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Friday, 29 July 2016

Know hepatitis. Act now

The World Hepatitis Day, 28 July 2016, presents an opportunity to step up national and internation­al efforts on Hepatitis and urge partners and Member States to support the roll-out of the first Global Health Sector Strategy on Viral Hepatitis for 2016–2021, which was approved during the 69th World Health Assembly in May 2016.
The new strategy introduces the first-ever global targets for Viral Hepatitis. These include a 30% reduction in new cases of Hepatitis B and C, and a 10% reduction in mortality by 2020.
Key approaches will be to expand on vaccination pro­grammes for Hepatitis B; focus on preventing mother-to-child transmission of Hepatitis B; im­prove injection, blood and sur­gical safety; “harm reduction” services for people who inject drugs; and increase access to di­agnosis and treatment for Hepa­titis B and C.

On World Hepatitis Day 2016, World Health Organiza­tion will call on policy-makers, health workers and the public to “Know Hepatitis, Act Now”. The Organization urges them to inform themselves about the infection, take positive action to know their status by getting tested, and finally seek treatment to reduce needless deaths from this preventable and treatable in­fection. Activities will take place around the world to improve public knowledge of the risk of Hepatitis, and enhance access to Hepatitis testing and treatment services.
Approximately 500 million people worldwide are living with either Hepatitis B or Hep­atitis C. If left untreated and un­managed, Hepatitis B or C can lead to advanced liver scarring (cirrhosis) and other complica­tions, including liver cancer or liver failure. While many peo­ple worry more about contract­ing AIDS than Hepatitis, the re­ality is that every year 1.5 million people worldwide die from ei­ther Hepatitis B or C faster than they would from HIV/AIDS.
Hepatitis groups, patients and advocates worldwide take part in events on 28 July to mark the oc­casion. Notably in 2012, a Guin­ness World Record was created when 12,588 people from 20 countries did the Three Wise Monkeys actions on World Hep­atitis Day to signify the willful ig­norance of the disease.
2016 is a pivotal year for Viral Hepatitis. At the World Health Assembly in May, WHO Mem­ber States are set to adopt the first ever Elimination Strategy for Viral Hepatitis, with ambi­tious targets and a goal to elim­inate hepatitis as a public health threat by 2030. This will be the first time national governments sign up and commit to the goal of eliminating Viral Hepatitis.
To mark this historic mo­ment and to leverage this po­litical commitment, we are us­ing the slogan of elimination for World Hepatitis Day 2016, which can be easily adapted for local use; to achieve elimination, greater awareness, increased di­agnosis and key interventions including universal vaccina­tion, blood and injection safety, harm reduction and treatment are all needed. This means ev­ery activity that addresses Viral Hepatitis is a step towards elim­ination. In other words, no mat­ter what your plans are to mark World Hepatitis Day, be it a ral­ly or press briefing or screening events, they can all come under the slogan of elimination.
To elevate the slogan of elimi­nation of No Hepatitis, a global elimination movement, will be launched to bring people togeth­er and provide a platform for people to speak out, be engaged and take action to ensure global commitments are met and viral hepatitis is eliminated by 2030.
In order to achieve the No Hepatitis objective of reaching 300 million by 2030, we need your help. Whether you do something as large as launching No Hepatitis on World Hepatitis Day in your country or as simple as signing up to the movement, every action has an impact. Join us and be part of making the elimination of viral hepatitis our next greatest achievement.
Viral Hepatitis – a group of in­fectious diseases known as Hep­atitis A, B, C, D, and E – affects hundreds of millions of people worldwide, causing acute and chronic liver disease and kill­ing close to 1.4 million people every year, mostly from Hepa­titis B and C. It is estimated that only 5% of people with chron­ic Hepatitis know of their infec­tion, and less that 1% have access to treatment.
                        Viral Hepatitis affects 400 million people globally and, given the size of the epidemic, anyone and ev­eryone can be at risk.
                        An estimated 95% of peo­ple with hepatitis are un­aware of their infection. Hepatitis tests are complex and can be costly, with poor laboratory capacity in many countries.
                        But WHO’s forthcoming hepatitis testing guidelines will give countries advise on simpler testing strate­gies that will enable them to scale up hepatitis testing services.
                        Globally, lack of awareness, and poor access to Hepati­tis treatment services mean that most people who need treatment do not receive it.
                        Over 90% of people with Hepatitis C can be com­pletely cured of the virus within 3–6 months.
                        Appropriate treatment of Hepatitis B and C can pre­vent the development of the major life-threatening complications of chronic liver disease: cirrhosis and liver cancer.
                        WHO advises that by scal­ing up treatment, 7 million lives can be saved between 2015 and 2030, with com­munities benefiting from economic gains.

