Dr Adwoa Agyei-Nkansah, a Senior Lecturer at the Department of Medicine and Therapeutics, University of Ghana Medical School, has called for the reintroduction of birth doses of Viral Hepatitis B vaccination for babies nationwide.
She said that would provide effective protection against Mother-To-Child-Transmission (MTCT), which had been found to be the most common mode of spread of hepatitis B, stressing, the birth dose could save many children from developing and dying from chronic liver disease.
Dr Agyei-Nkansah made the call at a public lecture at a stakeholder meeting in Accra as part of activities to commemorate the 2022 World Hepatitis Day, on the theme: “Bringing Hepatitis care closer to communities-Hep can’t wait!”
She said viral hepatitis was a life-threatening infectious disease that causes liver inflammation, leading to chronic cancer and cirrhosis, and that it was very common in infants infected at birth, or before age five.
Dr Agyei-Nkansah explained that whereas hepatitis B infection acquired in adulthood led to chronic diseases in less than five per cent of cases, it led to chronic ill-health in about 95 per cent of the disease in infancy and early childhood cases, which she said informed the basis for strengthening and prioritising infant and childhood vaccination.
“We are seeing too many young Ghanaians in their productive ages dying from hepatitis B, and C” although vaccine has been in existence for over 40 years.”
She, therefore, appealed to the Government and its health partners, to look for additional funding to close the life-threatening gap, saying “it costs just three Cents to vaccinate a child against Hepatitis B,” compared to the huge cost involved in treatment and management of liver diseases.
She said the unacceptably higher prevalence of hepatitis B and C was seen in the Northern, Upper East and West, and Savannah regions of Ghana, where health facilities were less developed, and commonly spread through MTCT at birth (perinatal transmission), or through horizontal transmission, which involved exposure to infected blood, especially from an infected child to an uninfected child during the first five years of life.
Unlike HIV, the hepatitis B virus could survive outside the body for at least seven days, and still cause an infection during this period, if it enters the body of a person who is not protected by the vaccine, the incubation period ranges between 30 to 180 days.
She indicated that the virus may be detected within 30 to 60 days after infection, and could persist and develop into chronic hepatitis B, especially when transmitted in infancy or childhood.
Other modes of spread are needle stick injury, tattooing, piercing and exposure to infected blood and body fluids, such as saliva, menstrual, vaginal and seminal fluids, the reuse of contaminated needles and syringes or sharp objects.
Sexual transmission is also more prevalent in unvaccinated persons with multiple sexual partners.
Dr Agyei-Nkansah said the most common and visible symptoms of hepatitis B included swollen feel, belly and yellowish eyes, which were often misinterpreted, misdiagnosed or associated with myths like curses and attacks by witchcraft, therefore, people reported to health facilities with advanced stages of the disease when very little could be done for them.
She commended the Ghana Association for the Study of Liver and Digestive Diseases (GASLIDD), supported by institutions, including the Ghana College of Physicians and Surgeons, for organising the meeting as part of the awareness creation towards eliminating the disease by 2030.
Mr Mahama Asei Seini, the Deputy Minister of Health, said the Ministry had initiated discussions on the eradication of hepatitis B, which included testing pregnant women for the virus; starting at birth vaccine doses; intensifying vaccination against hepatitis B in children; and building a data base for the appropriate management of patients.
Prof Yaw Asante Awuku, the National President of GASLIDD, said viral hepatitis was the most common and highly endemic type globally, with data showing that almost 3,000 people die a day from the type B and C.
He said current studies showed that one out of every eight Ghanaians had chronic hepatitis B infection, and for every 30 people, one had the C virus, and called for intensified commitment to global and national strategies to raise awareness for early screening, diagnosis and treatment, which had remained weak leaving most infected persons unaware of their statuses and untreated.
Dr Francis Kasolo, the WHO Country Representative, said viral hepatitis presently affected more than 91 million people in the Africa Region, accounting for 26 per cent of the global burden, and called on policymakers, decision makers and global funders to support rapid improvement in awareness, access to preventive, diagnosis and treatment services towards elimination by 2030.