Bolster fight against hepatitis E

The World Health Organisation has urged Namibia to urgently step up its methods to fight hepatitis E and put an end to the prolonged outbreak.

22 August 2019 | Health

The World Health Organisation (WHO) has again urged Namibia to boost its response to the protracted hepatitis E outbreak which has claimed the lives of 56 people and infected more than 6 000 over the past two years.

Meanwhile, since the onset of the outbreak in September 2017, the hepatitis E virus has become the leading cause of maternal deaths according to Dr Lilian Kahuika, an epidemiologist in the health ministry.

Of the 56 hepatitis E deaths recorded by 11 August, 23 were maternal deaths. A fatality is defined as maternal when a woman dies during pregnancy or within 42 days of termination of pregnancy.

Kahuika said the women who died from hepatitis E before or after giving birth were between 19 and 38 years old.

The latest statistics show that the number of hepatitis E infections have eclipsed the 6 000 mark, with a total number of 6 151 cases reported by 11 August.

The statistics further show that of the cases reported, 342 were maternal cases.

Former health minister Dr Bernard Haufiku, who heads the national health emergency management committee in response to the outbreak, warned earlier this month that hepatitis E was a growing threat to public health in Namibia.

“If the current situation is allowed to continue unabated, hepatitis E will become endemic in Namibia and Namibia will struggle to get rid of the virus in the community and we may actually never get rid of it at all,” he said.



WHO warning

The WHO's weekly bulletin on public health emergencies in Africa repeats its earlier warning to Namibian authorities to step up efforts to stop the outbreak.

The report says although a slight dip in new infections in recent weeks is encouraging, “a lot more work needs to be done to drastically interrupt transmission of infections”.

The WHO notes that ongoing efforts to respond to the outbreak are “still being hindered by many factors, including weak coordination at all levels, inadequate risk communication and community engagement and participation, and low levels of safe water, sanitation and hygiene (WASH) interventions.”

Moreover, the report stresses that poor sanitation and scarce access to safe drinking water in informal settlements compound the situation.

Although a national hepatitis E plan has been drawn up, it has not yet been ratified by the authorities and is not adequately resourced, it says.



Staggering

The first cases of hepatitis E were reported in the Khomas Region in September 2017.

Of the 6 151 cases reported by 11 August, the Khomas Region's informal settlements remain the hardest hit, with a total of 3 894 (63%) of all reported cases detected in some of the country's poorest neighbourhoods. Thirty-five of the 56 deaths reported to date were recorded in the Khomas Region.

The Erongo Region has reported the second highest number of

1 393 cases (23% of the total) and six deaths.

Increased hepatitis testing at health facilities has also led to the diagnosis of 137 hepatitis A cases, of which 81 were recorded in the Omusati Region this year, as well as 168 cases of hepatitis B, of which 61 were recorded in the Omusati Region.

“I have said it time and again, that hepatitis E and even A are diseases of poverty and low socio-economic status, where there is a lack of clean water and poor personal hygiene,” Haufiku told Namibian Sun.

He said although several campaigns are under way to curb the outbreak, there is a strong push to consider alternative options, “as our current intervention seem not to take us anywhere”.

He said the teams are “looking at all potential and available options including considerations for a vaccine against hepatitis E, because we simply cannot allow the situation to continue as it is now.”

JANA-MARI SMITH

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