More than 3million Ugandans are living with Hepatitis B; Government needs ush46bn to provide vaccines for all citizens

In 2011, the World Health General Assembly declared the 28th day of July every year World Hepatitis Day. However, due to a number of activities that have coincided with this day, Uganda could not join the rest of the World to commemorate this day. 

Uganda is commemorating the World Hepatitis Day today 1st August 2014 at the Mayor's Garden in Adjumani District under the theme "Hepatitis: Think Again." This is in recognition of the high prevalence of hepatitis and the associated deaths the world over.

L-R: Dr Jacinto Amandwa discussing with Dr. Jane Ruth Aceng

This day provides a chance for countries all over the world to learn about the devastating consequences of the disease and join the global partnership to fight it.

"More than 3million Ugandans are living with the deadly Hepatitis B and the worst bit of the situation is that currently the government cannot afford to provide free vaccinations for all Ugandans. The government needs Ush46bn to buy vaccination for everyone."

It further provides a unique opportunity for countries to come together to focus attention on the global threat of Hepatitis and promote actions to control it.

Director General of health services, Uganda Ministry of Health, Dr. Jane Ruth Aceng said that the government of Uganda needs  Ush46bn to provide Hepatitis B vaccination for all citizens.

Dr. Jane Ruth Aceng

"The vaccines are so expensive and the government cannot afford to provide free vaccination for all. Each does costs Ush40,000 ($16us dollars) per person," she added.

Dr. Aceng also warned that it is important that people get the vaccination  because once infected, the vaccine won't help.

She also commended the Chairperson LCV of Adjumani district (one of the most affected areas in Uganda) for passing a Bi-law that every home must have a pit latrine.

"Hepatitis A and B are both oral feacal; this means that one can contract the disease after eating food with feacal matter. Vaccines can be found at Ebenezer clinic in Kampala," she added.

Commissioner for Clinical Services in the Ministry of Health, Dr Jacinto Amandwa, said that treatment of this disease is very expensive and one will spend between ush200,000-300,000 on just tests before treatment.

Dr Jacinto Amandwa,

Dr. Amandwa said that Hepatitis B virus can be transmiteed through health care system by needle sticks injuries, sexual transmission, mother to child and blood transfusion.

"You are all aware of the epidemic of Hepatitis E that we are currently battling in the Napak district of Karamoja. This is due to poor sanitation

He also noted that the contribution of poor sanitation to the transmission of Hepatitis E is another concern especially with low latrine cover and lack of clean and safe water in many parts of the country.

   "Most victims panic and start using ARVs immediately but only 30% of the patients need to use that kind of treatment."

Minister of State for Health(Primary Health Care), Hon. Sarah Opendi said that Hepatitis is the inflammation of the liver which comes with a number of symptoms including yellowing of the eyes.
Viral hepatitis is the commonest cause of hepatitis all over the world.

Hon. Sarah Opendi added that it is one of the most infectitous diseases although many people remain unaware of its toll on global health.

"There are various types of hepatitis virus: these have been named chronologically as hepatitis A,B,C,D, and E following their discoveries," she said.

The Minister said that in Uganda, 10 % (or more than 3 million Ugandans) are living with the chronic hepatitis B infection. Presently, by region hepatitis prevalence in Uganda is ranked as follows: North East  21.7%, North Central 19.4%, West Nile 18.7%,  Western 7.8%,  Kampala 5.8%, Central 5.5% while South West has 2.9%.

Minister of State for Health(Primary Health Care), Hon. Sarah Opendi

Hon. Sarah Opendi said that while most people who are infected with the different types of Hepatitis are unaware of their status, they face the possibility of developing devastating or fatal liver diseases at some point in their lives.

"Unknowingly they can transmit the infection to others. The wide ranging impact of the disease, from health to social and economic issues, means that it present a considerable barrier and threat to health and socio-economic development.

How Do I Know if I Have Hepatitis B?

