the Communal Health Support Scheme (CHSS) set out to Oregun community for the World Hepatitis Day campaign, with the theme “Finding the Missing Millions”. Hepatitis B is a serious viral disease that causes inflammation of the liver and puts people at high risk of death from cirrhosis and liver cancer.
Here is what you need to know about Hepatitis B Virus(HBV): HBV antigens are proteins that appear in different areas of the virus. HBV has three antigens which the body’s immune system in turn releases antigens against them. Both antigen and antibody can be detected through blood tests. The surface antigen is detectable between 4-10 weeks after being exposed to HBV and is transmittable toothers. The HBV in adults can be cleared at this stage. However, if after 6 months, the patient still tests positive, then it is considered chronic and requires an evaluation. The core antibody indicates the history of an infection but does not fully acknowledge infection, re-infection or immunity. However, the surface antibody indicates immunity of the HBV and cannot be infected. All of these can only be reassured with a complete diagnosis and evaluation by a health professional.
Unfortunately, people living with hepatitis are unaware of the disease they have as Hepatitis B, a major asymptomatic disease. According to the World Hepatitis Alliance, WHA, over 290 million people worldwide are unaware they have this disease. The global campaign by the WHA is a three-year campaign which is drawing attention of the civic society to overcome the barriers of diagnosis. The barriers of diagnosis are known to be: lack of public knowledge of the disease ; lack of knowledge of the disease amongst healthcare professionals; lack of easily accessible testing; stigma and discrimination; and the out-of-pocket costs to thepatients.
Oregun, a community in Lagos, Nigeria, is a small town within Ikeja, the capital of Lagos. Although, one would expect that Ikeja residents are economically advantaged, there are communities within Ikeja that shouldn’t share such sentiments.
Oregun has poor people living in its community. This socio-economic status is seen to have ripple effects on the health of the citizens as the out-of-pocket costs scare people away from health centres to get diagnosed. The effect of this is that people living with the infection are left unaware and they continue to spread the disease until it becomes an outbreak.
Unfortunately, Hepatitis B Virus(HBV) can only be detected when the blood is tested and symptoms would only begin to manifest 30 days to 6 months after infection. However, when symptoms begin to manifest, their appearance include yellowing of the skin and eyes(jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. The seroprevalence of the test at Oregun, Nigeria was 6.25% as 7 out of 112 people tested positive. The carriers of HBV in Oregun did not show any symptoms of infection, neither were they aware they were infected. Unprotected sexual activities,usage of local unsterilized blades for commercial barbing services and use ofunsterilized tools for facial marks and tattoos all increase the HBV infection rate.6However, just like HIV, it cannot be transmitted without exchange of serum.Although, research has shown that HBV is hyperendemic among women as it was in our case study in Oregun Nigeria where 4 out of the 7 positive results were women.
The only way this disease can be managed and prevented from generating into an outbreak is for proactive policies to be put in place against the virus. Vaccination is one way to start but with the economical state of these communities, policies have to be put in place to include them, creating campaigns that remind them to take vaccinations and get diagnosed. Because of the risk of this disease and the easy transmutability, it is important that campaigns and sensitization are imbibed into state and local government health policies. It has been advised to strengthen the national immunization program for infants but the government should also consider the vaccination of older children and people at risk such as health-care workers.