The liver is the largest meta­bolic gland in the human body. It weighs approximately 3 lb (1.36 kg). It is reddish brown in colour and is divided into four lobes of different sizes and lengths. It is also the largest in­ternal organ (the largest organ is the skin). It is below the dia­phragm on the right in the tho­racic region of the abdomen. Blood reaches the liver through the hepatic artery and the por­tal vein. The portal vein carries blood containing digested food from the small intestine, while the hepatic artery carries oxy­gen-rich blood from the aorta.
The liver is made up of thou­sands of lobules, each lobule consists of many hepatic cells - Hepatic cells are the basic met­abolic cells of the liver.
The Liver has a wide range of functions, including:

Detoxification (filters harmful substances form the blood, such as alcohol)
                        Stores vitamins A, D, K and B12 (also stores minerals)
                        Protein synthesis (makes certain amino acids - the building blocks of proteins)
                        The production of bio-chemicals needed for di­gestion, such as bile
                        Maintains proper levels of glucose in the blood
                        Produces 80% of your body’s cholesterol (choles­terol is vital)
                        The storage glycogen (also converts glucose to glyco­gen)
                        Decomposing red blood cells
                        Synthesizing plasma pro­tein
                        The production of hor­mones
                        Produces urea (the main substance of urine).

Hepatitis is the acute inflam­mation of the liver as a result of virus infection. The condi­tion can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepa­titis viruses are the most com­mon cause of hepatitis in the world, but other infections, tox­ic substances (e.g. alcohol, cer­tain drugs), and autoimmune diseases can also cause hepatitis. It usually affects comparatively young people, while obstructive jaundice is more commonly in the middle aged and the elderly.
There are five main hepatitis virus, referred to as types A, B, C, D and E. These five types are of greatest concern because of the burden of illness and death they cause and the potential for out­breaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, togeth­er, are the most common cause of liver cirrhosis and cancer.
Hepatitis A and E are typically caused by ingestion of contami­nated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infect­ed body fluids. Common modes of transmission for these virus­es include receipt of contami­nated blood or blood products, invasive medical procedures using contaminated equipment and for Hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.
The incubation period is vari­able from two to six weeks as a rule. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes, dark urine, extreme fatigue, nausea, vomiting and abdominal pain, clay coloured stools, low grade fever, lack of appetite, itching, weight loss and headache
Hepatitis A Virus (HAV) is present in the faeces of infect­ed persons and is most often transmitted through consump­tion of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. How­ever, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infect­ed with this virus. Safe and effec­tive vaccines are available to pre­vent HAV.
Hepatitis B Virus (HBV) is transmitted through expo­sure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family mem­ber to infant in early child­hood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical pro­cedures, and through injection drug use. HBV also poses a risk to healthcare workers who sus­tain accidental needle stick in­juries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.
Hepatitis C Virus (HCV) is mostly transmitted through ex­posure to infective blood. This may happen through trans­fusions of HCV-contaminat­ed blood and blood products, contaminated injections dur­ing medical procedures, and through injection drug use. Sex­ual transmission is also possible, but is much less common. There is no vaccine for HCV.
Hepatitis D Virus (HDV) in­fections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.
Hepatitis E Virus (HEV) is mostly transmitted through con­sumption of contaminated water or food. HEV is a common cause of Hepatitis outbreaks in devel­oping parts of the world and is increasingly recognized as an important cause of disease in de­veloped, countries. Safe and ef­fective vaccines to prevent HEV infection have been developed but are not widely available.
The list of prevention tips of Hepatitis have been splited into the individual variation types of Hepatitis.
How to Prevent Hepatitis A
                        Wash your hands with soap after going to the toilet
                        Only consume food that has just been cooked
                        Only drink commercially bottled water, or boiled wa­ter if you’re unsure of local sanitation
                        Only eat fruits that you can peel if you are somewhere where sanitation is unreli­able
                        Only eat raw vegetables if you are sure they have been cleaned/disinfected thoroughly
                        Get a vaccine for Hepati­tis A if you travel to plac­es where Hepatitis may be endemic.

