(Sudanow) - Sudanese Health Minister Bahar Idris Abugarda has warned against the hiking infections of hepatitis B
, the most serious type of viral hepatitis, that has now become a global health problem claiming 780,000 lives each year.
According to the Sudanese health authorities the disease is now on the increase in Sudan. The Ministry is encouraging the citizens to do the necessary check-ups and have a good knowledge about the modes of transmission of the disease.
To learn about the disease magnitude and ways of its communication, its types and how to guard against it, Sudanow Magazine has approached Dr. Abdul Monem al-Tayyib, Director of the National Centre for Digestive System and Liver Diseases.
Q: Please tell us about hepatitis.
A: Hepatitis is a serious inflammation of the liver. Generally there are five types of hepatitis called types A, B, C, D and E. But we are very much concerned with virus B (or hepatitis B). This concern with hepatitis B is because infections in Sudan have risen, reaching between 2-8 percent, a rate which, by the WHO standards, is moderate. The infection is considered high when it exceeds 8%. However, for every 13 patients admitted to hospital, one is affected with viral hepatitis.
This rate varies from one state to the other. There might be a state with a high rate of infection, but we do not want to create panic. We do not have precise statistics on the infections. There should be careful and precise statics for us to know the exact rate of infection. Even the statistics available at the Blood Bank are inadequate because they are test results of blood donors, who are all of them males of a certain age group.
Q: Does jaundice always indicate infection with hepatitis B?
A: Jaundice is a symptom of a lot of diseases and is not a disease all by itself. It is a symptom of hepatitis B and other liver infections. Moreover, there are many other causes of liver inflammations such as certain drugs and foreign bodies which lead to jaundice.
Q: How is hepatitis B communicated?
A: Hepatitis (A) and (E) are communicated through contaminated water and food and usually infects children. But hepatitis (B) and (C) are communicated through contaminated blood, body fluids, sexual intercourse and the patient's personal belongings such as the tooth brush, razors used in tattoos and shaving and others. Hepatitis B infection rate is 100% higher than that of AIDS, because a single drop of human blood contains a million hepatitis B viruses. The virus can live very long even in a dry drop of blood. But the AIDS virus (HIV) dies at the least exposure to heat.
Q: That means people could get the infection in the beauty salons?
A: Yes, a study conducted on the disease has shown that many barbers are unaware about the best way to sterilize their equipment. Nail trimmers, eyebrow shapers and amateur cupping can also lead to infections.
Q: A few years ago a medical doctor lost his life after he contracted the disease from one of his patients. What are your measures for protecting your medical cadres?
A: Education at all levels is the best guarantee for fewer infections. The existing inoculation can guard against the disease and reduce its communication. Further, gloves should be put on when samples are taken. The Ministry of Health and the WHO have worked out a strategy for combating the disease that includes an education programme.
Q: Two years ago media reports revealed that some renal failure patients had contracted the disease through dialysis apparatus .. What measures have been taken to prevent a recurrence of such a thing?
A: That incident was true. Medical cadres and dialysis workers should be careful and follow the right procedures. But dialysis apparatus do not cause the infection. The problem could have been with the state of sterility in the place.
Q: It is known that hepatitis B checkups are expensive for the citizens. Why doesn't the government take that responsibility?
A: Checkup to verify whether one is a carrier of the hepatitis virus is not expensive and ranges between SDG20-100. But to determine whether the virus is active (needs treatment) or inactive (does not need treatment) the checkup costs between SDG 1700-2000. Inoculation (taken in three dozes) costs SDG 120. Inoculation is useless in case of active virus. Inactive virus needs follow up checkups for six months and this is expensive. In addition, most of these checkups are conducted abroad and at a high cost. But the National Laboratory (Stak) is conducting checkups at reasonable cost. We in the Centre have obtained an approval from the federal and regional health ministries to procure apparatus for these checkups, a matter that could help patients with low cost tests.
Q: How effective are the drugs prescribed to the patients? And is it true that belated treatment due to unaffordable cost can cause the disease to develop into cirrhosis or cancer?
A: Modern science has found a treatment for hepatitis (C). But drugs now available for the treatment of hepatitis (B) do not cure it, they just stop its activity. These drugs are not available or registered in Sudan. They are expensive. Most patients procure them from abroad at a high cost. Some of the registered drugs are not within the first-line treatment drugs stipulated in the international treatment protocols. We are seeking to provide such drugs in cooperation with the National Fund for Medical Supplies and the National Council on Drugs and Poisons. We seek to benefit from our experiment in the provision of AIDS drugs in order to provide these drugs. Because the rate of infection might be high, the cost of providing free medication could be high. And that had caused international organizations to hesitate from working in the area of hepatitis B disease.
Hepatitis B can cause a chronic infection and can lead to fatalities due to cirrhosis or liver cancer.
Q: Are there any countries that set freedom from the disease as a pre-requisite for granting entry visas?
A: There is no country that sets this condition except the Kingdom of Saudi Arabia. Alarmingly, some government units are setting such a condition for job seekers. This is wrong, as the disease is not communicated through food and drinks.