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‘Think Again’ About Hepatitis – World Hepatitis Day Events in Ghana

imagesTheobald Owusu-Ansah of the Theobald Hepatitis B Foundation works tirelessly to raise the profile of hepatitis B in Ghana, where the HBV prevalence is approximately 30% in blood donors. Through collaboration with others, and heightening awareness with Ghanaian celebrities, Theobald and others were able to raise viral hepatitis awareness, and provide free screening and HBV vaccination during their World Hepatitis Day event this year. Read his account below and check out Theobald and the work he and his foundation are doing at the www.theobaldhepb.org or find THBF on Facebook. 

Viral hepatitis is the leading cause of liver cancer, which is the second most common cause of cancer deaths in Africa. On World Hepatitis Day, we urged the government to take actions ASAP to improve hepatitis awareness, monitoring, prevention and treatment.
 ASAP is a blue print framework for Global action, developed by the WHO to guide national government on the effective ways to prevent and control the transmission of viral hepatitis. This framework has four axes:

1.  Awareness raising, partnership promotion and resource mobilization,
2.  Scientific evidence that drives policies and actions,
3.  Access to immunization and information to prevent transmission,
4.  Provision of screening, care and treatment.

Thousands of Ghanaians live with viral hepatitis. About a third of Ghanaians living with viral hepatitis are unaware of their status and are not receiving care and treatment for the condition. It is estimated that hepatitis B kills over 1 million people each year, and an estimated 1 in 12 persons are currently infected and have to face life with chronic liver disease.

Ghana belongs to one of the areas where the prevalence of chronic HBV infection is high (≥8%), and that of hepatitis C is from 5-10%. There is high prevalence in approximately 30% among blood donors.
 In the year ending 2010, the incidence of viral hepatitis in Ghana was 43/100,000 population, with 102 deaths, which represents a 30% increase as compared to the year 2006 incidence of 30/100,000 population. (Source: www.theobaldhepb.org)

Ghana is rated a high-risk country for hepatitis B & C with between 10 and 15 percent prevalence rate. Out of every 100 Ghanaians, 13 may test positive for hepatitis B, which is far more prevalent than HIV/AIDS.

On the 20th July 2014, Celebrities in Ghana united to raise funds to support free Hepatitis B screening and vaccination. The program was under the theme “Celebrities Car Wash”.  Celebrities including Okyeame Kwame, Ghana Rap Doctor, former national black stars captain Stephen Appiah, Ghanaian actor Van Vicker and others volunteered to wash public cars for a fee to raise funds to support the programme.

The staff of Theobald Hepatitis B Foundation, Okyeame Kwame Foundation and other medical officials joined the celebrities for the car washing fundraising event. Members of the public took advantage of the celebrities’ car wash to bring their cars to be washed by their favorite’s celebrities. Celebrities expressed their interest in becoming viral hepatitis ambassadors in Ghana.

The event showed that you don’t need a big bank account to be able to make a difference, but with a bit of vision, one can create awareness.

On that day, we are calling on the government to develop and implement coordinated national action plans to fight viral hepatitis. The Theobald Hepatitis B Foundation in collaboration with the Hepatitis Coalition of Ghana, Okyeame Kwame Foundation together with MDS Lancet Laboratories, Roche and Ridge Hospital RPD on Saturday 26th July, 2014, offered free hepatitis B screening and vaccination to hundreds of people at James Town – Mantse Abgona in Accra. Out of 359 people screened, 49 people tested positive and they received counseling on what to do and what not to do, in terms of treatments and other biochemical tests they needed to undergo.

The Rapper observed that the youth turned out for the screening this year and expressed appreciation for the turnout. “I am really glad to see most of the young people come for the screening. This is to say that the youth is giving attention to health and this also indicates that we are moving in the right direction as a people,” says Okyeame Kwame.

The president of the Theobald Hepatitis B Foundation, Mr. Theobald Owusu Ansah delivered his speech for the occasion on the theme: “HEPATITIS: THINK AGAIN”, calling on the government to give much attention to Hepatitis B.

Thank you to all World Hepatitis Day supporters, sponsors and the media who volunteered their time, supplies, and/or funds to support this year’s events, and raising the profile of viral hepatitis in Ghana.

