Rise of hepatitis E unstoppable

12 September 2019 | Health

Hepatitis E infections and deaths have more than doubled over the past year, with a total of 6 280 hepatitis E cases reported by 25 August this year, in addition to 55 deaths.

The majority of patients and fatalities are unemployed Namibians living in informal settlements.

A new report on the outbreak shows that over the past year, the number of hepatitis E infections rose by 3 726 new cases. A total of 2 554 cases had been reported since the start of the outbreak in September 2017 to 29 July 2018.

By 25 August this year, cumulatively a total of 6 280 cases had been reported.

Moreover, between September 2017 and 29 July 2018, a total of 24 deaths had been reported, rising to 55 deaths by 25 August this year.

The latest situation report shows that of the 55 deaths reported, the majority of fatalities (64% or 35) were women, compared to 20 men (46%).

Moreover, of the 35 women who died, 23 were categorised as maternal deaths, with 12 dying while still pregnant and 10 dying after giving birth. One woman had a miscarriage before she died.



Reality

The report notes that 30% (1 929) of those infected, are unemployed, and 75% (4 745) of infections occurred among people who use communal taps, while 55% of patients ate food from street vendors.

Of all those infected, only 9% of cases required hospitalisation.

The situation report notes there has been a decrease in newly reported cases of infection during the last two weeks of the reporting period - between 12 and 25 August- compared to the prior weeks.

Between 12 and 25 August, a total of 158 new hepatitis E cases were reported, compared to 163 cases reported between 29 July and 11 August.

Moreover, analysis shows that while cases continue to fluctuate, a decrease overall in new cases has been observed during the last three weeks.

The majority of new cases, 57, were reported in the Khomas Region, where a total of 3 956 or 63% of all cases have been reported to date.

The Erongo Region reported 32 new cases, followed by 32 cases reported in the Kavango regions during the period under review.

Since the start of the outbreak two years ago, the protracted outbreak has spread to most parts of the country, affecting primarily informal settlement residents with a lack of access to safe water and sanitation facilities.

The majority of infections, 73%, were reported among people aged between 20 and 39. Gender-wise, 3 807 men have been affected and 2 551 women.

Moreover, an increasing number of hepatitis A cases have been reported in the Omusati Region, with an estimated 98 cases reported to date. Sporadic cases have been reported elsewhere, with an estimated total of 58 cases to date.



Gaps

Among several challenges listed in the latest report, is that the “overall coordination is still suboptimal, due to no incident manager for this outbreak assigned yet”.

Moreover, inadequate sanitation and water interventions in some informal settlements “still persist”, the authors of the report indicate.

Those heading the response say there has been inadequate risk communication activities to facilitate behaviour change and enforce hygiene and sanitation practices, early health-seeking behaviours and a sense of ownership among community members.

Priority interventions identified include the development and training of additional health facility staff, to further strengthen testing abilities for the hepatitis E virus in the affected regions.

JANA-MARI SMITH

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