Viral Hepatitis is an inflammation of the liver caused by a viral infection. Viral Hepatitis B (HBV) and Viral Hepatitis C (HCV)  are responsible for  1,100,000 deaths every year worldwide, especially resulting from complications such as  cirrhosis and liver cancer. 

On July 28th every year, the world celebrates World Hepatitis Day to raise hepatitis awareness. However, many people, especially in Sub-Saharan Africa, still lack knowledge about the disease.

In December 2018, Rwanda took a bold step towards achieving the World Health Organization's global hepatitis elimination targets with the launch of a 5-year Hepatitis elimination plan endorsed by the Government of Rwanda – the first plan of its kind in the SSA region. 

The aim of the national HCV elimination plan is to achieve 90% treatment coverage for all confirmed  infections, In addition, it is projected that this ambitious goal will be achieved by 2024, but the current progress shows that it will surely be achieved before the expected time Rwanda is among the 6 countries selected to undergo Viral Hepatitis elimination validation in the near future, based on the progress in hepatitis management and further elimination.

Prior to the World Hepatitis Day, Health Development Initiative (HDI) organized a digital campaign to raise awareness around Hepatitis, including viral hepatitis, bacterial hepatitis, autoimmune hepatitis,  as well as hepatitis  resulting from drugs and toxins.

In a radio show organized last Saturday by HDI on Isango star, Dr Janvier Serumondo, the Director of Viral Hepatitis and Sexually Transmitted Infections in Rwanda Biomedical Centre (RBC) shed more light on the disease.

"Hepatitis is a disease characterized by inflammation of the liver. The different types are A, B, C, D and E. But types B and C are the most virulent  and prevalent,” he explains, citing that Rwanda, along with other countries around the world have pooled their efforts to concentrate on these two because of their severity.

"The two infections share a lot of similarities, but differ in their infection rate. Hepatitis B is ten times more infectious than Hepatitis C. Hepatitis B is mainly spread through unprotected sex and blood to blood contact,Hepatitis C is mostly spread  through blood-to-blood contact,” he adds.

Thus, the diseases are spread through unprotected sexual intercourse, sharing unsterilized needles and sharp materials, and can also be spread during delivery.

"In the absence of early treatment, Hepatitis B and C can lead to complications such liver cancer and cirrhosis traditionally known in Rwanda as Urushwima, which is often visually characterized by  abdomen distention due to ascites, an accumulation of a pathological intraperitoneal liquid," Dr. Serumondo notes, calling for early treatment.

"Hepatitis B and C can be asymptomatic for a very long time for a very long time — even ten years —  so we urge people to have regular check-ups and early treatment to avoid complications,” he comments.  

Among Viral Hepatitis B and C symptoms, we can cite jaundice (yellow colour which may be present in the eyes,on the hands and feet), dark urine, general fatigue, pain and headache, he added, emphasizing that the current prevalence in Rwanda stands at 1-2%. 

"The low prevalence can be attributed to awareness mass screening campaigns that have been conducted since 2016. This has allowed us to assess the disease prevalence and treat those infected, reducing both the prevalence and the incidence,” he said.

Building off its highly decentralized and robust HIV programming, Rwanda has now developed Hepatitis diagnostic capacities by using existing HIV testing platforms and laboratory transport systems. To date,  through HCV testing at health facilities and screening campaigns, more than 5,000,000 people have been screened and more than 50,000 have been treated and cured . Following the launch of HCV elimination, the Government of Rwanda negotiated prices for testing and treatment and the treatment price reduced from $1,200 to only $60 and as a result of a good governance, Rwanda has made hepatitis testing and treatment services free of charge in public hospitals and health centres at least during the HCV elimination period to facilitate the access to hepatitis services by the community.

Talking to the New Times, Dr Athanase Rukundo, Director of Programs at Health Development Initiative, called for the public to get tested in order to prevent complications from the disease that, when left untreated, could lead to cirrhosis and liver cancer.

"Infection caused by either Hepatitis C or Hepatitis B, if left untreated, could lead to long-term and serious complications. The general population can drastically reduce the risk of infection by avoiding the routes of contamination , such as sharing needles and sharp materials andhaving unprotected sex Treatment is available for HBV and HCV, vaccination is also available for HBV,” Dr. Athanase said

Regarding vaccination, Dr. Serumondo said that, to date,  when hepatitis B becomes chronic, it is not curable, the given treatment is for life. However, it can be vaccinated to prevent the infection. On the other hand, hepatitis C can be treated and cured within twelve weeks only, but it has no vaccine. 

Asked about the current efforts to educate people about the diseases, Dr. Serumondo said that awareness campaigns are ongoing, and due to the Coronavirus pandemic, the main messages are being streamlined through the media.