By Sharon Atieno
John Ndichu Muia, a 29 year old man, is among those diagnosed with Hepatitis C. A former heroin drug user, he has benefited from the needles and syringes programme launched by National AIDS and STIs Control Programme (NASCOP). This is in a bid to deal with the spread of hepatitis C.
“I started injecting heroin in 2004 but learnt about my Hepatitis C status in 2016,” he notes.
He recalls that it took the help of his nephew who noticed that his eyes were becoming yellow for him to go to a drop-in centre where he was examined and diagnosed with the disease.
Yellowing of eyes and palms is a distinctive symptom of viral hepatitis as it affects the liver and the system which deals with red blood cells, Dr. Richard Banda, a specialist in WHO’s department of Hepatitis and HIV/AIDS notes during an interview at the launch of the Hepatitis scorecard.
Other symptoms include nausea, vomiting, fever, which are non-specific as they mimic symptoms of other diseases.
“The disease is very silent, as symptoms do not show. You can live with it for even twenty years without knowing until you get cancer or your liver becomes compromised,” says Dr. Banda.
This is attested by the high number of incidences in Baringo, West Pokot and Turkana counties. Research conducted in these areas indicates that the virus was gotten at an early age faulting their lifestyle of scarifications and ear piercings.
One in 15 people are living with chronic hepatitis B in the WHO African region with Kenya having an intermediate prevalence rate of 2.2 percent. It is estimated that 1 million people in Kenya have chronic Hepatitis B with less than 50,000 being children at the age of 5 years.
Hepatitis C prevalence in the country, the WHO projects is at 0.2 percent. A condition which is prevalent with key populations such as people who inject drugs, men who have sex with men and commercial sex workers due to sharing of needles and auxiliary injecting equipment.
“The entry point to any of this is testing as it is the gate to any intervention that is to be done,” Dr. Ochwoto Missiani, a researcher at Kenya Medical Research Institute (KEMRI) notes.
As Africa gears towards the elimination of viral hepatitis by 2030, the World Health Organization (WHO) score card launched last week indicates that Kenya is not on track towards achieving that goal. However, efforts are underway to change this state.
As the main mode of transmission for Hepatitis C is using unsafe needles and syringes, comprehensive harm reduction services is being carried out. This involves distribution of safe injecting needles and syringes.
“Through the needles and syringes programme which is a partnership between NASCOP, Medicin sans Frontiere and Medicin du Monde, we are able to get access to the needles and injecting water which helps in reducing chances of re-infection,” Ndichu says.
Part of the indicators in the Hepatitis scorecard is the development of viral Hepatitis guidelines. Currently, the Government is working on developing the viral Hepatitis guidelines which Ochwoto says, is 95 percent complete with only a few areas remaining.
The guidelines are also in a bid to create awareness and dismiss speculations on transmission and progression of the disease among others.
Health workers have also been trained in Nyanza, Eastern, Nairobi and Coast in order to increase awareness and uptake of prevention services.
In addition, the Kenyan government is negotiating with Egypt for Hepatitis C drugs at a subsidized rate. The drugs used to cost shs. 120,000 but it has been cut down to shs. 60,000. The negotiations are seeking to lower the rate further to around shs. 20,000.
So far, the government has acquired Havoni, a pan-genotypic drug which will be used in the Hepatitis C treatment and does not require doing a genotype to determine which type of Hepatitis C is affecting a patient.
“Genotyping is very expensive costing around shs. 60,000. By removing this, the cost of treatment will be brought down by a great number,” notes the KEMRI researcher.
Moreover, a new study targeting 1000 people with Hepatitis C is to be conducted in Kenya.
“We are going to test people from the general population and those who inject drugs, and link them to care,” said Dr. Ochwoto.
Other studies targeting Hepatitis C are underway; this includes a NASCOP study which targets around 400 people. The study will enable the government to know how many people have Hepatitis C and know the cure rate. The study has already begun in Mombasa, Kwale and Kilifi.
Though these efforts are quite progressive, more work needs to be done to ensure that Kenya is on track towards the elimination of viral Hepatitis by 2030.