B said that mostpeople associate hepatitis B with HIV.
Kabagambe suggests that everyone should get tested and that communities should avoid stigamisting people who test positive for hepatitis C and B. Kabagambe has personally suffered from stigma and stigmatization having declared his hepatitis status. Over the years, Kabagambe has realized the lack of awareness about hepatitis. That the fact that many don’t know their status, they are reporting for treatment too late.
He has realized that viral hepatitis is not found in one location nor amongst one set of people; it is a truly global epidemic that can affect millions of people without them even being aware.
“ I thought that my wife is the one who infected me. Because she comes from a region with highest prevalence of hepatitis” he said. Northern Uganda is one of the regions with the highest prevalence of especially hepatitis B in Uganda. Hepatitis disease spreads through blood and bodily fluids.
The theme for this year’s World Hepatitis Day is “We’re not waiting.” It calls for immediate action to accelerate the elimination efforts of viral hepatitis and emphasizes the urgent need for testing and treatment for those who require it.
Several countries have adopted specific themes to draw attention to the importance of testing for hepatitis, such as “Don’t Wait to Get Tested for Hepatitis to Save Your Life” or “One Life, One Liver.” The latter theme is particularly relevant since hepatitis B and C primarily attack the liver, leading to liver cancer.
Early detection through testing enables proper treatment, but if the condition is diagnosed late, a liver transplant may be the only option for survival. Unfortunately, liver transplants can be prohibitively expensive and unavailable in many countries, including Uganda.
Uganda has one of the highest prevalence rates of hepatitis globally. In 2018, the prevalence of hepatitis B was reported at 4.3%, with higher rates among men (5.6%) than women (3.1%).
Viral hepatitis is a significant global health issue, causing approximately 1.34 million deaths annually, on par with HIV/AIDS, tuberculosis, and malaria. Hepatitis B and C combined account for 80% of liver cancer cases worldwide.
Regrettably, the majority of individuals living with hepatitis B (90%) and hepatitis C (80%) are unaware of their status, which puts them at risk of developing severe liver disease and unknowingly spreading the infection to others.
Experts emphasize the need for increased awareness about hepatitis and the importance of early testing. Dr. Neliswa Gogela, a specialist in liver disease from viral hepatitis, warns that hepatitis B is highly infectious, with transmission occurring during childbirth or early infancy.
Gogela is based at the University of Cape Town in South Africa. She acknowledges that hepatitis B is a silent killer and can be transmitted from mother to child. “Remember it is a blood-born infection. And these infections happen during delivery or early childhood in infancy where babies are dependent on their mothers for feeding,” said Gogela.
She says hepatitis B is 100 times more infectious than HIV. “So if I have hepatitis B now, and I leave my blood on the surface, that virus will survive on the surface for about a week.” She suggests that expectant mothers that test hepatitis B positive should be given one of the common ARVS known as Tenofovir during the last trimester of pregnancy to prevent her from passing the virus to the baby. Newborns from a mother with hepatitis B should be given a vaccine at birth. “
“A simple message, pregnant women should have their hepatitis B status known. And if they are positive, Tenofvir is key.
Pregnant women who test positive for hepatitis B should receive Tenofovir, a common antiretroviral drug, during the last trimester to prevent transmission to the baby.
Dr. Bilal Bobat, a Specialist Gastroenterologist involved in the care of liver transplant patients, stresses the urgency of raising awareness about hepatitis B and C. He points out that hepatitis B is the cause of 50% of liver cancer cases and remains a significant cause of cancer-related deaths.
Uganda has been making efforts to combat hepatitis, with a mass free hepatitis B screening program launched in 2015. By 2019, over four million people had been screened. However, only 30% of the infected population are currently aware of their status and have access to comprehensive treatment services, including free medication.
While Uganda achieved and surpassed the 2020 target of 20%, the complete elimination of hepatitis by 2030 remains uncertain. Continued efforts and awareness-raising actions are crucial in the fight against this disease.