 

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The Public Health Popularity Contest: Why You’ve Never Heard of Hepatitis B

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charlotte_lee_hep_b-1Please welcome guest blogger Charlotte Lee, a pre-med Duke University Senior who has a passion for global health. Charlotte recently learned first hand how viral hepatitis  disproportionately impacts her community and how it tragically touched her own family.  

I walked into the first day of my internship ready to take on what I thought were the major public health crises of the world – malaria, AIDS, avian flu. Instead, my supervisor gave me a hefty stack of literature on hepatitis B. Sure, as a premed student I knew that hepatitis had something to do with the liver, but I was shocked to find out that hepatitis B was the most common serious liver infection in the world—one that chronically affects over 350 million people worldwide, including 1 in 12 Asian Americans—and I had never heard of it.

As a 21-year old Asian American who is passionate about global health, I felt cheated to only now discover that there is an infectious disease disproportionately affecting my community. Somebody should have told me about this! To then find out that it was completely vaccine-preventable – somebody should have told everyone about this!

About halfway through my internship, I found out that my grandfather died from viral hepatitis that he contracted through a blood transfusion. Suddenly the disease had a face, and it was a smiling man with wide rimmed glasses who used to sit me on his lap and feed me popcorn. It now feels like my duty to spread the word.

Hepatitis B is transmitted through blood or body fluids and causes deadly liver disease, including liver cancer, in 1 out of every 4 chronically infected people. Meanwhile, the famous West Nile Virus causes serious illness in less than 1% of infected people.

So, what makes this disease so easy to ignore? Hepatitis B is unfortunately an invisible disease; it can take up to 20-30 years before symptoms appear, at which time cirrhosis or liver cancer may have already developed. Hepatitis B is a silent killer and it affects a population invisible to the media and policy.  Anyone can get hepatitis B; however, people born in countries outside the US that have not instituted a strong hepatitis B testing and vaccine program have a large population (2 out of 3 people) who are unaware they are infected. Most get the disease at birth from their mothers who are chronically infected with hepatitis B. Many are impoverished and disenfranchised. Asian Americans make up more than half of hepatitis B cases in the US, but those from many other countries around the world are also at risk for having the disease.

However, the “it won’t happen to me, so I don’t care” rule doesn’t work for all diseases. Most people in the US don’t consider themselves at risk for AIDS, malaria, or tuberculosis, yet those diseases have plenty of name recognition.

One thing that AIDS, malaria, and tuberculosis all have in common is their deadliness. AIDS killed 1.47 million people in 2010. But did you know that viral hepatitis (hepatitis B & C combined) killed 1.44 million that same year?

Its symptomless nature also makes it hard to visualize. While other diseases invoke graphic images of illness, hepatitis devastates the liver. Most people probably don’t really know where their liver is located.

What frustrates me most is that it is a preventable disease, one that we can eradicate. The hepatitis B vaccine is one of the safest and most effective immunizations available, and it protects you for life. The CDC recommends all babies receive the vaccination at birth, yet many major hospitals in NYC are not immunizing newborns, with some vaccination rates as low as 20%.

Hepatitis B needs public health champions to get it into the spotlight. Policies need to be passed to fund much-needed education, surveillance, and treatment programs. Doctors should be educated about it, tests should be automatically ordered, and the government should pay for everyone to be vaccinated. This system doesn’t yet exist, but thankfully there are people working tirelessly towards it.

Monday was World Hepatitis Day 2014. This year, the Viral Hepatitis Testing Act was introduced in the House and Senate to provide $80 million over three years for prevention, testing, and linkage to care. This is the second term this bill has been introduced, and now it’s time to pass it. Locally, the New York City Council just introduced a $750K viral hepatitis initiative for 2015. And just last week, Councilwoman Margaret Chin was on NBC talking about the first ever NYC Hepatitis B Awareness Week. My internship will soon end, but advocacy never rests. There is always more to be done.

charlotte_leeCharlotte Lee is a premed Duke University senior, where she studies Public Policy with minors in Global Health and Chemistry. This summer, she has been working on hepatitis B policy issues at the Charles B. Wang Community Health Center in New York City, where she was co-coordinator of the first-ever NYC Hepatitis B Awareness Week. She is passionate about health disparities and aspires to be an OB/GYN and women’s health advocate. Her biggest claim to fame is that she may have discovered a new species of sand fly last summer in the Peruvian Amazon (confirmation still pending). 

