Screening gap compounds South Sudan’s struggle with hepatitis, says official
As South Sudan enters its third year of struggling to fight COVID-19 cases in the country, the ministry of health has said access to hepatitis B and C treatment is below zero, with no public health facilities for treatment and testing.
“Currently, we don’t have screening serveries happening at all, and if it happens, it is just in a few private health facilities where people go and do the testing, so this is one of the challenges,” said Harriet Akello Pasquale, Director for HIV/AIDS and STIs at the ministry of health.
She was addressing the media on Thursday during the dialogue and advocacy meeting on triple HIV, syphilis, and HBV elimination.
On Thursday, the ministry launched the national guidelines for sexually transmitted infections and HIV self-testing guidelines in Juba.
According to World Health Organisation, HepatitisB is a viral infection that attacks the liver and can cause both acute and chronic diseases.
The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections, or exposure to sharp instruments.
“Access to hepatitis B and C treatment is very low in the country, below 0.1 per cent and the data on testing shows that we are doing less than one per cent screening for hepatitis and there is no treatment at all in the public health facility for hepatitis,” Harriet explained.
“This is how serious the situation is, and most of our patients reach the extent where they already have a complication and they are taken abroad for treatment.”
South Sudan is estimated to have a prevalence of about eight percent of hepatitis, and currently, the country does not have screening services at the public health facilities to make it affordable and accessible for citizens.
Efforts made
The government set aside SSP27.7 billion for the health sector in the final fiscal year 2020–2021 earlier this year.
The committee for finance and planning recommended that the ministry of health should pay its share of co-financing to the health partners to meet its obligation on vaccination against Hepatitis B and C and the treatment of HIV/AIDS.
WHO definition of hepatitis C states that hepatitis C is an inflammation of the liver caused by the hepatitis C virus and that the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness to a serious, lifelong illness, including liver cirrhosis and cancer.
Pasquale said that the disease can be prevented, “Hepatitis C is curable, but if it is not treated early, it will develop into what is called hepatocellular carcinoma (HCC) so it develops into cancer and by that stage, we cannot treat it,” she added.
Last week, the international medical humanitarian organisation Médecins Sans Frontières (MSF) reported that people living in the Bentiu internally displaced persons (IDP) camp – are being infected by waterborne diseases, specifically an outbreak of Hepatitis E. due to poor water and sanitation conditions.
The Deputy Medical Coordinator, Jetske Dunker, told The City Review an epidemic of hepatitis E is escalating across the Internally Displaced Persons’ camp in Bentiu. The outbreak has already resulted in the deaths of 13 people.
Dunker said cases of Hepatitis E have been escalating since July 2021 and more than 600 cases have been reported in its health facilities.
“There have been cases of hepatitis E in Bentiu since 2014, and that has been going on all those years, and later, we have seen an increase in cases since July 2021.” Then 667 patients with confirmed Hepatitis E and 13 of them died. And then, since the beginning of this year, it has been ongoing like that and that’s why we are very worried because we have even seen a person die of hepatitis E every week, which is why we are very worried about the situation there.”
Hepatitis E is caused by a virus that infects the liver. It is especially harmful to pregnant women because it can cause severe liver failure and death. Its symptoms can be managed, but there is no cure.
MSF says they are scaling up vaccination and awareness campaigns in Bentiu to control the spread of Hepatitis E.
The Director-General for preventive health serveries in the ministry of health Dr. John Rumunu, said efforts are being made to improve the state of sanitation through coordination with key line ministries.
Rumunu said the cases of Hepatitis E started increasing in 2014 in Bentiu, in the IDP camp located in Rubkona County, Unity State, and since then there has been sustained transmission within the camp with a number of cases for more than a year
“The data from 2018 tells us that, we had 157 cases, in 2019 we had 130 cases, in 2020 we had 277 cases and in 2021 the number rose to 1143 mostly within the camp, “he said.
