Health

Hepatitis B in Nigeria: Fresh data to inform prevention and care

Hepatitis B in Nigeria: Hepatitis B is a virus-borne infection that is transmitted by the hepatitis B virus (HBV). Worldwide, nearly 300 million people are infected with this virus, which caused an estimated 820,000 avoidable deaths in 2019. The virus is most frequently transmitted from mother to child after birth and through contact with an infected person’s bodily fluids. In around 95% of instances, infection during infancy or early childhood results in chronic hepatitis.

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Chronic HBV infection increases the chance of progressive liver damage and scarring, as well as liver disease, liver cancer, and mortality. It can be prevented through immunization, but there is no cure for it yet. The viral load can be reduced and the progression of liver cancer can be slowed by medications.

Reliable national statistics on HBV infection rates are critical for developing effective public health control measures. Regrettably, these data are either unavailable or out of date for the majority of low- and middle-income nations. This is because illness patterns are not adequately monitored, laboratories are underequipped, and healthcare services are inadequate. This complicates the process of developing evidence-based policy and making timely judgments.

The World Health Organisation (WHO) identifies HBV as a leading cause of death globally. WHO set a goal in 2016 to eradicate viral hepatitis as a public health hazard by 2030. Current national and subnational data on infection rates in the community are critical for tracking progress toward this aim.

In a recent review, we collected data in a systematic manner to assess the prevalence of HBV infection in Nigeria. This data will be crucial in achieving global and national goals for eradication.

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We discovered a prevalence rate of 9.5 percent or roughly 20,083,000 Nigerians. That is a substantial percentage. Infection rates varied according to geographical region. The findings provide insight into the magnitude of the potential liver disease catastrophe in Nigeria and indicate where preventative and care efforts should be concentrated given limited resources.

Our investigation on Hepatitis B in Nigeria

To evaluate HBV prevalence, we did a meta-analysis of publications published between 2010 and 2019. 47 studies were conducted, with a total sample size of 21,702 participants.

Nigeria meets the WHO’s standards for high endemicity with a prevalence rate of 9.5 percent, as determined by our analysis.

Notably, we discovered disparities in infection rates between geopolitical zones and contexts. The North-West geopolitical zone had a higher rate of HBV infection (12.1 percent), compared to the South-East (5.9 percent ). Rural areas also have much higher HBV infection rates (10.7 percent) than urban areas (8.2 percent ). Our study was unable to determine the explanation for this, although it is probable that it is related to disparities in access to health care and to cultural differences between culturally varied populations.

Cultural beliefs can act as impediments to HBV treatment. For example, spiritual poisons, curses, and witchcraft have been identified as the primary cultural beliefs related to the transmission of HBV in rural communities in northern Ghana.

Additionally, in Nigeria, healthcare resources are disproportionately allocated to secondary and tertiary services, which are concentrated in metropolitan regions.

How does this affect Nigeria?

In Nigeria, continued efforts are needed to improve HBV detection and testing, as well as treatment as part of normal care, as well as immunization to prevent new infections.

Despite the fact that a national response to viral hepatitis exists, fewer than 5% of persons with viral hepatitis B have ever sought clinical care. This is especially critical for rural dwellers, who account for a sizable proportion of the HBV population in Nigeria. To increase rural communities’ access to prevention and care, national viral hepatitis initiatives must be sensitive to varied cultural perspectives. This may facilitate communication and increase patients’ willingness to accept healthcare experts’ advice.

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Assuring that all Nigerians with hepatitis B receive timely diagnosis and adequate therapy is important for averting a liver disease crisis in the country. Given the limited funding available at the global level, national health budgets must effectively finance hepatitis response programs. This would reduce patients’ out-of-pocket payments and ensure that they have access to necessary services without financial hardship.

Attaining the 2030 aim for eradication

In February 2020, African Union chiefs of state and governments, including the Nigerian government, committed to eliminating hepatitis as a public health threat by 2030. Despite the hurdles posed by COVID-19, Nigeria can avert hundreds of thousands of avoidable lives with renewed political pledges, clearly stated targets and financial support.

To meet the elimination targets, Nigeria must enhance its population’s access to cheap diagnosis and care. Individuals living with HBV should not have to wait until their infection becomes chronic and their liver disease progresses to an advanced level before seeking care. HBV diagnostics must become more affordable and available immediately in order to connect people to care in a timely way.

Ensuring that babies receive a high dose of the vaccination at birth is critical for preventing new infections. Nigeria now has a coverage rate of 57 percent for HBV immunization, which leaves space for improvement. Additionally, rigorous pre-conception screening and the introduction of low-cost “test and treat” therapies for infected couples are critical for preventing mother-to-child transmission of infection.

Stigma and discrimination are significant impediments to health care access, which can result in delays in diagnosis and treatment. Marginalizing vulnerable populations, such as those who inject drugs, frequently results in their exclusion from testing and therapeutic care. Elimination of Hepatitis B in Nigeria will be feasible only if we ensure that no one is left behind.

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