The theme for this year’s World Hepatitis Day commemorated on July 28 every year was, ONE LIFE, ONE LIVER, a general term used to describe inflammation of the liver.
Liver inflammation can be caused by several viruses (viral hepatitis), chemicals, drugs, alcohol, certain genetic disorders or by an overactive immune system that mistakenly attacks the liver called auto immune Hepatitis. Depending on its course, Hepatitis can be acute, which flares up suddenly and then goes away or chronic which is a long-term condition usually producing wide subtle symptoms and progressive liver damage.
The liver is a large organ that sits up under your ribs on the right side of your belly (abdomen).it helps filter wastes from your body, makes bile to help digest food, and stores sugars that your body uses for energy.
CAUSES OF HEPATITIS
Hepatitis is commonly caused by a viral infection, but there other possible causes of hepatitis. There five main viral classification of hepatitis which include A, B, C, D and E. A different virus is responsible for each type of viral hepatitis.
Hepatitis A
This is the result of an infection with hepatitis A virus. This type of hepatitis is an acute, short term disease that one gets exposed to via contaminated food or water. This infection can resolve within six months even without treatment apart from the supportive care.
Hepatitis B
This causes hepatitis B viral infection, the commonest among them and most notorious viral hepatitis infection .it can cause both acute and chronic infection. The center for disease control and prevention (CDC) estimates that around 257 million people worldwide leave with Hepatitis B which is contracted through body fluids like semen, blood and through mother to child transmission intra uteral.
Hepatitis C
This comes from Hepatitis C virus which is among the most common blood borne viral infections in the developed countries like USA.
Hepatitis E
This is water borne disease that results from the exposure to the Hepatitis E virus. It is mainly found in areas with poor sanitation and typically results from ingesting fecal matters that contaminates the water supply. Hepatitis E is usually acute but can be particularly dangerous in pregnant mothers.
Noninfectious causes of hepatitis may include;
Alcohol and other toxins.
Excessive alcohol consumption can cause liver damage and inflammation. This may also be referred to as alcoholic hepatitis. The alcohol directly injures the cells of your liver. Over the time it can cause permanent damage and lead to the thickening and scarring of liver tissue (cirrhosis) and later liver failure
Other toxins that may cause hepatitis include misuse of drugs like acetaminophen and exposure to the toxins.
Autoimmune system response
In some cases, the body’s defense system mistakes the liver as a harmful and attacks it. This causes ongoing damage that can range from mild to severe often hindering the liver from functioning normally. This type of hepatitis is three times more common in women than in men, also common in individuals with other auto immune diseases.
EPIDEMIOLOGY OF HEPATITIS.
The commonest causes of hepatitis are the viruses, among them being hepatitis A, B and C.
Among these about 350 million people are infected with Hepatitis B across the globe and 170 million people have hepatitis C. WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019 with 1.5 million new cases each year. In 2019, hepatitis B resulted in an estimated 820,000 deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
Africa contributes 25%of the global hepatitis B burden and the prevalence in Uganda is 4.3% as of 2018 (5.6% among men and 3.1% among women)
In the 2005 Uganda national serosurvey, prevalence of hepatitis B was reported at 10%; currently with highest prevalence in northern region with 4.6%in mid north,4.4%in north east and 3.8%in west Nile.
There have been various hepatitis B prevention strategies by the ministry of health and non-government organizations such as vaccination of children since 2002 under Uganda national expanded program on immunization and vaccination of adolescents adults that was launched on 25th of July 2015 in Ngola district by president of republic of Uganda, there is still limited information on prevalence of hepatitis B virus in the hospital settings, leaving a health ministry with a lot of work to do.
COMMON SYMPTOMS OF HEPATITIS
If you’re leaving with a chronic form of hepatitis like hepatitis B and C, you may not show symptoms until damage affects liver function. By contrast, people with acute hepatitis may present with symptoms after contracting a hepatitis virus. Symptoms may include; fatigue, Flue-like symptoms, dark urine, pale stool, abdominal pain, loss of appetite, unexplained weight loss, yellow skin and eyes which may be a sign of jaundice.
DIAGNOSIS OF HEPATITIS
It is crucial to understand what is causing hepatitis in order to treat it correctly. Doctors progress through a series of tests to accurately diagnose the condition. These include;
-history and physical examination both aimed at identifying the risks one has that may predispose him to the infection.
Liver function tests, as these may be the first indication of the problem due to the leakage of liver enzymes in blood secondary to liver damage.
Other things may include ultrasound scan of the abdomen looking at the liver structure and the liver biopsy.
PREVENTION OF HEPATITIS.
Reducing the exposure.
Hepatitis can be transmitted from person to person through contact with bodily fluids, water and food containing infectious agents. Minimizing your risk of contact with these substances can help prevent contracting hepatitis viruses.
Practicing effective hygiene is one of the ways to avoid contracting hepatitis A and E .The viruses that cause these conditions can be present in water. If you’re travelling to places with high prevalence of hepatitis, you should avoid; ice, raw or undercooked fish (shell fish), raw fruits and vegetables
The hepatitis B, C and D viruses can transmit through contact with bodily fluids containing these infectious agents. You can reduce your risk of coming into contact with them by; not sharing needles, not sharing razors, not using someone else’s toothbrush, not touching spilled blood.
Hepatitis B and C can carry through sexual contacts using barrier methods such as condoms and dental dams during sexual activities can help decrease the risk of infection.
Vaccination
The advisory committee on immunization practices (ACIP) recommends Hepatitis B vaccination among all adults aged 19-59 years and adults >60 years of age with risk factors for hepatitis B or without identified risk factor but seeking protection
In Uganda, the Ministry of Health started the vaccination of adolescents and adults against hepatitis B in 2015 on 25th of July. The program was officially launched by the president of republic of Uganda H.E Yoweri Kaguta Museveni in Ngola district. The vaccination schedule most often used for children and adults is the three intramuscular injections, the second and third doses administered at 1 and 6 months respectively, after the first dose.
For the newborns, they‘re given the vaccine at birth, at six months, at six weeks, at 10weeks and lastly at 14th week post-delivery.
– Sponsored by SDI and written by Dr. Matovu Richar
