World Hepatitis Day 2016: How His Parents Caused His Death


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It was a lovely Wednesday morning as
I get prepared for the day’s clinic. I
wasn’t expecting much, today is going
to be like every other day. It is almost
always an infection, if not malaria it will
be one of those bacteria infections with typhoid being the most common.
But on few occasions, some patients
present with chronic diseases like
diabetes mellitus or hypertension.
The clinic was normal until a pregnant
man came in. A pregnant man! Other patients in the waiting room
wondered. A middle aged man with a
huge abdominal distention was
wheeled into the hospital. He was in
an obvious distress, he looked as if he
is seconds away from death. So jaundiced and pale that he could
barely stand. I swung into action with
the hope of helping him but my
enthusiasm was soon shattered.
There’s little I could do on knowing
the diagnosis. He has liver cancer from chronic hepatitis B infection.
The most touching part of this tragic
story was how he got the hepatitis B
infection. Before going neck deep into
his story let’s form a background by
knowing some basic information about hepatitis B. Hepatitis B is a viral
infection just like HIV but 100 times
more infectious. WHO 2014 facts
sheets estimates that 2 billion people
have been infected with hepatitis B
virus worldwide. 90% of those with the infection don’t know they have it
and only 1 in 100 gets treated. It is
transmitted by sharing of sharps,
unsafe sexual intercourse, exchange
of body fluids, needle pricks and also
from mother to child. Most people with this infection go unnoticed as the
immune system have the ability to
contain it but when this fail, an
infected individual becomes a chronic
carrier of the virus. And in the long
run, the chronic carriers develop liver cirrhosis and liver cancer. Chronic
hepatitis infection is the commonest
cause of liver cancer in sub Saharan
Africa.
So how did my patient got his? Exactly
42 years ago, his family of 7 felt the need to empower themselves against
metaphysical powers. His parent felt
they needed to fortify the children and
protect them from their numerous
imaginary enemies. This made them
visit an herbalist whose method of doing this was through incisions. He
incised the five children twenty one
different times, lacerating different
parts of their body while he rubbed a
black substance on each incision. He
used the same blade for all the five children. He ended up infecting all the
children with hepatitis B virus in the
process. Three of the children later
became a chronic carriers as
evidenced by being positive to
hepatitis B surface antigen. None of the children knew until one of them
developed liver cancer. I referred him
to a gastroenterologist but little could
they do to help him. He died 2 months
after. Important lessons from this story
are:
About 20 million Nigerians are
chronic carriers with most being
unaware.
Everyone should go for a screening test, it is not expensive.
One should avoid high risk
behavior like sharing of sharps and
having unprotected sexual
intercourse.
Parent with the infection should take adequate measures to prevent
its transmission to their unborn
child.
All new babies must be vaccinated
against the infections
If you have this infection it is not the end of the road, it can be cured. Let me leave you with the
recommendation of Prof. Olusegun
Ojo, the former President, Society for
Gastroenterology and Hepatology,
Nigeria and the current President of
Africa and Middle East Association of Gastroenterogy (AMAGE), “At the same
time, Nigerians should take steps to
determine their Hepatitis B Virus and
Hepatatis C virus statuses by getting
screened in hospitals and medical
laboratories. If negative, they should seek to be vaccinated and, if positive
they should ask to see hepatologists,
specialist physicians who are
knowledgeable and conversant with
further testing and treatment.”
An important question I ask myself is, should one blame the parent or
excuse them for the good intention
that turned sour?
This article was written to
commemorate the world hepatitis day,
July 28 and in remembrance of a fellow nairalander, DJDOLA who died
from chronic liver disease 2 years
back. May your soul and that of my
patient rest in peace.