How Africa is burdened by viral hepatitis
- Researchers assessed global burden of hepatitis C among children
- Of 21 nations forming 80 per cent of the global burden, ten are in Africa
- Advocacy and partnerships are needed to help combat viral hepatitis, say experts
According to a study presented at the World Hepatitis Summit in Sao Paulo, Brazil this month (1-3 November), 325 million people lived with viral hepatitis in 2016, with 48 million children under 18 years old having hepatitis B and four million children under 19 years old living with hepatitis C.
The ten African countries are Angola, Burundi, Côte d’Ivoire, Egypt, Ethiopia, Ghana, Mali, Niger, Nigeria and Tanzania.
Of the 21 countries, only Russia is a high-income country, with the rest including Afghanistan, Bangladesh, India, Indonesia and Pakistan.
“It is also essential to empower the public and increase demand for access to diagnosis, care and treatment.”
Manal El-Sayed, Ain Shams University
Manal El-Sayed, a professor of paediatrics at the Ain Shams University, Cairo, Egypt, who presented the study, tells SciDev.Net that mother-to-child transmission occurs at a rate of more than 90 per cent in the case of highly replicating hepatitis B virus and five to seven per cent for hepatitis C virus. The two viruses lead to liver disease, liver cancer and deaths.
She notes that a modelling approach was used to quantify the burden of disease among all age groups, adding that the objective of the study was to assess the global burden of hepatitis C among children and adolescents to shed light on the importance of tackling this curable disease in children.
El-Sayed explains that the data sources used for the modelling included published literature and national surveys.
“The risk of transmission of hepatitis B virus, however, decreased dramatically with the introduction of the birth dose of hepatitis B vaccine in several countries; although the risk of hepatitis V virus transmission increased to 20 per cent in HIV co-infected mothers,” says El-Sayed.
But El-Sayed adds that in low- and middle-income countries, transmission also occurs through unsafe injections, blood or medical devices, hospital-acquired transmissions, in addition to some traditional practices including circumcision and tattooing.
According to El-Sayed, hepatitis B is declining because of vaccination policies that are obligatory for infants in most countries. She cites the lack of vigilant infection control programmes in health care facilities and blood and injection safety issues as the main reasons for the continuing infection with hepatitis C and hepatitis B viruses.
El-Sayed urges the mass media and key actors such as physicians, scientific organisations patient groups and policymakers to come together and develop individual country strategies for control and prevention of viral hepatitis.
21 countries containing around 80% of the estimated burden of hepatitis C in children aged 0-19 years
“It is also essential to empower the public and increase demand for access to diagnosis, care and treatment and be aware of the modes of transmission and risks of infection with hepatitis viruses and long-term complications including liver cancer,” she explains.
Marianne Mureithi, a lecturer at the Department of Medical Microbiology, University of Nairobi, Kenya, applauds the study and says advocacy could help women of childbearing age, children, and adolescents get early access to care and treatment.
“This would cure the disease early preventing transmission before the age of risky behavior as well as preventing progression of liver disease,” notes Mureithi. She calls for effective collaborations among African countries through sharing of successful cost-effective models of care and also offering of technical assistance and developing tailored guidelines for resource-limited settings.
The mass media should help raise awareness to African governments about the size and brunt of viral hepatitis problem, and the need to address it, Mureithi adds.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.