28th of July every year is set aside as a day to mark World Hepatitis Day. This year World Hepatitis Day fell on Thursday last week with the theme “Bringing Hepatitis Care closer to you”.
The day is set aside purposely to raise awareness around hepatitis, its impact on our health and what we can do to protect ourselves against Hepatitis and the treatment and care available for those living with Hepatitis.
On Saturday last week, the Ministry of Health and World Health Organization (WHO) commemorated the day with speeches followed a by radio talkback show which was live on radio via the Solomon Islands Broadcasting Corporation (SIBC).
In her speech to mark the day, Dr. Sonja Tanevska, Officer in Charge, WHO in Solomon Islands highlighted the different types of hepatitis viruses and the global situation on hepatitis. (see at the end, detailed WHO descriptions of these different hepatitis infections).
Dr Tanevska said that globally, Hepatitis disease, HIV and sexually transmitted diseases are an ongoing global health threat and they account for more than 2.3 million deaths per year, more than 1 million new infections every day and 1.2 million people developing cancer each year.
“For hepatitis B and C they account for 1.1 million deaths and 3 million infections per year globally. Only 10 percent of people have chronic hepatitis B infection are diagnosed and only 22 percent of them receive treatment”, stated Dr Tanevska.
She highlighted that WHO country office in Solomon Islands is assisting the Ministry of Health with hepatitis program with technical support towards program implementation and procurement of STI drugs and HIV test kits.
At the global level, progress towards reducing hepatitis infection have also been taking place one of which is the development of the global health sector strategy for viral hepatitis by WHO. “This global health strategy prioritizes effective interventions, promotes service delivery approaches that ensure quality and equity, takes programmes to scale to achieve sustained impact at the population level and establishes clear stakeholder responsibility and accountability”,
“The global target is to reduce the number of people who are newly infected with hepatitis B and C by 30 percent by 2020 and 90 percent by 2030”, said Dr. Tanevska.
Head of MHMS STI/HIV Department Dr. Jackson Rakei in delivering the keynote address on behalf of Health Permanent Secretary Mrs. Pauline McNeil at the event, said that the Solomon Islands has the highest burden of Hepatitis, especially hepatitis B in the Western Pacific region estimated at 20 percent and hepatitis C at 1 percent.
“Approximately 1 out of every 5 people in Solomon Islands has hepatitis B. An estimated 53,000 to 79,000 people are living with hepatitis B in the country. It is the 6th most common cause of death at our National Referral Hospital and ranks 4th in all causes of cancers in the country”, highlighted Dr Rakei.
He went on to outline what the Ministry of Health has been and is doing to curb hepatitis B burden.
“We have embedded the hepatitis program into our STI/HIV National Strategic Plan 2019 – 2023 which was supported by WHO. Next year there are three key priority action areas for the elimination of Hepatitis in the country which are on prevention, screening/testing and treatment of Hepatitis B. The program will also collaborate with the Reproductive, Maternal, Neonatal, Child and Adolescent health (RMNCAH) program and embark on triple elimination of hepatitis B, HIV and Syphilis in pregnant mothers”,
“In addition, the National STI/HIV/Hepatitis program with the support from the Australasian Society for HIV, viral hepatitis and Sexual Health Medicine (ASHM) experts conducted a virtual training for Honiara-based health professionals on hepatitis B in health settings in 2019. Currently, the program is concentrating on upgrading hepatitis services in Honiara, and plans are now in place to roll out the program to the provinces as stipulated in the theme for this year.”, outlined Dr Rakei.
With vaccination, Dr Rakei said that hepatitis B vaccination is administered 24 hours after birth and then remaining three doses at week 6, week 10 and week 14 after birth and this remaining three doses are administered via pentavalent which contains 5 different types of vaccines, one of which is hepatitis B. As of next year health care workers will also be vaccinated against hepatitis B due to their exposure to the virus at their work place.
With treatment, Dr Rakei said that TENOFOVIR has been procured to treat hepatitis B since last year and is now included in the National Essential Medicine List so the government will continue to procure the drug on annual basis. “Treatment is taken for life to achieve a healthy and long productive life and to suppress hepatitis B virus to undetectable level”, added Dr Rakei.
Dr Rakei concluded by calling on all persons to get tested for hepatitis so they know of their status which is important to receive treatment at the earliest but also to adjust lifestyle for better health outcomes.
He also advised parents and guardians to ensure their babies get their hepatitis vaccines and encouraged the use of condoms during sex as well as urged people to not share needles to take drugs or for tattoos, practice good personal hygiene such as hand washing with soap and refrain from using personal items of people infected with hepatitis.
Detailed WHO descriptions of the different hepatitis viruses
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.