By Chioma Obinna
To stem the rising cases of liver cancers, a Professor of Medicine,, Gastroenterology and Liver Unit, Faculty of Clinical Sciences, College of Medicine University of Ibadan, Prof. Jesse Abiodun Otegbayo, has said that the identification and prevention of factors that encourage the spread of HBV will break the link between the virus and liver cancer.
Otegbayo who stated this in his inaugural lecture at the University of Ibadan, entitled: “The Human Workhorse and Microbial Afflictions: Hepatitis Its Fatal Sting and The Tragic Trajectory” said in a study among unremunerated blood donors at the university, it was discovered that the most common risk factor for the spread of HBV is scarification, followed by indiscriminate injections.
According to him, the study also found that in 54 per cent of the subjects, there were no identifiable risk factors.
Noting that the spread of HBV could be vertical or horizontal, he said while vertical transmission is from mother to child at birth, horizontal transmission is from person to person other than by birth.
He listed means of transmission to include; sexual contacts, transfusion of unscreened blood and blood products, dental manipulations, surgical procedures with unsterilised equipment and sharp objects, and contact sports, among others.
Acknowledging that the HBV vaccine has been developed and declared safe and effective, even in pregnancy, he said several countries, including Nigeria, are signatories to the inclusion of the HBV vaccine in the National Programme on Immunisation but the degree of implementation and compliance have been low.
He said in Nigeria, only 41 per cent of newborns are immunised against HBV, according to the 2022 World Bank data.
Otegbayo who lamented that a study of healthcare workers’ hepatitis vaccination for HBV at the UCH, Ibadan, showed 59.7 per cent completed the three doses of the vaccine, said healthcare workers are among the greatest risks for HBV infection and are supposed to be most knowledgeable.
“The vaccination rate among non-healthcare workers is then better imagined. I must however praise the efforts of the Students Union government of the University of Ibadan for the concerted efforts and measures it has put in place in the last few years to ensure that students are screened and immunised against HBV.”
He argued that there is ample evidence of tested and workable approaches and experiences that showed that if appropriate measures are taken, the problems of HBV and liver cancer would be surmountable.
“In the Gambia, the smallest West African Country with a population of less than one and a half million human heads, and Taiwan, longitudinal studies with The institution of HBV immunisation have reduced the incidence of HBV infection as well as liver cancer.”
He said the prevention and treatment of liver cirrhosis by treatment or monitoring of individuals who are HBV positive and treatment of patients with chronic hepatitis to prevent progression to liver cirrhosis and subsequent development of liver cancer, cannot be overemphasised.
“Again, in Sub-Sahara Africa, hepatitis B virus is the most common cause of liver cirrhosis. There are genetic causes of HCC, and there is a need to explore the causes of death by autopsy, as studies have shown that liver cancer is more common among individuals with a family history of liver cancer, both in those with environmental risk factors like HBV and HCV and those without known environmental risk factors.
“Unfortunately, one of our studies has shown a drastic decline in autopsy rates in Ibadan.”
He expressed worry about the size of Nigeria’s population and what it portends if no concrete actions are taken urgently.
“The World Bank Data, 2022, showed a high fertility rate in Nigeria, with an average of 5.2 births per woman, 102 births per 1000 of women aged between 15 and 19 years, and a population growth rate of 2.4 per cent, which is above the world average. Comparing the birth rate per woman in other African countries, Egypt (2.9), Ethiopia (4.2), Ghana (3.6), Senegal (4.4), and Sierra Leone (4). It is worthy of note that developed countries have less than 2 births per woman. population explosion is imminent in Nigeria, and it will, needless to say, overwhelm and overstretch our healthcare system, thereby worsening our health indices.
“It is estimated that by 2050, Nigeria will have a population of 401 million people, larger than the United States of America. This is a ticking time bomb.”
“The managers of our healthcare system deserve a certain level of financial and training empowerment to be able to function optimally. Healthcare Costs are expensive anywhere in the world.
“The Federal Government has also come out with a workable family planning blueprint, which is aimed at curbing the country’s population explosion. Nigeria therefore has to address our primary healthcare system, institute Universal healthcare and put in measures to control our population.
The only difference between success and failure is the ability to take action.