Symptoms of acute infection (when a person is first infected with hepatitis B) include:

•  Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine)
• Unusually light-colored stool
• Fever
• Unexplained fatigue that persists for weeks or months
• Gastrointestinal symptoms such as loss of appetite, nausea, and vomiting
•  Abdominal pain 
• Frequently there will be no symptoms, and it is only discovered in a blood test

Often, symptoms occur one to six months after exposure. An estimated 30% of those infected do not show typical signs or symptoms.

Members of Parliament from the most affected areas(Napak and Adjumani) with Hepatitis B

Who Should Be Vaccinated for Hepatitis B?

Hepatitis B vaccinations should be administered to:

• All newborn babies
• People who are exposed to infected blood or body fluids of friends or family members
• People who use needles to take recreational drugs
• All people who have sex with more than one person
• Health care providers who may come in contact with the virus
• People working in day care centers and institutions caring for children and prisoners

 Is There a Cure for Hepatitis B?

Currently, there is no cure for hepatitis B. Luckily, the disease is limited in most acute cases and occasionally disappears in those with chronic disease.

Hepatitis B and Pregnancy

A pregnant woman can spread the hepatitis B virus to her baby at the time of birth. It is unlikely that an infected woman will spread the virus to her baby during pregnancy.

If not treated, many babies infected with hepatitis B develop long-term liver problems. All newborn babies from hepatitis B-infected mothers should be given hepatitis B immune globulin and the vaccine for hepatitis at birth and during their first year of life.

Prevention

1. Promotion of frequent hand washing with clean and safe water
2.  Use of appropriate sanitation facilities
3. Eating well cooked food
4. Drinking boiled water
5. Promotion of safe sexual practices e.g Use condoms every time you have sex.
6. Do not share razors, toothbrushes, manicuring tools, or pierced earrings with anyone.
7. Do not share chewing gum or pre-chew food for a baby.
8. Avoid sharing of skin piercing devices and make certain that any needles for drugs, ear piercing, or tattooing are properly sterilized.
9. Get vaccinated (if you have not already been infected).
10. Wear gloves when touching or cleaning up body secretions of others on personal items, such as bandages/Band-Aids, tampons, and linens.
11. Cover all open cuts or wounds.

Hon. Sarah Opendi and Dr Jacinto Amandwa,

 Measures put up by the government. 

The Ministry of Health  is dedicated to ensuring that the issues of Hepatitis are well addressed at all levels using available means.
In effort to achieve this the Ministry set up a number of measures which have been integrated into the overall health service delivery.

• Health Education and promotion; The Ministry of Health conducts a number of sensitization campaigns to communities on safe practices of preventing the spread of the disease. These programs are conducted on continuous basis through out the country.
• Routine immunization:  The Ministry of Health introduced the pentavalent vaccine since 2002 into the routine schedules of the Expanded Program on Immunization (UNEPI). These vaccines have been available on continuous basis. This effectively means that if the UNEPI schedules were followed and adhered to, a cohort of children up to 13 years of age are fully immunized against Hepatitis B.
• Vaccination of health worker and medical students in all training institutions against Hepatitis B: A statutory instrument  declaring Hepatitis B virus a formidable disease in Uganda and the regulations for the compulsory vaccination of all health workers has been put in place. Health workers who  are at the front-line who can infect patients, if infected or can be infected by patients who may be having Hepatitis B Virus. Vaccination the health workers therefore has a dual advantage of securing both the patients and the health workers themselves.
• Scaling up of sanitation campaign and provision of safe water: Hepatitis E still remains a major threat especially in Northern Uganda and Karamoja regions. Effective sanitation facility coverage and their proper use are the only means of control.
• Early Screening: The Ministry of Health promotes the screening for hepatitis to help individuals to know their status. Erly diagnosis provides an opportunity for medical support befroe complications occur. It also creates awareness so that the infected people take precautions to prevent transmision of the virus to others. 
• Testing kits are available at health facilities across the country and testing is free of charge.
• Provision of safe blood for transfusion: The Ministry has in addition instituted a policy of screening of blood before transfusion. This is done to prevent transmission of diseases that are likely to be got from unsafe blood, with hepatitis Band C virus.