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I read the pathetic story of a concerned citizen entitled, Hepatitis management in Nigeria: A red alert, published in The PUNCH edition of March 5, 2012.
The writer said, “I find it compelling to call attention to the dangerous state of medical knowledge in Nigeria, as experienced in the last three years of my battling a chronic disease called Hepatitis B. Without prejudice to my respect for professionals in Nigeria, I owe it a duty as a concerned Nigerian to raise a red flag on this.”
The patient raised many issues: how the medical experts were unable to help him out of his dilemma; how he was able to join an hepatitis online community group abroad where he got the up-to-date information about the management of hepatitis; how he has been able to stay alive several years after the diagnosis; and how he lost a friend to the complications of hepatitis B Virus due to inadequate management.
I will start this discussion by going through the basics of the disease before x-raying the dilemma in the diagnosis and management of hepatitis in general.
There is also the issue of not knowing what to do, where to go for treatment and who to see when it comes to hepatitis.
While working at a National Paediatric Hospital, I had several encounters with many young men who are willing to donate blood to save the life of sick children, but most of them failed to meet the requirements, as they were infected with either Hepatitis B or C.
Also, women attending antenatal clinics were screened, and a few of them had the virus. Such women were counseled on the risk to the pregnancy, the possible effects on the unborn babies as well as on their partners.
I normally advise hepatitis patients to visit the website of Society for Gastroenterology Hepatology in Nigeria, www.soghin.org, being the highest body in the country that provides up-to-date and most accurate information about the diagnosis and management of the disease.
Hepatitis is an inflammation/infection of the liver and can result in liver cell damage and destruction. Many people mistakenly think that hepatitis means viral hepatitis, and that all forms of hepatitis are contagious. Actually, the word ‘hepatitis’ just refers to any inflammation of the liver; or the irritation or swelling of liver cells from any cause.
Causes of hepatitis
Toxic hepatitis: This form can occur if someone drinks a lot of alcohol, takes certain illegal drugs or medications, or is exposed to poisons.
Viral hepatitis: There are lots of hepatitis viruses: from Hepatitis A virus to Hepatitis G virus. Though the viruses differ, they have one thing in common: They cause infection and inflammation that are harmful to liver cells.
Non viral infective hepatitis: Malaria Hepatitis
Autoimmune liver disease: Here, the body’s immune system develops antibodies that attack the liver, causing an inflammatory process that leads to hepatitis.
Hepatitis in children
Hepatitis in children has many different origins or causes. A child may contract hepatitis from exposure to a viral source. The following is a list of some of the viruses associated with hepatitis:
Hepatitis viruses: Six main types of the hepatitis virus have been identified, including hepatitis A, B, C, D, E, and G. Other viruses: cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), rubella, adenovirus, parvovirus, varicella zoster virus (VZV, also known as chickenpox), and a complication of VZV called hepatitis enteroviruses.
More than 350 million people globally are infected with chronic Hepatitis B and C, which are the commonest causes of liver cancer and liver cirrhosis. Hepatitis virus is transmitted through contact with body fluids vide unprotected sex with an infected person and sharing of infected needles or other sharp objects that can break the skin.
In addition, babies born to infected mothers have a 90 to 95 per cent chance of contracting Hepatitis B virus during childbirth.
Nigeria started routine hepatitis immunisation for infants over a decade ago, and this protects them from developing full-blown hepatitis as adults.
The biggest obstacle confronting hepatitis treatment in Nigeria is not necessarily the deadly nature of the virus or even the spread of the disease, but a lack of awareness among Nigerians about the importance of discovering their hepatitis status.
Hepatitis is a concern because it often originates from a virus and can be spread from one child to the other. In some cases, liver failure or death can occur. However, not everyone who is infected will experience symptoms. Depending on the type of virus, viral hepatitis is spread through contaminated food or water, contact with infected blood, sexual contact with an infected person, or from mother to child during childbirth.
Symptoms
The following are the most common symptoms for hepatitis. However, each child may experience symptoms differently and some children may experience no symptoms at all.
Symptoms of acute (abrupt onset) hepatitis may include flu-like symptoms, fever, nausea and/or vomiting, decreased appetite, not feeling well all over, abdominal pain or discomfort, diarrhoea, joint pain, sore muscles, itchy red hives on skin, unexplainable tiredness, yellowing of the skin and whites of the eyes, and belly pain (especially on the upper right side).
Later symptoms include dark coloured urine and jaundice (yellowing of the skin and eyes).
The symptoms of hepatitis may resemble other conditions or medical problems. Most adults may be asymptomatic, i.e. no symptom. Do consult your child’s physician for an accurate diagnosis of hepatitis.
To be continued.
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