Hepatitis B screening & Prevention

Health Care and Prevention Campaign

Hepatitis B virus (HBV) infection is highly prevalent around the globe. An estimated 3.6% of the world’s population (or 248 million persons) are positive for hepatitis B surface antigen (HBsAg) [1], and HBV causes significant morbidity and mortality. In 2013, approximately 686 000 HBV-infected persons died from causes related to acute infection (69 000 deaths), cirrhosis (317 000 deaths), and HBV-associated liver cancer (300 000 deaths) [2]. The age of acquisition of HBV infection is the main determining factor in the clinical expression of acute disease and the development of chronic infection. Genetic characteristics of HBV might also contribute to the outcome of infection [3, 4].

Safe and effective hepatitis B vaccines have been commercially available since 1982, and, over the years, recombinant DNA vaccines have replaced plasma-derived vaccines. Gaps in hepatitis B vaccination policy were first addressed in 1992, when the World Health Organization called for all countries to incorporate hepatitis B vaccination into their national childhood immunization services. In the following decade, hepatitis B vaccination coverage grew rapidly, and by the end of 2014, 184 countries had integrated hepatitis B vaccine into their national childhood immunization systems, and the global coverage with 3 doses of hepatitis B vaccines was estimated at 82% [5]. Elimination of HBV transmission is an achievable public health goal, particularly in light of the proven effectiveness and safety of hepatitis B vaccine. In general, studies conducted in areas with high HBV endemicity have demonstrated declines in the prevalence of chronic HBV among children to <2% after routine infant immunization [6].

With that background we can add that as for the case of Uganda Hepatitis B infection is highly endemic in Uganda as per findings from a national sero survey. A prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg).

Results indicated as below in that study

HBcAb was present in 52.3% (95% CI: 51.0–53.6) of adults, and HBsAg in 10.3% (9.5–11.1). By 15–19 years of age, 40.0% had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda, in rural areas, among the poor and least educated, and in uncircumcised men. Other independent predictors of infection were age, ethnic group, and occupation, number of sex partners, and HIV and HSV-2

In conclusion to that study it was realized that Hepatitis B virus infection is highly endemic in Uganda, with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children.

Byidi has acknowledged these global trends of HEP B research results to come up with a health initiative in relation to HIV and Hepatitis B program that involves sensitization to create awareness with a community approach that is based on prevention.

This health campaign is geared towards creating awareness and education on the importance of screening, testing, and vaccination of Hepatitis B among Ugandans and other residents in the country. We are utilizing unique health communication strategies to break the silence and normalize discussions of Hepatitis B amongst communities.

The key priorities of the Byidi campaign are (1) to create public and health care provider awareness about the importance of testing and vaccinating communities for hepatitis B, (2) to promote routine hepatitis B testing and vaccination within the primary six months’ period medical cycle, and (3) to ensure access to treatment for chronically infected individuals.

Focus is on communities that have mobile migrations like at work places on construction sites, schools with young populations that are so much influenced by life style factors, traders or business communities and rural based communities.

In the year 2018 so far an average of 200 clients are beneficiaries to this HIV and Hepatitis B prevention program. So far construction sites workers in the age group of 18 to 45 are beneficiaries to this program and these have been met on Mulago Roko construction site and others are from corporate service utility companies like Dusupay who have come in partnership with Byidi to enroll their staff on the screening and vaccination community campaigns.

There is focus to reach out to over ten thousand construction workers on different construction sites in different social settings.

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