Bangladesh's hidden hepatitis crisis: 1 crore infected, most unaware

Infographic: TBS

Around 1 crore people in Bangladesh are living with hepatitis B and C, while viral hepatitis claims 20,000 to 21,000 lives annually through liver cirrhosis and liver cancer, making the country one of the world's 10 hardest-hit nations.

Ahead of World Hepatitis Day on 28 July, liver disease specialists call for nationwide hepatitis screening, expanded vaccination and stronger public awareness campaigns to help Bangladesh achieve the global target of eliminating viral hepatitis by 2030.

Professor Dr Md Shahinul Alam, chairman of the Department of Hepatology at Bangladesh Medical University and president of the Hepatology Society, told The Business Standard that the biggest barrier to eliminating hepatitis is low public awareness.

He said about 90% of people infected with hepatitis B or C are unaware they carry the virus.

"A person can live a normal life for 10 to 20 years while the liver is gradually being damaged. By the time the disease is diagnosed, many patients have already developed complications such as liver cirrhosis, liver failure or liver cancer. That is why we want every adult in the country to be tested for hepatitis B and C at least once," he said.

He said the inclusion of the hepatitis B vaccine in the Expanded Programme on Immunisation (EPI) in 2003 has sharply reduced infections among children. However, many people aged 25 and above missed the vaccine in childhood and should be screened for hepatitis B and vaccinated if needed.

Professor Shahinul also stressed vaccinating women of reproductive age. About 85 lakh people in Bangladesh are infected with hepatitis B, including around 18 lakh women aged 18 to 45. As mother-to-child transmission remains a major route of infection, screening women before pregnancy and vaccinating those who need it could significantly reduce infections in future generations.

This year's World Hepatitis Day theme, "Hepatitis: Let's break it down," calls for removing barriers that prevent people from accessing life-saving hepatitis services.

According to the Hepatology Society, about 57 lakh men, 28 lakh women and 400,000 children in Bangladesh are living with hepatitis B, while at least one member of around 15 lakh families is a hepatitis B carrier.

Experts said hepatitis has five major types – A, B, C, D and E. Among them, hepatitis B and C are chronic infections and the leading causes of liver cirrhosis and liver cancer. Hepatitis B can be prevented through vaccination, which also significantly lowers the risk of liver cancer.

They said widespread hepatitis B vaccination and regular screening are cost-effective measures that can prevent substantial future healthcare costs and economic losses. 

They also emphasised hepatitis A vaccination, safe drinking water and improved sanitation to reduce hepatitis E infections.

Professor Dr Md Golam Azam, head of the Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders at BIRDEM General Hospital, said Bangladesh could eliminate viral hepatitis by 2030 by ensuring universal birth-dose hepatitis B vaccination, safe healthcare practices and regular screening.

"Achieving this goal will require coordinated efforts by the government, physicians, researchers, the media, professional organisations and the public. Such collective action offers the most effective path towards a hepatitis-free Bangladesh," he said.

On the occasion of World Hepatitis Day, Prime Minister Tarique Rahman said last night that millions of people worldwide develop liver cirrhosis, liver cancer every year due to hepatitis B and C.  However, the diseases are preventable through timely vaccination, screening, safe health practices and proper treatment.

He said Bangladesh remains firmly committed to achieving the World Health Organization's goal of eliminating viral hepatitis by 2030.