Hepatitis B in Sierra Leone

The Hepatitis B virus (HBV) is the leading cause of liver disease. An estimated 248 million people are infected with the virus worldwide. HBV contributes to 600 thousand liver disease-related deaths a year. It is most prevalent in the Western Pacific with 6.2 percent infection rate and African regions with 6.1 percent of the population are infected. Instances of Hepatitis B in Sierra Leone are high, so the government is working to improve access to vaccinations.

Hepatitis B in Sierra Leone

Sierra Leone suffers an especially high prevalence of Hepatitis B. An estimated 8 percent of the population is actively infected, and 6-11 percent of mothers risk passing the disease onto their children through birth. HBV is most often transmitted via childbirth. It can also be transmitted through exposure to infected blood. In highly endemic areas, this occurs most often before age five. Adults can become infected through exposure to any infected body fluids, including through sexual activity.

Typically, the older an individual is at the time of exposure, the less likely the disease is to become chronic. However, children under a year old are 80 to 90 percent likely to develop chronic HBV if exposed, 30 to 50 percent before age 5 and fewer than 5 percent in adults. There is no cure for the disease, which often manifests without symptoms at initial infection. However, those suffering from it can suppress the virus through life-long treatment.

However, the HBV vaccine is 98 to 100 percent effective and has been shown to significantly decrease a country’s HBV prevalence when systematically administered. Sierra Leone has made a push toward improving its national health through international efforts. Though it is limited in its own resources, the country has facilitated “free testing, treatment and counseling” provided through the help of international donors.

Efforts to Reduce Hepatitis B in Sierra Leone

In 2014, the African Regional Committee of the World Health Organization passed a resolution to reduce HBV prevalence in children under 5 years old by 2020 to less than 2 percent. In 2007, Sierra Leone introduced HBV in the vaccine to newborns at week 6, 10 and 14, but the WHO recommended birth dose was not being given.

Much of the efforts on studying hepatitis B in Sierra Leone have been focused on providing accurate information on its epidemiology. The Center for Disease Control conducted a survey measuring the frequency of mother-child transmission and the effectiveness of the current immunization program. Data recently collected on 3,158 households in three provinces of Sierra Leone. Over the course of six weeks, 551 samples of serum were collected

This information will be used to inform Sierra Leone’s Ministry of Health and Sanitation on the success rate of the vaccination campaign. It will show how well the WHO recommended birth-dose works in reducing Hepatitis B. The research also compares Sierra Leone’s mother-to-child infection rate with that of other African countries with similar strains of the virus. The information is expected to be released by the end of 2019.

Areas to Improve

There are still many areas to cover. While the country focuses on expanding the vaccination program, there have been little effort put towards the prevention of adult to adult transmission. Some studies have shown that many healthcare workers lack adequate knowledge of the disease. At least 77 percent of healthcare staff were unable to recognizing clinical symptoms following infection. These areas need to be addressed in order to effectively reduce tranmission of the virus.

Still, the country has made massive strides in improving its HIV and malaria treatments in the past. Now, it must focus treatment on Hepatitis B in Sierra Leone. Education and vaccinations are essential to reducing the spread of the disease.

Katie Hwang
Photo: Flickr