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Nucleoside Analogues’ Benefits in HBV Vary

UnknownThis informative article from Internal Medicine News, July 1, 2014, analyzes two studies from the July issue of Gastroenterology, and looks at the impact of antivirals on the incidence of liver cancer, the need for liver transplantation and the risk of death in chronic HBV patients.  The potency of the antiviral made a significant difference and supported current practice guidelines recommending the use of entecavir and tenofovir as first line drugs for the treatment of chronic HBV. Be sure to also read the accompanying editorial by Dr. George Papatheodoridis. 

Internal Medicine News Digital Network, July 1, 2014, article written by DENISE NAPOLI.

Nucleoside analogues are effective at preventing hepatocellular carcinoma in hepatitis B, but all are not equal when it comes to overall mortality and liver transplant, according to two new studies in the July issue of Gastroenterology.

In the first study, Dr. Chun-Ying Wu of the National Yang-Ming University, in Taipei, Taiwan, and his colleagues examined the long-term protective effects of nucleoside analogue therapy among chronic hepatitis B patients (doi.org/10.1053/j.gastro.2014.03.048).

They conducted a retrospective nationwide cohort study using data from Taiwan’s National Health Insurance Research Database, collecting records from 1997 through 2010 on patients with chronic hepatitis B.

Click here to read Internal Medicine News article and editorial in its entirety. 

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U.S. Residents Only: Reporting Discriminatory Behavior Due to Chronic HBV Infection

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Unknown-1An important message from the U.S. Department of Justice (DOJ) which pertains only to U.S. Residents:

If you or someone you know is dismissed or barred from a program due to chronic hepatitis B infection, report the incident to the Department of Justice, whether the complaint is against a State or local agency, a school or any private entity that serves the public.

As a friend, advocate or colleague, you have the right to file a complaint to report discriminatory behavior.  Fill in and submit the Americans with Disabilities Act (ADA) Complaint Form (www.ada.gov/t2cmpfrm.htm).

Kindly return the form to the following address:
U.S. Department of Justice
Civil Rights Division
950 Pennsylvania Avenue, NW
Disability Rights – NYAV
Washington, D.C. 20530

Or you may print and send the report via fax to the following number: (202) 307-1197.

Please note: you must be a U.S. resident in order to file a complaint with the U.S. Department of Justice

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Re-energized in Our Mission … A Message from Joan Block of HBF

Historic ruling now officially recognizes HBV infection as a protected disability under the Americans with Disabilities Act.

What a difference two years make. In 2011 the Hepatitis B Foundation celebrated its 20th anniversary and we were ready to rest awhile on our laurels after working so hard. But instead, we rallied for new challenges and now we have a lot to celebrate in 2013! Continue reading "Re-energized in Our Mission … A Message from Joan Block of HBF" →

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Big Thank You to 2 Hep B Heroes

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HBF would like to thank Hep B Heroes Nina and Richie Kahn. Richie recently ran the Delaware Marathon, and he and Nina used this opportunity to raise money for the Hepatitis B Foundation. Nina and Richie, thank you for your generous donation and your commitment to those living with hepatitis B!

“Back in 2008, I suffered a pretty horrific knee injury running the Philadelphia Half-Marathon. Several years, surgical procedures, and rehabilitation sessions later, I’m running again. So, I figured why not put my stamina to the test by running my first marathon while raising money for a wonderful cause?

On May 12th, I ran the Delaware Marathon to raise money for the Hepatitis B Foundation (HBF). For those of you who haven’t had the pleasure of working with HBF, the foundation is the only national non-profit organization solely dedicated to the global problem of hepatitis B. They are dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide. This commitment includes funding focused research, promoting disease awareness, supporting immunization and treatment initiatives, and serving as the primary source of information for patients and their families, the medical and scientific community, and the general public.

