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OPINION: Get Tested and Vaccinated to Eliminate Hepatitis B

By Arthur Musinguzi

Hepatitis is a liver disease caused by the hepatitis virus. The virus is not spread though shaking of hands, kissing, coughing, sneezing, sharing food or drinks, using bathrooms or mosquitoes. It is transmitted by direct blood to blood contact including mother to child or from sexual contact.

The good news is that the Hepatitis B vaccine is available. Globally, only 62% of people living with hepatitis B have been diagnosed and surprisingly many have no symptoms.

In Uganda, according to the 2016 Uganda Population based HIV Impact Assessment (UPHIA) survey, prevalence of Hepatitis B infection among adults stands at 4.1%. The survey indicates that the highest infection rates are in Northern Uganda with 4.6% in mid North, 4.4% North East and 3.8% in West Nile. Lower rates were noted in Eastern region (2.7%), Central (2.0%), Kampala (1.9%), Mid –West (1.8%) and South-West (0.8%).

When infectious body fluids like blood, saliva, semen and vaginal fluid come into contact with body tissues beneath the skin for instance, through needle punctures or broken skin or mucous membranes the thin moist lining of many parts of the body such as the nose, mouth, throat and genitals, Hepatitis is spread.

A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person. Other ways of contracting hepatitis include: Accidental needle stick or blood splash to broken skin or mucous membrane. Household contact like sharing razors, hair clippers and toothbrushes, sharing equipment used for injecting drugs not forgetting unprotected sex with an infected person.

Another common way is tattooing and body piercing with unsterilized equipment. The risk of spread is increased when there are higher levels of virus in the blood. The level of virus varies considerably between people infected with hepatitis.

Hepatitis B symptoms, if they occur may include the following: Fever, loss of appetite, nausea and vomiting, abdominal pain (especially in the right upper abdomen), yellow skin or eyes (jaundice) (see image), dark colored urine and pale faeces, muscle and joint pain and a rash.

The Ministry of Health is aware of the existence of the virus and has been implementing Hepatitis B control activities in the country since September, 2015. It started with regions of high prevalence to regions of low prevalence. This is in line with the country’s National Hepatitis Strategic plan 2014/2019.

Phase 1 of the control activities started in the 41 districts of Northern, Phase 2 of the exercise started in FY 2018/2019 in the Eastern region (Busoga and Bugisu regions. A total population of 3,750,356 adolescents and adults was targeted. So far 1,663,497 people have been screened and 4,150 have tested positive. Phase 3 was rolled out in central 2 and mid-west regions this FY 2019/2020 it targeted a population of 3,497,485 people. 

The fourth phase of the exercise will cover the central 1, Western region and Kampala districts:  This phase will target a population of 532,801 people and 2,085,466 people in Central 1 and mid-west regions respectively and 1,516,695 in Kampala district.

The Ministry of Health has on different occasions called upon the general public to join its control activities like; testing all adolescents and adults born before 2002. In addition, the hepatitis B vaccine was introduced into the routine childhood immunization schedule; pentavalent vaccine which is given at 6, 10 and 14 weeks.

Testing and vaccination is done across all Public Health Center IIIs, HCIVs and General hospitals at the implementing districts. Vaccination for those who test negative is given at intervals of 0, 1 and 6 months.

Preventive measures include but not limited by the following; Injecting drug users should never share injecting equipment. Exclusion from childcare, preschool, school or work is not necessary.

Infected health care workers must comply with the requirements of their professional boards. Any open sores, cuts or abrasions should be covered with waterproof dressings, all donated blood and organs are screened for evidence of hepatitis B infection, practice safer sex, use condoms consistently and correctly and many others.

Currently, there is ongoing screening and Vaccination in all HCIVs, district hospitals in all central districts of Buvuma, Kayunga, Buikwe, Mukono, Nakaseke, Luwero, Kiboga, Kyakwanzi, Nakasongola, Mityana, and Wakiso.

The same arrangement is ongoing in western districts of Kyenjojo, Kiryandongo, Mubende, Kyegegwa, Bundibugyo, Buyangabo, Fortportal, Kasese, Kikuube, Kakumiro, Kagadi. All hepatitis B positive cases are referred to the nearby Regional Referral Hospital for further management. Take note, the disease is serious.

The Writer is a Communications Assistant at Government Citizen Interaction Centre (GCIC), Ministry of ICT and National Guidance.

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