WORLD HEPATITIS DAY 2019 |What You Need To Know About Hepatitis

Important facts you must know about viral hepatitis
A blog post Important facts you should know about Viral Hepatitis by SMILE With Me Foundation

Hepatitis is an overall term for the inflammation of the liver. The liver is a vital organ in the human body which performs several functions that aid in metabolisms such as the breakdown of certain nutrients, activation of enzymes, toxin filtration, blood protein and clotting factors syntheses.

Inflammation of the liver could be self-resolving or progressive leading to cirrhosis, cirrhosis or liver cancer. The most common cause of hepatitis is viruses, which accounts for about 50% of all cases. However, certain medications, excessive alcohol intake and other toxins could also lead to liver inflammation. Also, the body itself could produce antibodies against the liver, thus leading to autoimmune hepatitis.

Statistics About Hepatitis

By the end of 2015, according to the WHO, approximately 325 million people were living with chronic hepatitis and 1.34 million deaths were recorded in the same year due to viral hepatitis, which is more than those caused by HIV. Nigeria is one of the 11 countries which carry 50% of the burden of the global burden of chronic hepatitis with about 13.7% (20-30 million people) of the population affected by the disease.

However, hepatitis is highly preventable via safe practices and vaccines. Treatment and management strategies are also available.

Viral Hepatitis

This is caused by viruses and is the most common presentation of hepatitis. There are 5 main hepatitis virus strains; A, B, C, D, E. Only about 7% of existing cases in every year are actually reported. These viruses could lead to acute or chronic hepatitis and there are various ways these viruses are transmitted.

Hepatitis A (HAV)

Formerly known as infectious hepatitis because of the ease of transmission between individuals, HAV causes acute hepatitis. It is spread mostly via the consumption of infected food and water or the fecal-oral route. It can also be spread through the exchange of oral secretions (as in intimate kissing) and through sexual (anal-oral route).

Most of the worldwide spread of this virus happens in areas with low socioeconomic status, poor hygiene or common fecal-oral contact, like daycare centres. The incubation period is 2 to 6 weeks and there are safe and effective vaccines to prevent Hepatitis A.

Hepatitis B (HBV)

This is one of the most common forms of hepatitis. The HBV virus is transmitted via body fluids like semen, blood from an infected person. This could be through sexual contact, drug-injection equipment like needles, sharp objects like razors or from mother-to-child during birth. The effect of this virus could be short-term or chronic. The risk for chronic infection is related to age at infection as 90% of infected infants become chronically infected, compared with 2%–6% of adults. The incubation period is 2 to 5 months and vaccination is available to prevent HBV infection.

Hepatitis C (HCV)

HCV can be transmitted via the percutaneous contact with blood which could be via blood transfusion, shared needles in drug abusers or haemodialysis, among others. Viral transmission is possible via perinatal or sexual means, but this is rare. Together with HBV, Hepatitis C constitute the most common source of liver cancer and cirrhosis. The incubation period is 2 weeks to 6 months and HCV has no vaccines available yet.

Hepatitis D (HDV)

Hepatitis D usually occurs concomitantly with HBV because the virus cannot survive without the presence of HBV.  A combination of both viruses usually leads to faster disease progression and a more difficult treatment regimen. It is usually transmitted in similar ways as HBV.

Hepatitis E (HEV)

This is mostly contracted through the oral intake of fecal matter present in contaminated water and food. It is usually self-limiting and does not result in chronic infections. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.

Other viruses

Hepatitis G Virus (HGV) has been found to be present as a co-infection in Hepatitis B and C but clears in 75% of the infection.

Cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), and varicella-zoster virus (VZV) may also cause inflammation of the liver, but they do not primarily target the liver.

Common Symptoms Of Hepatitis

Most people with HAV, HBV and HCV infections usually have little symptoms or are asymptomatic. When the symptoms do occur, they are usually similar across viruses and are usually flu-like. They include;

Loss of appetite, nausea, vomiting, abdominal pain, fever, weakness.