I finished the race in 3:59:23, 218th overall. More importantly, thanks to the generous support of friends, co-workers, and colleagues, we were able to raise nearly $3,000 for the Hepatitis B Foundation. Be sure to check out the Hepatitis B Foundation’s website to learn about the excellent work they do at http://hepb.org/.”

 

 

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HBF and HBUP’s Hepatitis B Awareness Raising Event at the Philadelphia Art Museum

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What a great hepatitis B awareness raising event for the Hepatitis B Foundation (HBF) and Hep B United Philadelphia (HBUP). The event took place at on the “Rocky Steps” of the Philadelphia Art Museum.  Participants including student volunteers, community leaders and health care professionals were dressed in their super hero t-shirts and red capes for their run up the steps to raise HBV awareness.

 

 

 

 

 

 

 

 

 

 

 

Hep B Heroes joined Philadelphia Councilman David Oh as he presented a city council resolution to eliminate Hepatitis B in the City of Philadelphia.

 

A special guest appearance was made by HBF’s own mascot, O’Liver B Hepatitis. In the past, O’Liver has appeared at numerous public events, and he was thrilled to step up and raise HBV awareness on the Rocky Steps.

 

 

 

 

 

Multicultural dancers get a thumbs up from O’Liver as he and other participants enjoy their performance on the steps.

 

 

 

 

 

 

 

B A Hero. B sure. Get Tested. Get vaccinated…

 

 

 

 

 

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Hepatitis B Awareness Month at HBF

Daniel Chen - "Hep B Hero", HBF Public Health Program Manager, today's guest blogger

“B a hero!” is not simply a slightly-cheesy-yet-very-awesome campaign theme and slogan. It is a statement that we stand behind and strive for. It is about having the courage to stand up for the disenfranchised among us. It is about taking the time and effort to improve the lives of those we could have easily ignored. It is about not just doing the right thing, but going above and beyond.

Over 900 people. That’s the number of people we provided free hepatitis B screening tests for within just the past 12 months. The screening tests were offered at 17 different events that took place all around the city.

Over 70 organizations. That’s the number of partners we currently work with to serve the community and empower the underserved. Besides hosting screening events, our partners also help us raise awareness through education, provide in-language patient follow up service for linkage to care, connect us with new partners, and many more aspects of our work in the community.

Over 30 vaccine clinics. That’s the number of vaccine clinics we will have held in collaboration with the Philadelphia Department of Public Health at community sites by the end of 2013. By hosting the clinics at community sites, we remove the transportation and language barriers and make vaccines much more accessible for community members.

The list of accomplishments goes on. And all of this became possible because Philadelphia, as a city, has decided to “B a hero”. So get involved this May and help us celebrate the Hepatitis Awareness Month by coming out to one of our events. Come and support heroes everywhere in our fight against hepatitis B.

Friday, May 17

Hepatitis B Awareness & Media Event

11:30am-12:15pm @ Rocky Steps (Philadelphia Museum of Art, 2600 Benjamin Franklin Pkwy)

Join us in celebration of Hepatitis Awareness Month and Asian Pacific American Heritage Month by running up the Rocky Steps with us! All participants get a “B a hero” t-shirt and a cape. City Councilman David Oh will present a city council resolution, and a surprise performance will take place when we reach the middle level of the steps.

Saturday, June 1

Independence Dragon Boat Regatta

8am-5pm @ Schuylkill River (Kelly Drive, near St. John’s Boathouse)

Come cheer for team Philadelphia Hep B Heroes as well paddle our way to victory! The regatta is a family event with lots of entertainment such as cultural performances, rock climbing, and of course the exciting dragon boat races. So visit the Hepatitis B Foundation/Team Philadelphia Hep B Heroes tent for some snacks and cheer for our heroes.

Additional event:

Saturday, May 11

Hepatitis B Screening & Mini Health Fair

10am-1pm @ AmeriCare Pharmacy (600 Washington Avenue, Unit 18E, Philadelphia)

May Hepatitis Awareness Month would be incomplete without a screening event. In collaboration with the Jefferson Medical College APAMSA medical students and the AmeriCare Pharmacy, we will be providing free hepatitis B screening tests for those who were born in Asia or whose parents were born in Asia. Additional service such as blood pressure and blood glucose measurements will also be available at this event.

