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Understand the dramatic decline in the prevalence of hepatitis B

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The Uganda HIV / AIDS Sero Behavioral Survey 2004-2005 showed that 1 in 10 adults (10%) in Uganda were infected with hepatitis B at that time

In record time 13 years, Uganda has reduced the hepatitis B virus from a prevalence of 10% to currently 4.3%. This is in sharp contrast to the time the country needed to eradicate an equally aggressive virus; HIV to the current 6.7%. According to data from the Uganda AIDS Commission, HIV / AIDS was at 6.4% in 2004/05, currently at 6.7%.

It is also worth noting that areas with a high hepatitis B rate tend to have a lower HIV / AIDS prevalence than two viral states, which are almost equally common.

In 201

6, the Ministry of Health published the preliminary results for 2016 in Uganda The HIV Impact Assessment (UPHIA) of the population showed that the national prevalence of adult hepatitis B was 4.3% (15-64 years) , The report, according to the report, included a total of 16,670 women and 12,354 men in the country's districts.

In terms of regional distribution, the study shows that the hepatitis B prevalence in the northern region, which is subdivided into Mid, is highest in North (4.6%), followed by North East (4.4%). ) and West Nile (3.8%). The lower burden areas are South West (0.8%) and East Central (2.7%).

The Uganda HIV / AIDS Sero-Behavioral Study 2004-2005 showed that 1 in 10 adults (10%) in Uganda were infected with hepatitis B at that time. Like the UPHIA study, the Northeast, North Central and West Nile regions had much higher infection rates than the other respondents (24, 21 and 18%, respectively). Residents in the southwestern region had the lowest infection rates of 4%, Kampala (5.5%), East Central (5.5%), Central (5.8%) and Eastern (6.7%). This included a total of 6000 respondents aged 15 to 59 years.

It is discussed how the interventions, which had been in focus for the last five years, were able to reduce the virus to the current UPHIA levels, a study supported by the Ministry of Health in collaboration with ICAP-Columbia University financed by the USA. AIDS Aid to the President (PEPFAR) and Technical Assistance from the United States Center for Disease Control and Prevention (CDC)

Dr. Sam Biraro, the country's representative of the ICAP in Uganda and coordinator of UPHIA in defense of their findings, said, "Our research design has been scrutinized scientifically by various evaluation panels in both Uganda and the US It has therefore been adopted to cover both the national and national level

Possibility of Suppression

According to the 2014 Census data, children aged 0-14 years account for 47.9% of the total population. The Department of Health points out that since 2002, children have been receiving the hepatitis B vaccine as part of the regular Uganda National Expanded Program for Immunization. This would mean that children under the age of 16, who make up almost half of the population, were protected if they followed the recommended vaccination schedule.

The other argument is the fact that more than 85% of adults are capable of fighting the infection because of good immunity, chances are that many have since developed a natural immunity to the virus.

Dr. Biraro also argues that although the country needed almost two decades to reduce HIV / AIDS infections, the same standard does not necessarily apply to hepatitis B. "Different infections or viruses respond differently to interventions, which explains why the numbers have dropped dramatically," he says.

Dr. Jacinto Amandua, the retired clinical services commissioner at the Ministry of Health, who led the country's hepatitis B interventions, called it the "dilution" effect.

"This shows that the interventions that we carry out in the communities have an impact and that nearly one million people are admitted to our population every year, the virus can not be as aggressive as before," he argues.

Banson Barugahare, a virologist and immunologist, argues that the hepatitis B virus is said to precede HIV / AIDS with a chance that the virus has undergone mutational processes to adapt to changing environmental conditions. It can not be more than 10% at the moment.

"There is no possibility that the double-digit prevalence with some regions like West Nile with a prevalence of over 18% is less than 5%." What magic have we done in the past 10 years that made the virus to that extent? One of the hepatitis B advocates who favored anonymity added that the disease had been politicized at the expense of the plight of many Ugandans.

Dr. Patrick Anguzu, District Health Commissioner for Arua in West Nile (one of the regions with the highest prevalence), is surprised by the sharp decline, but notes that a number of factors could have contributed to it. Like Biraro, he also mentions that in the case of vaccination of nearly half of the population, the virus was actually suppressed. V3.espacenet.com/textdoc?

"However, we need to look at the dynamics that led to the past prevalence. Factors are no longer relevant," he says.

He argues that the district is currently unable to clearly assess the impact of interventions that had barely begun four years ago. It also includes understanding how the various interventions, such as mass vaccination and health education, have disrupted the spread of the virus and its effects on behavior.

In Nakapiripirit, dr. John Anguzu, the district health officer says she is currently struggling with stigma, pushing people away from test centers. "When we first called people for mass screening and vaccination, they came in droves, but they're pulling back on overtime because of the stigma they felt was positive," says Dr. Anguzu.

Ongoing Intervention

According to the head of the Department of Clinical and Social Services of the Ministry of Health, dr. Charles Olaro, following a "successful universal screening and vaccination" in 39 districts of Karamoja, Lango, West Nile and Teso, has now launched another 26 districts in Busoga and Bugisu. The program will eventually be introduced nationwide.


• Hepatitis B is a viral infection that affects the liver and can cause both acute and chronic conditions.

• The virus is transmitted by contact with the blood or other body fluids of an infected person can survive at least 7 days outside the body.

• An estimated 290 million people (men, women and children) are living with a hepatitis B virus infection (defined as hepatitis B surface antigen positive). 9 out of 10 people living with viral hepatitis are unaware and every 50 seconds a person dies from the complications of this vaccine-preventable disease.

• Hepatitis B is a major occupational risk for healthcare workers.

• However, it can be prevented by currently available safe and effective vaccine.

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