Save SA from the silent killer, hepatitis — experts urge

South Africa is one of the overburdened countries by hepatitis infections with about 4-million cases. This viral infection causes the inflammation of the liver, cirrhosis the liver cancer.
South Africa is one of the overburdened countries by hepatitis infections with about 4-million cases. This viral infection causes the inflammation of the liver, cirrhosis the liver cancer.
Image: Bloomberg

Public health specialists have called for political will to deal with the country’s silent killer, hepatitis, which kills thousands of South Africans each year.

Statistics show that SA is one of the most overburdened countries with a prevalence of about 7% or about 4-million cases of hepatitis — a viral infection that causes inflammation of the liver, cirrhosis and liver cancer. In Africa chronic viral hepatitis (B and C) affect over 70-million people.

These types of infections, which mainly affect the liver, are known as silent killers because the diseases develop slowly over many years and most patients do not have symptoms.

In a recent virtual roundtable hosted by Abbott Rapid Diagnostics, which brought together medical professionals across the continent to discuss insights about Hepatitis in Africa, local experts said given the incidence of hepatitis in the region there is an urgent need to have universal access screening and diagnostics of this deadly epidemic.

One of the speakers and head of hepatology at the University of Cape Town and Groote Schuur, Prof Wendy Spearman, said: “We need political will to recognise viral hepatitis as a health priority and to set national elimination targets with dedicated funding to implement national viral hepatitis action plans. Importantly there must be universal access to affordable diagnostics and therapeutics.”

She said the burden of this disease and its complications such as cirrhosis and liver cancer is underestimated.

While hepatitis B is vaccine preventable, Spearman said hepatitis C is now curable.

Recent research by the National Institute for Communicable Diseases and Durban University of Technology shows that the national prevalence rate of hepatitis per 100,000 population increased from 56 in 2015 to about 68 in 2019.

Over the five years, the prevalence rate was higher in males than females, highest among individuals 25 to 49 years old and highest in Gauteng. During the same period the hepatitis test positivity rate was higher in males than females among individuals 25 to 49 years old, mostly in Limpopo. Among children under the age of five that tested positive for hepatitis, two-thirds were less than a year old.

Hepatitis C is mainly a concentrated epidemic among key populations, mainly people who inject drugs and share needles. If left untreated, around one-third of those chronically infected with viral hepatitis will die as a result of serious liver disease, including cirrhosis, liver failure and hepatocellular carcinoma.

The World Health Organisation has provided a road map for the elimination of viral hepatitis B and C as a public health problem by 2030 — which includes a 90% reduction in incidence and a 65% reduction in mortality by 2030.

Dr Kuku Appiah, medical director for Abbott’s rapid diagnostic business in Africa, said early screening followed by adequate treatment is paramount for better health outcomes.

She said the biggest barrier to eliminating hepatitis B and C “remains the lack of awareness by both patients and healthcare workers”.

In Nigeria, the prevalence of hepatitis B and C is 8.1% and 1.1% respectively, making it one of the highest impacted countries by hepatitis on the continent with an estimated 19-million people living with the disease. In Uganda the prevalence of hepatitis is 4.3% while in Rwanda, which introduced a hepatitis screening programme in 2015, has the lowest prevalence of hepatitis of only 2%.


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