Other symptoms include; yellowing of eyes or skin (which may be jaundice), dark urine, light coloured stools, unexplained weight loss.

 Diagnosis Of Hepatitis

Prior to any laboratory investigations, the doctor will take a comprehensive history of the patient’s health to determine signs and risk factors. Acute viral hepatitis is commonly confirmed by blood tests after the presence of the aforementioned symptoms has been ascertained.

However, chronic infections are usually asymptomatic or have mild non-specific symptoms, hence, patients could remain undiagnosed for years.

There are three types of blood tests for evaluating patients with hepatitis: liver enzymes, antibodies to the hepatitis viruses, and viral proteins or genetic material (viral DNA or RNA).

An abdominal ultrasound may be requested and is useful for differential diagnosis. a liver biopsy may also be done to see the extent of liver tissue damage.

Prevention of Viral Hepatitis

Like other diseases, prevention of hepatitis is preferable to treatment.

Increased hygiene practices such as proper refuse disposal, thorough washing of food, proper handwashing practices, should be encouraged and promoted in communities.

Precaution should be taken to protect oneself from bodily fluids of others. Having unprotected sex with multiple partners is highly discouraged. Personal effects such as toothbrushes should not be shared. Unnecessary exposure and careless handling of sharp objects like razors, needles must be minimized.

Vaccination is available for HAV, HBV (consequently, HDV) and HEV. When given to infants, children and adults who have not been exposed to the virus, they provide protection from the disease for a long time. Hepatitis B vaccines are 90% effective in infants and 95% effective in adults

Immunoglobulins could also be given to people who have been exposed to the virus to prevent infection. There are different types for the viruses.

Treatment/ Management of Hepatitis

This is usually dependent on whether it is an acute or chronic phase of/ the disease. Alcohol intake and smoking should be totally eliminated and drug use minimized. These could hasten the progression of the disease.

Hepatitis A

This is usually acute and self-limiting, hence, it mostly requires a symptomatic resolution until it resolves. For example, hydration and proper nutrition after vomiting. Care should be taken when giving the patient med

Hepatitis B

The acute phase is not treated with drugs but the chronic phase is treated with antiviral medication.

Chronic Hepatitis B is treated with prescription-only antiviral medication. They may be taken for a long time and the regimen requires monitoring. Vaccines are available, for all ages, to protect against this disease.

Hepatitis C

Antiviral drugs are used to treat both acute and chronic forms of the disease. A combination of drugs may be needed for effectiveness.

Due to the constant development of safer, more effective antiviral drugs for hepatitis B and C, the drug regimen is likely to be reviewed every year.

Hepatitis D

There is no antiviral treatment regimen available currently but a 2013 study has suggested the use of alpha interferon. However, this has been effective in about 25% to 30% of all cases.

Hepatitis E

Currently, there are no medical therapies for this disease. However, it usually resolves on its own. Patients are advised to stay hydrated, get enough rest and avoid alcohol.

Autoimmune Hepatitis

Corticosteroids such as prednisolone and budesonide are usually effective in about 80% of cases. Immunosuppressants like azathioprine and budesonide are usually very used alone or in combination with corticosteroids.

Hepatitis could lead to complications such as cancer (hepatocellular carcinoma), liver cirrhosis, liver failure and possibly death. on the other hand, the prognosis is usually as virtually all patients with acute HAV infection and over 95% of adults with acute Hepatitis B recover fully.

Do you know your Hepatitis status?

Get screened and/or vaccinated today!

Pages from S.H.E.E.T. || How S.M.I.L.E. With Me Foundation Touched The Lives Of 1000 Students In Lagos

School Health Education Empowerment Scheme (S.H.E.E.T.) is an initiative of SMILE With Me Foundation to empower students and children of school age through improving health literacy. We aim to inspire a healthier Africa, one student at a time.

S.M.I.L.E. With Me Volunteers at Junior Model College, Ikorodu

 The World Health Organization promotes school health programs as a strategic means to prevent important health risks among children and adolescents to engage the education sector in efforts to change the behaviour that impact health. There is a gap in the flow of information concerning health in Nigeria and one of the major ways to combat this is to begin at a young age to disseminate information.

