WHO adopted in 2016 a global strategy to eliminate hepatitis B and C by 2030. On the basis of anthropological analyses conducted in multiple African countries, a group of researchers, including some from the Institut Pasteur, suggest that to achieve these goals it is essential to improve the communication about viral hepatitis.
According to WHO, viral hepatitis caused 1.34 million deaths in 2015 (a number comparable to deaths caused by tuberculosis and higher than those caused by HIV) and an estimated 328 million people are living with chronic hepatitis B or C infections worldwide. On the African continent, hepatitis B prevalence is particularly high, with more than 8% of its adult population chronically infected.
In the context of its global elimination strategy, WHO recently released new guidelines for hepatitis B and C testing. In a communication published in the Lancet Infectious Diseases, a group of researchers led by Yusuke Shimakawa and Tamara Giles-Vernick from the Institut Pasteur, call for better training of health workers around viral hepatitis and improved communication strategies with general populations in Africa.
Anthropological studies conducted in various African countries (Burkina Faso, Central African Republic, Côte d’Ivoire, The Gambia and Madagascar) demonstrate the lack of information and misknowledge about hepatitis. “Most of the populations we have studied have very little to no knowledge about viral hepatitis. They do not know the routes of transmission and often offer alternative explanations for the symptoms that they observe in people suffering, sometimes invoking HIV. Anthropological investigations can help develop tools for more adapted, effective communications with the public.” explains Tamara Giles Vernick, leader of the Medical anthropology and environment group at the Institut Pasteur. The same situation was observed regarding healthcare workers, who lack biomedical knowledge and sufficient training to explain the illness to the patients. “Affordable antiviral therapies exist against hepatitis B and their access can be considerably improved in Africa. However, the current treatment is lifelong for most people, and thus a genuine understanding of viral hepatitis is essential for them to fully commit to the long-term treatment. Another important area for hepatitis B control is to increase immunization coverage at birth as recommended by WHO” explain Yusuke Shimakawa, from the Emerging disease epidemiology unit at the Institut Pasteur.
In Africa, the virus is commonly spread from mother to child at birth and between children during the first years of life. The Institut Pasteur is coordinating the NeoVac project (Neonatal Vaccination against Hepatitis B in Africa), a large international study conducted in collaboration with Institut Pasteur in Madagascar, Institut Pasteur in Dakar and Lamivac in Burkina-Faso. The objective of this project is to develop and evaluate in each country the best locally adapted strategy to improve the coverage of a timely birth dose of hepatitis B vaccine and other neonatal care practices.
Source : Yusuke Shimakawa, Dolorès Pourette, Louis Bainilago, Catherine Enel, Roger Sombié, Ramanampamonjy Rado, Maud Lemoine, Tamara Giles-Vernick, Improving communication about viral hepatitis in Africa, The Lancet Infectious Diseases, Volume 17, Issue 7, July 2017, Pages 688-689