Worry as hepatitis becomes silent public health threat

Dar es Salaam. Hepatitis, a medical condition that affects the liver, is silently emerging into a major public health threat and experts say the disease is also hampering the efforts to tackle the scarcity of blood in the blood banks.

The impact of hepatitis also remains largely unknown to the public and there seems to be no concerted efforts to try and educate the mass on the disease in the country.

About five months ago, researchers on infectious diseases revealed that one of the forms of Hepatitis—known as Hepatitis B, was more prevalent among healthcare workers in Tanzanian tertiary hospitals.

Findings from a study which was carried out at Bugando Medical Centre in Mwanza Region and published in the BioMedCentral Journal, recommended the need to strengthen vaccination programmes among the healthcare workers in the country.

According to the study, the health staff carry a greater risk of acquiring the infections due to the nature of their work. However, other studies have also noted that patients undergoing surgery and kidney dialysis were also at risk.

All the hospital’s employees, medical students and nursing students at Bugando, who have regular contacts with patients were included in the study titled: Titled, “Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania.”

On a global scale, more than 2 billion people are infected with hepatitis B virus (HBV). Of these, 240 million are chronic carriers of HBV and are at risk of death from acute fulminant liver disease, such as liver cirrhosis or liver cancer, according to World Health Organization (WHO).

The WHO has also stated that the prevalence of hepatitis B is highest in sub-Saharan Africa and East Asia, and they estimate that between 5–10 per cent of the adults are chronically infected.

Yesterday, medical officers from various hospitals in Dar es Salaam, who have been attending to cases of hepatitis told The Citizen that the most common types of the disease among Tanzanians were Hepatitis B and C.

Dr Sylvanus Ernest, a general practitioner who has previously worked at the cholera treatment camps in the city, noted that hepatitis could be caused by a variety of factors but the most common cause was viral infection.

“Hepatitis is simply the inflammation of the hepatic cells (liver cells) which can be caused by a variety of things. Some of the cases can be fatal,’’ he warned.

According to medical sources, other common causes of non-viral hepatitis include toxic and drug-induced, alcohol and immunity-related disorders. Less commonly, some bacterial or parasites and fungus can cause hepatitis.

They further indicate that there are five types of the disease—Hepatitis A, B, C, D and E. Of all the types, the most serious condition was Hepatitis C—in which the victims can remain without symptoms for a long time as they spread the disease to others.

Some of the types can naturally heal without medical interventions, yet others can lead to death, says Dr Ernest.

Another medic, a general practitioner, Dr Ibrahim Urio, stressed that the biggest challenge with Hepatitis in Tanzania was the lack of public awareness but the disease was preventable.

“If patients get screened early they could be treated and they fully recover. This would also prevent the patient’s condition from progressing into complications of the liver and finally liver cancer,’’ said Dr Urio.

Some studies have revealed that Hepatitis B, C, D and E are as nearly dangerous as HIV/Aids. However, hepatitis is not given as much importance as HIV/Aids, doctors told The Citizen.

However, they noted, it is still easy to recover from Hepatitis than from HIV/Aids, even if Hepatitis was more transmissible. At times the body itself can clear out the hepatitis virus but in most cases, the disease advances.

“To a greater extent, it’s easy to control HIV than Hepatitis B, for example. There is a vaccine for Hepatitis B but there is no vaccine against HIV,” says Dr Urio again.

Even though there seems lot of similarity of symptoms in hepatitis and Aids—especially after initial stages and during final stages of both diseases—the treatment of the two diseases is very different.

Like HIV/Aids, hepatitis B, D and E are not considered curable by modern medical systems, the doctors say.

Recently, experts from the National Blood Transfusion Services (NBTS) told The Citizen that about ten out of 100 litres of blood collected from donors every month, were being discarded due to contamination with various forms of infectious diseases—including hepatitis.

According to the NBTS Eastern Zone manager, Dr Aveline Mgasa, 5 per cent of the blood collected is thrown away due to Hepatitis B infection.

But, she noted, Hepatitis C accounted for 3 per cent while HIV is only 1 per cent. The least percentage, 0.9, is lost due to Syphilis.

“This means that most of people who donate blood are victims of Hepatitis B than other infections,’’ explained Dr Mgasa, and added that the rise of hepatitis B, and other infections was hindering the effort in ensuring optimal blood collection.

On a general scale, Tanzania needs 450,000 blood bottles per year but only half of the amount is collected, data from NBTS shows.