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Saving your liver from the stealth killer

THE liver is a large, meaty organ that sits on the right side of the belly. Weighing about three pounds in adulthood, the liver is reddish-brown in color and feels rubbery to the touch. Though it is the largest solid gland in your body, roughly the side of a football for teens, you can’t feel the liver, because it’s protected by the rib cage.
The liver’s major functions include: making toxins less harmful to the body and removing them from the bloodstream, creating immune system factors that can fight against infection, creating proteins responsible for blood clotting, breaking down old and damaged red blood cells, storing extra blood sugar as glycogen, storing vitamins as well as minerals such as copper and iron as well as releasing them if the body needs them, and storing fats or releases them as energy.

The many cells of the liver, known as hepatocytes, accept and filter blood. They act as little sorting centers, determining: which nutrients should be processed, what should be stored, what should be eliminated via the stool, and what should go back to the blood.

However, an inflammation of the tissues of the liver known as hepatitis can be very fatal, if not diagnosed early and treated. Some of the common symptoms of the contagious disease include poor appetite, tiredness, vomiting, yellow discoloration of the skin and the white portion of the eye to mention but a few. The viral agents responsible for hepatitis are grouped into four sub-types as follows: A, B, C, and D. However, Hepatitis virus B and C are responsible for 96% of all mortality due to the disease. Nigeria has a prevalence of 11% for Hepatitis B and 2.2% for Hepatitis C respectively, a 2013 report from the Federal Ministry of Health says.

In 2015, about 1.34 million deaths were recorded from Viral Hepatitis globally; this number is comparable to deaths caused by tuberculosis. It is also higher when compared to deaths caused by HIV/AIDS. It is sad that while mortality from tuberculosis and HIV is on the decline, the number of deaths from Viral Hepatitis is on the increase as reported in a WHO Report of 2017.

The same WHO report says 22 million Nigerians are estimated to be infected with Hepatitis B, while roughly four million are infected with Hepatitis C.
In Nigeria, the leading risk factors include: local circumcision, local uvelectomy, and scarifications on the body. Other predisposing factors include surgical procedures, deliveries that occur at home and blood transfusion to mention a few.

According to the Minister of Health, Prof. Isaac Adewole, cases of viral hepatitis are more common amongst people between the ages of 21 and 40 years. He said one in every 12 persons is estimated to be living with the infection.

Unfortunately, most of them may not be aware of this giving the hepatitis virus the alias of stealth killer just as the Minister said: “Over 300 million people living with Viral Hepatitis globally, 90% of them do not know their status. In Nigeria, the knowledge of Viral Hepatitis remains low even though it is a leading cause of death. As a result most Nigerians living with Viral Hepatitis B or C are undiagnosed, increasing the likelihood of transmission to others. It also places the individual at the greater risk of severe, even fatal health complications such as liver cirrhosis and liver cancer (hepatocellular carcinoma). So, we need regular diagnosis to reduce the burden and deaths due to Hepatitis.”

Using the occasion of the 2018 World Hepatitis Day on July 28, 2018 to galvanize support towards tackling the ignorance fueling the country’s high burden of hepatitis, Adewole said: “On this day we call on all to take action, raise awareness and join in the quest to find the ‘missing’ millions who are living with Hepatitis. Nigeria’s target is to eliminate Viral Hepatitis by the year 2030 in line with the Sustainable Development Goals (SDGs). We must all know our status. Everyone must go to the nearby facility and get screened; it takes less than 15 minutes to do this. Save your Liver Today!”

Policy documents like the National Guideline for the Management of Viral Hepatitis and a five year National Strategic Plan (2016-2020) have been developed to give the national response the strategic direction it deserves. With support from WHO, the National Directory on Viral Hepatitis has been developed and launched in Abuja to further improve access to care.

The federal government through its Ministry of Health is currently working with partners and pharmaceutical companies to facilitate the provision of anti-viral drugs for the management of Hepatitis B and the treatment of Hepatitis C at the lowest possible price. The Ministry recently signed a Memorandum of Understanding (MOU) with Gilead Pharmaceutical to provide drugs for the treatment and cure for Hepatitis C.

However, funding of the country’s programme for the control of viral hepatitis remains a challenge.
To former Military Head of State, Yakubu Gowon (GCFR), who is Nigeria’s Goodwill Ambassador for Viral Hepatitis, the only way the nation can deal its high hepatitis burden is for federal and state governments to give serious attention to an upward review of the budgetary allocation for its hepatitis programme to a benchmark that can reduce the burden of the viral disease.

“I therefore plead and urge the Federal Government and state governments to review the annual budgetary location to the Federal and States Ministries of Health to a benchmark that can reduce the burden of viral hepatitis and promote inclusion into the National Health Insurance Scheme (NHIS) to improve the quality and access to medical facilities across the country.

“We also call on the Federal Government to utilise the ongoing Nigeria AIDS Indicator and Impact Survey to determine viral hepatitis burden in Nigeria,” Gowon said.

As stakeholders and partners express willingness to help Nigeria eliminate hepatitis and save our livers, the government and the people must bear in mind the saying that “health is wealth, and a healthy nation is a wealthy nation.”

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