The burden of viral hepatitis in Africa

The burden of viral hepatitis in Africa is difficult to quantify precisely because of inaccurate statistical data and under-reporting. Of the various agents causing viral hepatitis, data on hepatitis B virus have been relatively more available and suggest that 15 to 60 per cent of the normal population in many African countries may be positive for one or more of the serologic markers of hepatitis B virus infection, whilst the corresponding values for patients with PLCC ranged from 49 to 80 per cent. Liver disease was the third most common (12.1%) of all 4,568 deaths on the medical wards of the University College Hospital, Ibadan, Nigeria over a 14-year period. Of all causes of deaths from liver disease, PLCC alone accounted for 42.5% while liver cirrhosis accounted for 21.1% of the deaths and, in both disease, HBV was the commonest cause. PLCC, which accounted for 491 out of 100,000 admissions in that teaching hospital, was the commonest malignancy on the medical wards and was the commonest cause of deaths from cancers in middle-aged and elderly Nigerians. Recent reports suggest that the prevalence of Hepatitis C infection in normal Africans may be as high as 10.9% while the corresponding value for patients with PLCC would be about 18.7 to 38 per cent. There is a need for control of hepatitis particularly hepatitis B virus infection through health education, active immunization of all new-borns and other people at risk in Africa.