Doctors treating Hepatitis want to see patients early before it’s too late. Go for Test.

Doctors treating Hepatitis in Nigeria tells an inconvenient truth about the diseases, saying it should not be confined to the back seat of public priorities since Hepatitis destroys one of the most important organs of the body-the liver. Hepatitis symptoms are severe and when they are obvious, help might just be far away hence experts are asking Nigerians to test early, reports KINGSLEY OBOM-EGBULEM

Dr. Olufunmilayo Lesi’s job at the Lagos University Teaching Hospital (LUTH) is mainly to treat patients infected with Hepatitis. She has been being doing this for the past 15 years.

“I love my job”, she says; “I love to talk about Hepatitis; I am passionate about what I do especially when you are in a position to give hope to a patient who may have seen Hepatitis as a death sentence”.

Watching Lesi talk about Hepatitis brings back memories of former US Vice President, Al-Gore expressing his emotions about Climate Change as a global crisis in his now famous speech-An Inconvenient Truth.

Dr.Olufunmilayo Lesi,speaking to journalists ahead of World Hepatitis Day in Nigeria

But there is something Lesi hates about her job; “I wish we could see Hepatitis patients early and treat them before the disease develops into liver cancer or liver cirrhosis; I wish patients would present early for us to give them hope and treat them and not bother about the issue of liver transplant which is still a dream in Nigeria”.

Lesi disclosed that about 20 patients diagnosed with different stages of severe liver damage are seen every other week in LUTH. Her colleague, Dr. Ganiat Oyeleke from the Lagos State University Teaching Hospital (LASUTH) corroborates this figure. “We see no less than 10 cases every week and these are cases you really can’t do much about”.

Call it the lamentation of a Consultant Physician and Gastroenterologist and you might just be on point. “Most Hepatitis patients who present with liver cancer or who develop cirrhosis showed up late; they came when they noticed the symptoms of chronic Hepatitis and at that point we can only do little or nothing”, Lesi added.

Hepatitis causes inflammation of the liver usually due to a viral infection. Over 350 million people are infected around the world with chronic Hepatitis B and C. Hepatitis B in particular is a severe, sometimes recurring or fatal form of hepatitis that is caused by a virus and transmitted through contact with infected blood, blood products, and bodily fluids.

According to data from Society for Gastroenterology and Hepatology in Nigeria (SOGHIN), about 19 million Nigerians are infected with Hepatitis B with North Central and North East having the highest prevalence.

In a society like Nigeria where the culture of regular check up is unpopular; where you only need to be sick for you to walk in (or be stretchered) into a hospital, early case detection of diseases is usually low.“It is not normal to pick up patients at the early onset of diseases in Nigeria because of our attitude to regular evaluation of our health and that has serious implication when you are dealing with hepatitis B”, says Dr. Hameed Oladipupo, consultant gastroenterologist and member of SOGHIN.

Oladipupo argued that some diseases like malaria or typhoid can be reversed even when the patients are carried into the hospital but “when you are carried into the hospital for Hepatitis B, that is a dangerous sign and if its end stage, it is usually irreversible”, he added.

Perhaps one suggestion that could address the concerns of these gastroenterologists could be to grab every Nigerian and test them for Hepatitis; or better still, pass a decree that makes it mandatory for every Nigerian to test for Hepatitis; that way we would detect the disease early and save more lives than currently being saved.

Of course, this cannot happen even in a territory administered by a despotic Draconian. Ideally, a health seeking culture engendered by consistent health promotion campaigns would have been one way out. Unfortunately, hepatitis campaigns are not donor-driven; “it is not a priority to the World Bank, Bill Gates Foundation and other foreign donors hence no one is talking about it”, says Oladipupo.

“Our political leaders cannot even think and realize that our people are dying in their hundreds of thousands of this disease and declare it a public health emergency and make commitment to funding it”.

This female Cambodian patient presented with a distended abdomen due to a hepatoma resulting from chronic hepatitis B infection. The incidence of liver cells carcinoma in patients with a hepatitis-B infection is 12-300 times greater. These are conditions Lesi wants to prevent.

For Lesi, the moment you have UK Aid, the United States Agency for International Development (USAID), the Global Fund and other donors focus on Hepatitis everybody will move in there. “You will observe a huge disconnect when you realize that there are 40million people infected with HIV/AIDS globally and the world is focusing on it and pumping so much money and doing nothing about Hepatitis B for which there has been a vaccine since 40 years, and it is treatable, yet it’s affecting about 350million people globally; there is definitely something wrong somewhere”, Lesi wondered.

Lesi’s concern could easily be dismissed as mere sentiments unless perhaps they are examined based on careful consideration of the global hepatitis burden.

About 2 billion people worldwide have been infected with Hepatitis B with 350 million of these cases being chronic carries of the virus out of which 1million deaths are recorded annually. And 25 percent of these deaths are usually from severe liver disease like chronic active hepatitis, cirrhosis, or liver cancer.

With the World Hepatitis Day holding today, July 28-the fourth in the series, there is hope that these worrisome figures may move political actions in favour of efforts to address the epidemic. Of concern to SOGHIN is the need for Nigerian government to assist in increasing access to treatment and testing which for now is beyond the reach of an average Nigerian. Hepatitis test and vaccination cost as much as N1, 500($10)-the same amount for buying gsm airtime in Nigeria. Unfortunately many people would rather pay for their Blackberry subscription than test for or vaccinate against Hepatitis B.

No doubt there is enough work for doctors treating Hepatitis in Nigeria.But they really need help.

The Nigerian government is not moved yet. Although Nigeria deserves some kudos for emphasising Hepatitis immunisation for children. But when will we learn to put our money where our heart is? Who knows? Until then, Lesi and her colleagues will have to learn to cope with seeing more cases of liver cancer for which they can really do little or nothing about.

©NIGERIAN HEALTH JOURNAL