How to Prevent Hepatitis B
•Tell the partner if you are a car­rier or try to find out whether he/she is a carrier
•Practice safe sex
•Only use clean syringes that have not been used by anyone else
•Do not share toothbrushes, ra­zors, or manicure instruments
•Have a hepatitis B series of shots if you are at risk
•Only allow well sterilized skin perforating equipment (tattoo, acupuncture, etc.).
How to Prevent Hepatitis C
•If you are infected do not let others share your toothbrush, razor, manicure equipment
•If you are infected cover open wounds
•Do not share needles, tooth­brushes, or manicure equipment
•If your skin is to be pierced, make sure equipment is well sterilized (tattoo, etc.)
•Go easy on the alcohol
•Do not share drug equipment.
How to Prevent Hepatitis D
•Use the same guidelines as for hepatitis B. Only a person who is infected with Hepatitis B can become infected with Hep­atitis D.
How to Prevent Hepatitis E
•Do the same as you would to protect yourself from hepatitis A infection.
How to Prevent Alcoholic Hep­atitis
•Go easy on the alcohol, or ab­stain from consuming alcohol.
How to Prevent Toxic/Drug In­duced hepatitis
•Make sure you know about the lethal contents of all chem­icals
•Make sure the spray is not pointing at you
•Make sure you wear protec­tive gear if you have to.
Nigeria as a third world coun­try does not have enough infra­structural materials, medical equipment and personnel to provide adequate medical facil­ities for the teaming population of the nation. Economic depres­sion, unemployment, want of means of livelihood and gener­al financial impecuniosity mili­tates against the combat and pre­vention of hepatitis ailment.
Most of the hepatitis drugs are not manufactured in the coun­try, and with a very high foreign exchange rate of currency, the cost price of drugs are very pro­hibitive. Importation of genu­ine hepatitis drugs is also a mi­rage as there are only very few pharmaceutical companies that can import and dispense genu­ine drugs. Exorbitant hospitals bills sequel to cost of drugs, in­frastructure, wages and general economic factors vitiate the pro­vision of therapeutics and rem­edies for the ailment of hepati­tis. Harsh environment, lack of provision of clean and chemical­ly treated water is a total health hazard to the populace. There are no swage facilities in the most urban towns, Refuse are dumped along the roads, inside the gut­ters and at the center of dense­ly populated areas without ef­forts to remove them. Residents of such areas breath and inhale polluted air that contains virus which in turn causes pathogen­ic diseases to the people.
Manufacturing industries are located in residential and dense­ly populated areas. Most of the machineries of these factories emit polluted smokes into the air, while chemical by-prod­ucts of the companies littered streets and neighbourhood without proper channeling, as children and adults marched on such toxic waste substances moving about unconcerned. A lot of people live in very unsani­tary conditions without toilet fa­cilities at all. An improvised toi­let pit in the form of buckets is made by urban and sub-urban residents which they release into the gutters and on refuse dumps at nights. Such dangerous un­hygienic habit results in serious health hazards to them and oth­ers. In such unsanitary condi­tions, food is prepared and sold to public, confectioneries, vege­tables, and fruits are hawked, to the members of the public and travellers. Unhygienic and im­pure drinking water is poured into cellophane, packaged as pure water, cooled and hawked to the public.
Habitual drinking of badly prepared local gin, palm wine and excessive consumption of alcoholic beverages pose bigger dangers to the livers inhabitants which will result in hepatitis.
Abusive use of all sorts of drugs without competent pre­scriptions, and drinking of herb­al concoctions without correct and proportional acid and alka­line level and non-availability of concise and proportional dosag­es of such medicines are another serious health hazards.
The Nation is the ultimate los­er in terms of man power loses during sickness, loss of revenue in the provision of therapy and at times resultant lost of lives.
Know hepatitis, act now to eliminate hepatitis.

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