Rwanda is expanding efforts to identify hepatitis infections among people at higher risk, including healthcare workers, people living with HIV, people who inject drugs, and those in correctional facilities, refugee camps and rehabilitation centres, as the country continues its viral hepatitis elimination campaign. ALSO READ: Rwanda on track to eliminate Hepatitis B by 2030 - RBC Latest data from the Rwanda Biomedical Centre (RBC) show that hepatitis C prevalence has decreased from 4 percent in 2017 to 0.17percent, while hepatitis B prevalence has declined from 3 percent in 2017 to 0.26 percent over the same period. ALSO READ: Rwanda on course to eliminate Hepatitis C Dr Charles Berabose, Director of Sexually Transmitted Infections and Other Blood-Borne Infections at RBC, said that although hepatitis prevalence has declined in the general population, some groups still have a higher prevalence of infection. “We are now identifying and targeting those groups.” Berabose made the remarks on Tuesday, July 28, during a World Hepatitis Day event at Hôpital La Croix du Sud in Remera, where Rotary Club Rwanda partnered with RBC to support Rwanda’s viral hepatitis elimination efforts. The event featured hepatitis screening for hospital staff. Millions screened, thousands treated Rwanda launched its viral hepatitis elimination campaign in December 2018, with the initial focus on finding people living with hepatitis through nationwide screening. Since then, the country has screened nearly 11 million people for hepatitis C and about 6.5 million for hepatitis B. “The screening programme has led to the identification and treatment of around 63,000 people with hepatitis C, while nearly 5,000 people are currently receiving treatment for hepatitis B, which requires lifelong care,” he said. Berabose said hepatitis remains difficult to detect because many people do not develop symptoms until the disease has progressed. “This is a silent disease. People come to the hospital complaining of a headache or flu, and when we screen them, they are found positive,” he said. He added that the initial screening campaign helped identify people living with hepatitis and connect them to treatment. Rwanda is preparing to submit an application this year for validation of its hepatitis C elimination milestone. Berabose said the country has surpassed its target of screening seven million people and meets the requirements needed for the application. The requirements include screening more than 80 percent of the target population, treating more than 70 percent of eligible patients, ensuring all blood used for transfusion is screened, and maintaining safe injection practices in public and private health facilities. “The reason we are applying is that we are meeting the requirements. The validation process will include an assessment to confirm whether Rwanda has met the required standards.” Berabose said the Rotary-supported screening activity will continue in other private health facilities as the country works to reach more healthcare workers. “We aim to screen healthcare providers from both public and private health facilities, with the support of partners. This is the beginning, intending to screen other health workers from other health facilities,” he said. Hepatitis B vaccination expands The country has expanded hepatitis B prevention through vaccination. In January, the country introduced universal hepatitis B birth-dose vaccination, where newborns receive the vaccine regardless of their mother’s hepatitis B status. Previously, the vaccine was given only to babies born to mothers who tested positive for hepatitis B. Berabose said coverage of the birth-dose vaccination programme is above 90 percent, with vaccines available in public and private health facilities offering maternity and antenatal care services. The need for early action Dr Jean-Chrysostome Nyirinkwaya, Director of La Croix du Sud Hospital in Remera, said his father died of liver cancer in 1991 after he had tested positive for hepatitis years earlier. Nyirinkwaya said his father tested positive for hepatitis in 1982, but at the time, little attention was given to the disease. “Nobody was taking care of him, nobody was concerned, and people did not understand the problem,” he said. He said his father’s death showed the need for greater awareness about hepatitis and the importance of preventing complications through vaccination and early detection. Dr Alexis Muderevu, Rotary Action Group National Commission Chair for Rwanda Hepatitis B and C Zero campaign, said eliminating viral hepatitis requires collective efforts focused on prevention, early detection, treatment, and reducing stigma. He said the partnership with RBC will promote hepatitis B vaccination, expand access to screening and diagnosis, support timely care for people living with the disease, and raise public awareness about prevention. “Millions of people around the world are living with viral hepatitis, many without knowing they are infected. Every year, hepatitis silently claims lives through liver cirrhosis and liver cancer, even though hepatitis B can be prevented through vaccination and hepatitis C can be cured with effective treatment,” Muderevu said. He called on citizens to know their hepatitis status, seek care when needed, and support prevention efforts in their communities, adding that collaboration between government institutions, health workers, communities, and partners is crucial to eliminating hepatitis B and C as public health threats.