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Hep B Discrimination – Part Deux

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Francis Deng is a medical student at Washington University School of Medicine in St. Louis. He is a graduate of Harvard University, Bachelor of Arts (AB), magna cum laude, Human Development and Regenerative Biology. Mr. Deng was an instrumental leader of Team HBV – President at Harvard, and the co-chair of the National Advisory Board, Team HBV Collegiate.

I wrote previously about discrimination against health care workers and trainees who have chronic hepatitis B on KevinMD.com.  Since that time, major advances have happened. News surfaced that since 2011, the US Department of Justice (DOJ) has investigated 4 cases of Asian/Pacific Islander students who were infected and were not allowed to enroll in specific medical or dental schools, both private and public, that they were initially accepted to. Another case is still pending investigations from the Department of Health and Human Services Civil Rights Division.

In March 2013, the DOJ released a settlement noting that chronic hepatitis B infection is considered a disability, so discrimination, under specific circumstances, is prohibited under the Americans with Disabilities Act (ADA). This was groundbreaking in being the first ADA settlement ever reached on behalf of hepatitis B carriers. If you or someone you know has experienced HBV-related discrimination in the community, school, or the workplace, you are encouraged to file ADA complaints to the DOJ.

You might be thinking, I’ve never heard of such a thing, there must be so few cases where denial of admission or other discrimination has occurred based on hepatitis B status; or I know my school has students with hep B, so this really isn’t an important issue.

Here’s why the issue is important. Discrimination issues are only ever important to minority groups; I don’t mean racial minorities, I mean people who are not the majority in some way. It happens to people who don’t have a political voice or were not involved with policy making and are helpless in the face of institutional policies. When there are not explicit and systematic policies to protect such individuals, they are at the mercy of individuals who make judgments on behalf of the institution. In this situation, school administrators may be reasonable, allow students with hep B to matriculate, ensure proper precautions are made with respect to patient care, and give non-coercive guidance to students regarding career decisions. I know several schools where this is the case. Or they may be unreasonable and ignorant (willfully or unwillfully) of the CDC recommendations regarding HBV-infected health care workers. They may bar such infected students to matriculate, bar them from clinical activities even when it’s reasonably safe (i.e. they are not highly viremic or it’s a minimally invasive activity), or coerce them into going into specialties that do not involve direct patient care. Their lives are derailed and redirected needlessly.

Here’s who should care.

Pre-health students, especially 1st and 1.5 generation API Americans: If you were born outside of the US or your parents were born outside the US, particularly in a highly endemic region such as Asia, Africa, or Eastern Europe, you should know that you are at greater risk for having chronic hepatitis B infection. You may have been vaccinated as a requirement of entering school, and you may feel in excellent health, but you probably will have never been screened for hepatitis B infection or antibodies until you enter a healthcare environment. In these cases investigated by the DOJ, 3 out of 4 students were previously vaccinated but did not discover their infection until entering medical/dental training. This is because maternal screening and newborn vaccination policies have not been universally applied until recently, and screening children is not standard. There are always holes in the health care system where people fall through, whether in the US or (especially) abroad. Further, HBV immunization at birth, while effective, is not guaranteed to protect against infection. Get tested.

Health students: If you know of someone who has been denied enrollment based on HBV infection or experienced other types of discrimination in any kind of arena (childcare, employment, etc.), get in contact with hep B advocates. They can connect you to private or pro bono attorneys that will help you file a complaint with the DOJ. This can be confidential (name not public) and doesn’t even have to be filed by the individual. Nadine Shiroma, a community civil rights advocate, gave me most of the information I used to write this blog post. Joan Block, co-founder and executive director of the Hepatitis B Foundation, is another key resource.

School administrators: Protect your institution by implementing clear policies regarding HBV that are compliant with the ADA, and consistent with CDC recommendations for that matter. Help prospective students by making these policies public.

Student leaders: If you’re in APAMSA, serve on school policy committees, you can push your schools to make public and make clear their policies regarding hepatitis B infected students and staff involved in health care.

Baruch S. Blumberg Institute