Tanzania’s doctors urge action over killer liver disease

By Kizito Makoye

DAR ES SALAAM, Tanzania (AA) - Tanzania could be on the brink of a major health crisis due to rising cases of hepatitis triggered by a growing number of infections and delayed diagnosis, health experts have warned.

Hepatitis, a potentially life-threatening infection branded as a silent killer, is an inflammation of the liver often caused by viruses but sometimes by drug or alcohol abuse.

The virus is often transmitted from mother to child during birth and delivery and also through contact with blood or body fluids during sex, unsafe injections, or exposures to sharp instruments, say medical experts.

There are five main types of hepatitis known as A, B, C, D, and E.

John Rwegasha, a gastroenterologist at Tanzania’s Muhimbili National Hospital, said the prevalence of hepatitis B from blood donation centers has risen from 9.5% to 16% over the last five years. HIV prevalence is 5.3%.

Rwegasha, however, said there is no accurate data to know the exact burden of the disease.

“We rely on data from blood donation centers, which is not always accurate,” he told Anadolu Agency.

According to him, most hepatitis patients do not experience symptoms when infected by the virus, although others may become seriously ill with symptoms including yellowing of the skin and the eyes.

“Acute hepatitis can cause liver failure resulting in death,” Rwegasha said.

The expert said many rural residents are at risk of contracting chronic liver disease, cancer, and suffering a premature death, urging medical authorities to intensify testing and treatment.

“This disease is a major public health challenge that requires a coordinated response and urgent action,” he said.

The deadly virus affects 354 million people globally, and given the size of the epidemic, everyone could be at risk, according to the World Health Organization (WHO).

The WHO estimates that 296 million people were living with chronic hepatitis B infections in 2019, with 1.5 million new infections recorded each year. In 2019, hepatitis B resulted in an estimated 820,000 deaths, primarily from liver cancer.

In Tanzania, most people with hepatitis are unaware of the infection. Worse still, hepatitis tests are complicated and can be costly, with poor laboratory capacity where diagnostic and therapeutic evaluations cost 470,000 Tanzanian shillings ($201), according to local experts.

Rwegasha said because the medications for treating hepatitis B are expensive, patients are often advised to take antiretroviral drugs.

“Hepatitis infection requires life-long treatment. We usually give them tenofovir, a generic antiviral drug also used in HIV treatment,” he said.

Across Africa, dying from hepatitis is increasingly becoming a bigger threat than dying from HIV/AIDS. However, experts say those who are sick are not getting diagnosed and treated until it is too late.

Kidawa Halfani, 32, recalled how her mother contracted hepatitis in Tanzania’s western town of Tabora and doctors at Kitete Referral Hospital could not immediately diagnose the symptoms.

“No one knew it was hepatitis even though we repeatedly took her to the hospital each time her eyes turned yellow,” she said.

According to her, doctors said she was suffering from a mild fever and gave her painkillers, which did not help.

Nine years after the symptoms started, Halfani’s mother was diagnosed with end-stage liver cancer.

“Her condition worsened even more. It was too late to save the life of my mother. She died a very painful death,” she said.

According to Rwegasha, hepatitis is usually hard to detect since it only shows mild flu-like symptoms including fever, body aches, and fatigue.

“These are the symptoms that many patients ignore. They will only start to take it seriously when they experience massive weight loss and skin disorders, which may take months to appear,” he said.

- Glimmer of hope

Recently engaged and heavily pregnant, Tausi Kiwanga got a blood test and was shocked to find out that she has hepatitis B.

Upon seeing a doctor, she was inspired to learn how to protect her unborn baby from the disease.

Hepatitis B no longer haunts her. She transformed herself from a survivor to a helper. She is making sure that her soon-to-arrive baby is immunized against the virus.

“I am confident that everything will be just fine,” she said.