Nigeria Content Online

Nigerian
hepatologists say they watch most of their patients die of end stage
liver diseases without being able to help them, because the patients
report at hospitals too late. End stage liver disease is caused by
viral hepatitis over a long period of time.
Under the
professional body, Society for Gastroenterology and Hepatology in
Nigeria (SOGHIN), the scientists at a workshop creating awareness ahead
of the World Hepatitis Day, marked every May 19, decried the increasing
rate of patients who could have been prevented from dying, if only they
had been screened earlier.
“Early screening is
the key to preventing this deadly disease,” says a liver specialist,
Oluyemi Aderemi. “We should have more screening centres across the
nation. Once a person is screened, if he tests positive to the disease,
he can be further treated before it develops into liver cirrhosis or
cancer. And if he is negative, he can be immunized against it.”
Vaccination provides 95 per cent immunity.
According to Dr.
Aderemi, Nigeria has a prevalence rate of 10-20 per cent, which means
about 14-28 million people are infected with hepatitis, and about 5
million die of the consequences, annually.
Knowing hepatitis
The World Health
Organization defines viral hepatitis as a small virus that attaches
itself to the DNA. In other words, the virus attaches itself to the
genetic components of a person. Experts say it takes 20-30 years for an
infected person to develop a full blown liver disease.
“So all the people
who present with liver diseases at age 20 or 30 must have been infected
since childhood without knowing it,” Dr. Aderemi says.
Viral hepatitis has
various types, but B and C are most common. From their clinical
experience, the experts say Type B is the commonest in Nigeria, being
highly infectious, and about 50-100 times more infectious than HIV. The
virus lives in body fluid; blood, sweat, semen, tears, urine, vaginal
fluids, even saliva.
Transmission could
be during pregnancy from mother to child; through injection drug use
that involves sharing needles; through breaks in the skin resulting in
contact with blood or opens sores of infected persons; needle pricks;
sharing items such as razor blades; blood transfusion and through
unprotected sexual intercourse with infected persons.
“If left untreated
for years, infection with the virus can lead to scarring of the liver
(cirrhosis), liver cancer, liver failure and, ultimately, death.”
Treatment dilemma
Dr. Aderemi says
hepatitis is treatable and preventable if it is detected early through
early screening, but there are not enough screening centres and there
is low awareness.
Describing it as a
silent killer, he says hepatitis shows no symptoms until it has got to
the end stage where the patient comes into the hospital with a swollen
stomach, jaundice and coughs or vomits blood. At this stage, there is
really little any doctor can do.
In her experience,
Funke Adeleye, a physician at the Gastroenterology department of the
Lagos University Teaching Hospital (LUTH) Idi Araba, says, “It is very
sad when you watch your patient die without being able to help them.
…Many of them show up when the liver has become severely damaged. We
tell their relatives the truth so that the dying patient has enough
time to put his her house on order…there is nothing we can do.”

Calling on the government
SOGHIN called on
the government and NGOs to raise awareness by conducting screening
exercises just like in the cases of hypertension and diabetes, in
market places, schools, pre-employment and so on.
“When people are
screened, they will know their fate early. That is the only way to help
us (hepatologists) to save lives. Otherwise, late presentation will
always lead to death.”
They added that
vaccination in Nigeria has been available since 1982 but there has been
low awareness. Not until 2005 did the government make hepatitis
vaccination part of the routine immunization for all children.
The message for the public is that children born before 2005 are
unlikely to have been immunized and should, therefore, go for screening
and be vaccinated if not already infected.