Annet Mbabazi remembers the night her 48-year-old Uncle, Niyonshuti first showed signs of body weakness and yellowish eyes. He had been found fainted on the bathroom floor one morning. “He didn’t even have strength to get up. “We called an ambulance,” Mbabazi said.
Doctors came to their home the next day to examine the patient. Niyonshuti was diagnosed with hepatitis B. He had been complaining for months but the family didn’t know it was about Hepatitis B. When he was diagnosed finally, it was too late to treat him.
“If the disease had been detected early, he would have lived perhaps,” says Audressa Teta, his sister sadly. Hepatitis is the inflammation of the liver that is commonly brought about by the patient’s lifestyle.
Scientists say the disease is primarily transmitted by parenteral exposure, such as transfusion of contaminated blood or blood products, but can also be transmitted via sexual or intimate personal contact.
Rwanda’s minister of health Diane Gashumba says the country regards viral hepatitis as a serious public health concern in the country but her government has increased commitment to maintain momentum of scaling up screening and treatment of the people.
In 2015, the National Guidelines for HBV and HCV Prevention and Treatment were updated to include recommendations for treatment of HCV with direct-acting antiviral (DAAs) and implementation of the HBV birth dose vaccine.
She says the national guidelines lay out the service package that should be available at each health facility level. These levels include referral, provincial, district hospitals and, health centers.
Government health officials say tests against hepatitis across the country are going on and hundreds of people at high- risk of infection have been immunized.
The high-risk group includes pregnant women, People Living with HIV (PLHIV), Health Care Workers/Community Health Workers (CHWs), and other high-risk groups.
The national prevalence of hepatitis B and C infection in Rwanda is not well known, and the mortality related to these infections is poorly documented.
Data corrected from ministry of health in Rwanda compiled from different studies indicated an HBV surface antigen (HBsAg) prevalence ranging between 1.9% and 7%, while HCV studies have suggested an antiHCV seropositivity ranging between 0.8% and 5.7% %.
According to this year screenings from hospitals against Hepatitis, it indicates that, 117,258 HIV-positive individuals were screened for the presence of HBsAg and anti-HCV.
Also, the prevalence of HBsAg and anti-HCV were 4.3% and 4.6% respectively. 182 (0.2%) HIV+ individuals were co-infected with both HBsAg and anti-HCV.
The findings show that the prevalence was found more higher in males; HBsAg, 5.4% vs. 3.7%; and anti-HCV, 5.0% vs. 4.4 %(11).The findings also suggest, the disease increases with age, 17, 8% in people aged 65 years; and varied geographically.
In the past, access to screening, care, and treatment, in Rwanda, had been ignored by many due to high costs, the complexity of therapy, and limited access to diagnostics services. Health ministry officials now say, the perception has changed following massive awareness campaigns and the reduction in the cost of treatment.
Globally, 90% of people living with hepatitis B and 80% living with hepatitis C are unaware they are living with the disease, resulting in the real possibility of developing fatal liver disease or liver cancer at some point in their lives and in some cases.
According to Dr. Damascene, the acting director of Viral Hepatitis and STI Unit at Rwanda Biomedical Centre, vaccination is the best solution to live a hepatitis B-free life.
While hepatitis B is never treated but can be vaccinated, health officials said and warn that hepatitis C can be treated ‘but at an expensive’ cost.
Rwanda has also reduced down the cost of carrying out tests for hepatitis from Rwf75, 000 to Rwf30, 000. “We are still working with partners to continue reducing the cost,” Dr. Makuza told local media in Kigali.
According to World Health Organisation, in 2015 alone, hepatitis B resulted in 887, 000 deaths worldwide, mostly from complications while approximately 399 000 people die each year from hepatitis C.
Hepatitis B and C can last over 20-30 years in someone’s body without being detected and many people have died of the diseases mostly because they don’t go for tests.
There are different types of hepatitis viruses Rwandans have suffered which include deadly hepatitis B and C. As part of the campaign to make Rwandans test against the disease, over 2600 Rwandans have been vaccinated.
In 2016, 194 governments including Rwanda adopted WHO’s Global Strategy on Viral Hepatitis, which includes a goal of eliminating hepatitis B and C by 2030, but many countries don’t bothered to meet these targets.
In 2011, the government established its hepatitis control unit under the Division of HIV/AIDS, STIs and Other Blood Borne Infections at the Rwanda Biomedical Centre.
The objective was to develop a specific programme for the prevention, care and treatment of hepatitis B and C.
In 2013, the viral hepatitis technical working group was set up, comprising health ministry specialists, clinicians, academic researchers, laboratory experts, implementing partner organizations, United Nations agencies, and civil society and private sector representatives.
By Our Reporter.