Experts urge early Hepatitis screening

Concerted efforts are needed to curb the prevalence of Hepatitis B and C, experts have said. They were speaking during an event to mark the World Hepatitis Day in Kigali on Monday. The day was characterised by a march from Kimihurura to Remera, aimed at raising awareness about the disease. “A survey carried out in 2012 on 12,000 pregnant women in selected health facilities countrywide showed that 3.7 per cent of them had Hepatitis B, while 2.6 per cent had Hepatitis C, an indication of the severity of the problem,” noted Stany Ngarukiye, a public health specialist working with Mount Kenya University, and a member of the Rwanda Organisation for fighting against Hepatitis (ROFAH). Dr Aimable Mbituyumuremyi, the director of other blood born Infections unit at Rwanda Biomedical Centre (RBC), said estimates show that four out of every 100 people in the country have Hepatitis C. Statistics from the World Health Organisation (WHO) show that viral hepatitis, a group of infectious diseases known as Hepatitis A, B, C, D, and E , affects hundreds of millions of people worldwide, causing acute and chronic liver disease and killing close to 1.4 million people annually. Mbituyumuremyi noted that another study carried out between 2013 and 2014 in Kigali showed that 5 per cent of HIV positive people were found to have Hepatitis B. “We found Hepatitis B commonest around border post areas, perhaps because of high levels of prostitution,” Mbituyumuremyi said. Cost of care Mbituyumuremyi said the two diseases are not covered by community based public health insurance, making their treatment expensive. “Treatment of Hepatitis C, for instance, takes about 42 to 48 weeks, at a cost ranging from Rwf8 to 12 million.” Currently children access Hepatitis B vaccines free of charge, but an adult has to part with about Rwf27,000 for the whole vaccine dose. A single test for Hepatitis B and C ranges between Rwf4,000 and 5,000, in most hospitals. “We have not carried out a survey to ascertain the number of hospitals offering that kind of care, but all I know is that the four referral hospitals in the country do,” Ngarukiye said. He said there is need for a countrywide survey to ascertain the scope of the Hepatitis problem, as the existing figures are for pregnant women from a few health facilities. “The biggest challenge with Hepatitis B and C is that one can go for up to 30 years without noticing, since signs and symptoms take long to show up. It is, therefore, important for anyone who has never gone for screening to do so” Measures put in place Mbituyumuremyi said the government had come up with various measures to curb the prevalence of the two diseases. In 2013 alone, three medics were trained in each public hospital and health centre, and 2 per health facility countrywide on Hepatitis care, he said. In the same year, about 70,000 HIV positive people were freely vaccinated against Hepatitis B, courtesy of the health ministry. “In partnership with other sector players, in July this year, we put in place guidelines for medics as far as the handling of Hepatitis B and C is concerned,” he said, adding that they are trying to negotiate with drug manufacturers on the cost of drugs. “We also want to ensure that every province has a modern laboratory that can effectively screen for Hepatitis B and C.” A three-months public sensitisation campaign has been launched to raise awareness about the disease. “We are also trying to lobby the Health ministry to add those two types of Hepatitis on the list of diseases covered by Mutuelle de Sante community based health insurance.” Some of the symptoms of the disease include general body weakness, high temperatures and head ache. About 350 million people around the world have Hepatitis B, while 210 million have Hepatitis C, according to the World Health Organisation. Statistics from WHO indicate that, Hepatitis B and C account for almost 80 per cent of all liver cancer cases. Information from the same organisation shows that HIV and Hepatitis C have common routes of transmission and approximately 4 to 5 million are co-infected with these two viruses. The transmission risk is estimated at four to eight per cent among mothers without HIV infection and 17 to 25 per cent among mothers with HIV infection. While the number of deaths from HIV/Aids reduced from 1.7 million in 2005 to around 1.3 million people in 2013, deaths from viral hepatitis increased by 50 per cent between 1990 and 2010, and now kills 1.5 million people worldwide annually, according to new findings published in the Lancet, a medical journal.

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Experts urge early Hepatitis screening