One of the ways we intend to do this is by maximizing S.H.E.E.T. to ensure the provision of health education and promotion as well as the provision of health aids to students and schools.

We also include teachers and caregivers in these schools by carrying out screening for non-communicable diseases via blood pressure and random blood checks. We also give them proper education on the right in-school health practices, first aid techniques as well as the availability of a well-equipped school clinic.

Dr. Mariam Toye running blood pressure checks on teachers.

As the S.H.E.E.T. tour progresses, we intend to vaccinate and carry out further health screenings for the students with the consent of their parents and other relevant authority. This project is comprehensive, intended to cut across major aspects of health care.

SMILE With Me Foundation’s S.H.E.E.T. tour kicked off in Lagos on June 13, 2019, at Government Junior Model College, Ikorodu. Our volunteers, along with our founder, Dr Chioma Nwakanma were received by the principal and members of staff of the school and the program commenced at 12 noon with health education.

Cross-section of students of Government Junior Model College, Ikorodu

There were various classes for the students highlighting different health issues. A live-action class providing students with practical ways to administer first aid was carried out by Mr Lola of AID services.

Hand washing lessons with Nurse Aramiposi

A session on the vaccination, citing its importance, was led by Dr Chioma Nwakanma. Nurse Aramiposi taught tthe students handwashing techniques.

Mr. Lola giving a practical lesson on first aid.

Abeke Lawal led a session on mental health, teaching the students about feelings and emotions in relation to their health while drug abuse was dissected by Pharm. Dotun Adegbite.

Menstrual hygiene was also discussed by Dr Chisom Nweke while a practical class on dental hygiene was taken on by Dr Henrietta. S.M.I.L.E with Me Foundation gave dental aids (toothbrushes and toothpaste) to the students.

Dr Collins Akanno and Funbi Oyewole of Diet234, a top clinical nutrition company in Nigeria taught the students the importance of a nutritional diet.

Dr. Henrietta giving lessons on dental hygiene

All sessions in S.H.E.E.T. were highly interactive, as a total of 900 students were involved in discussions and asked questions too. The most interactive students were given prizes, refreshment was distributed and a first aid kit donated to the school to assist with first aid provision for the students.

The S.M.I.L.E. With Me Team

The next school impacted in Lagos was Morit International School, Ajegunle. Situated in one of the most populous rural areas in Lagos, this primary school is known for accepting plastic in lieu of school fees. This is an ingenious way of providing affordable education as well as cleaning and sustaining our environment. S.H.E.E.T at Morit International School took place on June 20, 2019.

Students of Morit International School

The SMILE With Me Foundation team was given a warm reception by the members of staff and the programme kicked off at 11 a.m. with an in-depth class on hand washing techniques by Dr Mariam Toye.

Dr Chisom Nweke interacting with the students while taking her session on child abuse

Dr Ifeanyi Urakpa took a class on first aid with the students. A practical session on basic dental hygiene was handled by Dr Henrietta. A mental health class was carried out by Abeke Lawal while Dr Chisom Nweke led a session on child abuse.

Dr. Chioma Nwakanma, Founder, S.M.I.L.E. With Me Foundation and students of Morit International School

In commemoration of World Sickle Cell Day, which was on the same day, the pupils were enlightened about the condition as well as a catchy, creative song highlighting genotype.

After sessions were done, with over 200 pupils in attendance, the teachers were given free blood pressure checks and the most interactive pupils were rewarded with prizes.

Dr. Mariam Toye running blood pressure checks on the teachers.

SMILE With Me Foundation donated cartons of antibacterial soap and a first aid box to equip them to maintain hygiene and deal with simple emergencies.

The S.H.E.E.T tour by S.M.I.L.E. With Me Foundation has also kicked off in Abia state and we intend to take this all over the country, one school at a time. Our goal is to work with schools to create a health-conscious and foster a well-informed generation.

Would you like to join us at S.M.I.L.E With Me Foundation?