By Andi Kezh, Task Force Communications Intern
Every year on July 28th, World Hepatitis Day raises global awareness about viral hepatitis, a group of infectious diseases, including viral hepatitis B (HBV) and viral hepatitis C (HCV), that affect more than 357 million people. Known as ‘silent killers’ because symptoms often do not appear until decades after infection, HBV and HCV infections kill 1.1 million people annually.
Since these diseases can be transmitted from mother-to-child, newborns are vulnerable to hepatitis B and C infection and subsequent long-lasting health impacts, such as cirrhosis or liver cancer. Children infected with HBV at birth have a high risk for remaining infected for life, and one in four newborns with HBV will die early from cancer and liver disease.
“Our messaging around World Hepatitis Day, and every day, is one of advocacy on behalf of all pregnant mothers and children to ensure that HBV, which is preventable, and HCV, which is curable, do not continue to cause suffering,” said Lindsey Hiebert, Associate Director of The Task Force’s Coalition for Global Hepatitis Elimination (CGHE).
CGHE, which supports national and sub-national programs in eliminating HBV and HCV, has launched new initiatives specifically aimed at strengthening elimination efforts among pregnant persons and newborn children.
A major challenge is the lack of awareness about the importance of HBV vaccination for newborns, known as the “birth dose,” among policy makers, healthcare workers, and pregnant women. When given within 24 hours of a newborn’s life, the birth dose is the most effective intervention for preventing mother-to-child transmission.
“Very few African countries have a birth dose policy, despite the dominant mode of transmission being mother to child,” said Dr. Henry Njuguna, Epidemiologist with CGHE. Less than 10% of newborns receive a timely dose of HBV vaccine.
To alleviate this health challenge, CGHE has funded seven civil society organizations in Africa to develop HBV “birth dose” advocacy and awareness campaigns, in partnership and with funding support from the US Centers for Disease Control and Prevention.
One of them is The Hepatitis Alliance of Ghana. With the grant from CGHE, the Alliance hosted a training for midwives on the importance of giving the HBV birth dose vaccine within 24 hours of birth to prevent mother-to-child transmission. The training event, which took place on International Day of the Midwife, informed midwife professionals from the Bono and Ahafo regions of their role in preventing transmission of HBV in primary health facilities.
“The most exciting result witnessed is the enthusiasm of the midwives to become HBV birth dose champions in their own facilities and communities,” said Dr. Charles Ampong Adjei, Executive Director of Hepatitis Alliance of Ghana.
Assessments of participants in the training indicated a positive knowledge increase of 35% between pre-test and post-test evaluation for 14 items regarding Prevention of Mother to Child Transmission of HBV and how to administer the birth dose.
“From the seminar I’ve been empowered. From here I’m going to pass this knowledge onto my other colleagues,” said one midwife in attendance.
Support from CGHE enables organizations like the Hepatitis Alliance of Ghana to continue their essential work: “We plan to provide similar training to midwives in two other regions, create culturally appropriate posters on the prevention of mother-to-child transmission and make them available in health facilities, and create a short documentary on the challenges midwives and pregnant women with hepatitis B face in arranging HBV vaccine for their newborns in order to generate political will for the introduction of HBV birth doses in Ghana,” said Dr. Adjei.
Along with efforts to reduce HBV infections, CGHE works to improve treatment for HCV for pregnant women and reduce HCV mother-to-child transmission. An estimated 21% of people infected with HCV are women of childbearing age and the proportion of pregnant women with HCV is growing. In response, CGHE recently launched the Treatment in Pregnancy (“TiP Hep-C”) registry, an initiative to improve the evidence around safety of HCV treatment during pregnancy.
Watch for testimonials from midwives on the importance of healthcare provider trainings for hepatitis B birth dosing.
The registry allows providers to submit cases of mother-infant pairs exposed to HCV treatment during pregnancy. Ultimately, this data will inform decision-making around treatment options for pregnant women with HCV infection. In addition, this initiative will grow the community of practice of partners interested in improving treatment options for pregnant women, and will provide an online knowledge hub for scientific research and policy discussion. Providers from routine clinical practice and hepatitis treatment centers worldwide are encouraged to submit data.
This World Hepatitis Day, an emphasis on prevention of mother-to-child transmission aims to protect all mothers and children from hepatitis and secure the livelihood of our world’s next generations.
Photos courtesy of the Coalition for Global Hepatitis Elimination and the Hepatitis Alliance of Ghana.