Crucial facts about Hepatitis B: its transmission, prevention measures available in Uganda

Compiled by our reporter:

Hepatitis continues to be a public health burden in Uganda with an estimated 4.1% of the population aged 15-64 years having chronic hepatitis B infection.

Hepatitis is inflammation of the liver caused by infectious such as viruses, bacteria and non-infectious agents
such as toxins, drugs, alcohol. The commonest causes of viral hepatitis include one of the five heterotypes; A,B,C,D and
E. Hepatitis A and E viruses usually cause acute infections which are self-limiting.

Hepatitis B (HBV) and hepatitis C (HCV) infections may progress to chronic infection with long term complications such as liver cirrhosis (a condition that causes scar tissue to gradually replace your healthy liver cells), liver failure and Hepatocellular Carcinoma(HCC) -the most common type of primary liver cancer.

Your liver is an important organ that filters toxins from your blood, makes enzymes that help you digest food, stores sugar and nutrients, and helps you fight infections.

Worldwide, over 2 billion persons have been exposed to HBV infection and the majority of these live in sub-Saharan Africa
and Southeast Asia.

According to the Population based HIV Impact Assessment survey, (UPHIA, 2016) the disease prevalence in Uganda varies from region to region being highest in North and lowest in Southwest.

Hepatitis B spreads by mucosal exposure to infected blood or other body fluids such as vaginal and seminal fluids. In highly endemic areas, HBV is mostly spread from mother to child at birth (perinatal transmission) or through horizontal transmission (exposure to infected blood) from an infected close contact to an uninfected child during the first five years of life.

It can also be spread through sharing of sharps such as needles, instruments used for tattooing and body piercing, razor blades, contaminated surgical instruments (including instruments used for tribal markings), sexual intercourse and blood transfusion (if blood is either not screened or is screened negative during the window period of HBV infection).

Hepatitis B does not spread through greeting, sharing food, utensils, water, clothes, or witchcraft. Persons who are infected should not be isolated on the basis of this infection. They should therefore not be discriminated in schools, water sources or places of employment.

During a recent engagement with journalists, Dr Felix Kawooya a MOH Associate summarized the mode of transmission of the Hepatitis virus from one person to another, as similar to that of the HIV which causes AIDS.

Hepatitis infection that is acquired in the neonatal period leads to chronicity in more than 90% of the exposed. Infection acquired above 5 years of age will spontaneously be eliminated in over 90% of the infected individuals within 6 months.

Uganda currently has strategies for prevention of transmission of hepatitis B and C virus infection. These include early childhood vaccination against hepatitis B which was incorporated into the national expanded program on Immunization in the year 2002, safe injection practices, screening donor transfusions for TTIs and Hepatitis B vaccination for health workers, adults and adolescents.

According to the Ministry of Health, routine vaccination services against Hepatitis are available in health centers across the country. A HBV vaccine dose is also available and given to every child born in public health centers within 24 hours of birth. Routine vaccination for children is then administered at 6 weeks, 10 weeks and 14 weeks.

HBV vaccination is the main stay for prevention. However, it is important to note that vaccination is only beneficial to individuals who have never been infected with hepatitis B virus.

Adult vaccination may also be offered as long as there is no evidence of chronic infection (HBsAg negative and anti-HBc negative) following a test conducted by a trained laboratory personnel or any other qualified health worker.

In spite of these interventions, information from the Ministry of Health indicates there is still a large cohort of people who are infected with Hepatitis B virus and Hapatitis C virus.

It is important to note that most of the time, you can’t fix the damage to your liver, but if you catch it early, there are treatments that can keep problems in check.

For anyone to know whether they have Hepatitis B virus, they have to undergo a test undertaken by a health professional.

Where to get tests for Hepatitis:

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