Every year, July 28 is marked as World Hepatitis Day, WHD. It is a day dedicated to increasing the global awareness and understanding of viral hepatitis and the diseases that it causes. Viral hepatitis is inflammation of the liver caused by a group of viruses known as hepatitis A, B, C, D, and E virus. The liver is the largest internal organ and has several indispensable functions such as removal of harmful substances from the blood, break down and storage of many of the nutrients absorbed from the intestines as well as the production of the chemicals that prevent excessive bleeding from cuts or injuries. Worldwide, 290 million people are living with viral hepatitis unaware. Globally, infection with Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV) is the main cause of liver cancer, making hepatitis a target disease of the Big War Against Cancer, the current focal cause of GivingTide. Globally, viral Hepatitis causes 80% of deaths from liver cancer which is diagnosed in more than 800,000 people annually. Liver cancer is also a leading cause of cancer deaths worldwide, accounting for over700,000 deaths each year (over 1,900 deaths daily). In Nigeria, 14 people die of liver cancer every day.
Yet, hepatitis and liver cancer are largely preventable. A major contributor to the sad hepatitis/liver cancer statistics is lack of awareness. With better awareness and understanding of its preventive measures, much of these life-threatening conditions could be eliminated. The theme of this year’s World Hepatitis Day (WHD) is “FIND THE MISSING MILLIONS”, a clarion call for everyone to take action and raise awareness to find the ignorant multitudes, who are unaware of their hepatitis infection. In this case, ignorance is not bliss. First, it is important to let people know the mode of transmission, the symptoms and preventive measure of hepatitis. Viral hepatitis is one of the most contagious diseases in the world. It is spread through contaminated blood, intravenous drug abuse and sexual contact with an infected person. In highly endemic areas like sub-Saharan Africa and Asia, hepatitis B is most commonly spread from mother to child at birth (perinatal transmission). In addition, infection can occur during medical procedures, tattooing, or through the use of razors and other sharp objects that are contaminated with infected blood. Most cases of hepatitis are asymptomatic. When symptoms do occur, they may include yellow skin or eyes (jaundice), nausea, abdominal pain, fatigue and fever. Like hepatitis, liver cancer is also asymptomatic in most cases until the later stages of the disease. However, liver cancer can be diagnosed early when treatment is most likely to be helpful, if the doctor is seen as soon as symptoms are noticed. Some of the most common symptoms of liver cancer are: weight loss (without trying), loss of appetite, feeling very full after a small meal, nausea or vomiting, belly pain or swelling, itching, yellowing of the skin and eyes (jaundice). For people who have chronic hepatitis or cirrhosis, worsening of their usual symptoms or just changes in laboratory test results may indicate progression to cancer. Prevention One of the most successful ways of preventing Hepatitis is vaccination against hepatitis B. The first dose is now being given at birth. The vaccine is safe and effective, protecting from HBV infection for life and preventing the development of chronic disease and liver cancer due to HBV. Adults can also benefit from the vaccine. Although vaccination for HCV is currently unavailable, antiviral medicines can cure HCV infection. Other preventive measure include: avoid sharing of sharp objects like needles, toothbrushes, razors or nail scissors and screening of blood donation products. Safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), also protect against transmission. Screening and early diagnosis can prevent health problems that may result from viral hepatitis infection and prevent transmission of the virus. Treatment with drugs, including oral antiviral agents can decrease the risk of liver cancer. In line with the theme of this year’s World Hepatitis Day, GivingTide hereby invites all Nigerians to ACT! (Attack Cancer Together! Attack Cancer Today!! Attack Cancer Totally!!!). This could be done through advocacy and by donating towards scaling up of the on-going pilot phase of the mobile health system operated by the National Cancer Prevention Programme (NCPP) of mass medical mission. This is being carried out using the Mobile Cancer Centres (aka the PinkCruise), the complementary Mobile Eye Centre (aka PinkVISSION where “VISSION” stands for Voluntary Integrated Sight Saving Initiative of Nigeria) and the Mobile Dental Centre (aka PinkDentist). These mobile units are deployed for free health campaigns, targeted mainly at the underprivileged. Through the mobile eye screening, individuals with eye signs of hepatitis such as jaundice can be picked up at an early stage. Efforts are currently underway to establish the first Comprehensive cancer centre (CCC) for the optimal care of confirmed cancer cases, including liver cancer. A CCC is a tertiary health institution that is focused exclusively on cancer care in all its departments. The current COVID-19 pandemic underscores the need to ensure that there is a CCC in Nigeria. We invite you to join us and be a voice for the 700,000 lives that succumb to liver cancer every year! Dr. Nzelu is the Executive Secretary, GivingTide International.