Around 10 million (1 crore) people in Bangladesh are living with hepatitis B and hepatitis C. Bangladesh is among the 10 countries with the highest number of hepatitis-related deaths worldwide.
The country remains far behind in achieving the goal of eliminating hepatitis by 2030. Participants at a roundtable discussion said that achieving this target will require broad social participation.
These observations emerged at a roundtable discussion titled “Hepatitis: Social Participation is essential for prevention and control”, held yesterday, Tuesday, at the Prothom Alo office in Karwan Bazar, Dhaka.
The Hepatology Society of Dhaka, Bangladesh, and Prothom Alo jointly organised the event ahead of World Hepatitis Day, observed on 28 July.
Speaking as the chief guest, Professor Foara Tasmim, additional director general (Planning and Development) at the Directorate General of Health Services (DGHS), said, "We cannot solve the hepatitis problem through treatment alone. We must ensure that people do not contract the disease in the first place. We need to raise public awareness, encourage people to protect themselves from infection, and ensure treatment for those who become infected."
She added that the DGHS has prioritised hepatitis prevention and is discussing expanding vaccine coverage and ensuring an adequate vaccine supply with Gavi.
At the beginning of the discussion, Mohammad Saiful Islam, associate professor in the Department of Liver Diseases at Bangladesh Medical University and Scientific Secretary of the Hepatology Society, cited findings from a study showing that 8.5 million (85 lakh) people in Bangladesh are infected with the hepatitis B virus.
Of them, 5.7 million (57 lakh) are men and 2.8 million (28 lakh) are women. Among women of reproductive age between 18 and 45 years, around 1.8 million (18 lakh) are living with the infection, while approximately 400,000 children are affected.
Nearly 1.5 million (15 lakh) families in Bangladesh have at least one member infected with the hepatitis B virus.
Mohammad Saiful Islam said that around 2.5 million (25 lakh) job seekers and working-age people aged 15 to 30 years are infected with hepatitis B.
He noted that many employers automatically declare hepatitis B-positive candidates ineligible for employment, adding, "This is not a scientifically justified practice."
The event also highlighted that several types of hepatitis viruses exist, including hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E, each causing different forms of the disease. Hepatitis C is a leading cause of liver cirrhosis and liver cancer.
Ten countries account for 69 per cent of hepatitis C-related deaths worldwide, including China, India, Bangladesh, Indonesia, Nigeria, Ethiopia, Ghana, the Philippines, South Africa, and Vietnam.
Mohammad Kamrul Anam, physician at the National Institute of Gastroenterology and Liver Diseases and Hospital and International Affairs Secretary of the Hepatology Society, emphasised the importance of screening and vaccination to prevent hepatitis transmission.
He said that all adults living in areas with a high prevalence of hepatitis B should undergo hepatitis testing at least once in their lifetime.
He added that people with liver disease, individuals with weakened immune systems, people who use or previously used injectable drugs, prisoners, patients undergoing dialysis, blood or organ donors, healthcare workers, and pregnant women should all undergo hepatitis screening. He then explained the methods used for hepatitis screening and diagnosis.
Tanvir Ahmad, assistant professor at Bangladesh Medical University and Media and Publications Secretary of the Hepatology Society, said that hepatitis is preventable, detectable, treatable and, in many cases, can be eliminated.
He said that the Hepatology Society organises education and training programmes, workshops, scientific seminars, and conferences for physicians.
He also said that the organisation plans to expand nationwide awareness campaigns, conduct targeted screening among high-risk populations, introduce awareness programmes in educational institutions, and strengthen international collaboration.
SAM Nazmul Hasan, associate professor in the Department of Liver Diseases at Bangladesh Medical University and Organising Secretary of the Hepatology Society, said the media has five key responsibilities: presenting science-based information; promoting preventive behaviour; encouraging people to undergo screening; highlighting fear, stigma and social discrimination; and playing a constructive role in shaping public health policy.
Professor Abdullah Al Mahmud, head of the Department of Liver Diseases at Chattogram Medical College and Founding President of the Liver Care Society, said Bangladesh has been administering the hepatitis vaccine through the Expanded Programme on Immunisation (EPI) since 2003.
He said everyone born before 2003 should undergo hepatitis screening. He added that surveys have found hepatitis infection rates ranging from 1 to 5 per cent among various occupational groups in Chattogram, including students, salon workers and hospital technicians.
Professor Ruknuzzaman, chairman of the Department of Pediatric Gastroenterology at Bangladesh Medical University, said hepatitis A and hepatitis E spread primarily through contaminated food.
He noted that street food is one of the major sources of these infections. He added that the hepatitis vaccine effectively protects people against liver cancer and therefore may also be regarded as a cancer-preventing vaccine.
Professor Firoza Begum, president of the Obstetrical and Gynaecological Society of Bangladesh (OGSB), said hepatitis B and hepatitis C are among the leading causes of chronic diseases such as liver cirrhosis and liver cancer.
She explained that these viruses spread from mother to child as well as from one infected person to another. Transmission from mother to newborn usually occurs during childbirth. She said newborns should receive the hepatitis vaccine within 12 hours of birth to prevent infection.
Speaking about the history and significance of World Hepatitis Day, Professor Mohammad Golam Azam, general secretary of the Hepatology Society and Head of the Department of Liver and Gastroenterology at BIRDEM General Hospital, said fatty liver disease can lead to hepatitis. He added that alcohol consumption and certain tuberculosis medications may also cause hepatitis.
In his closing remarks, Professor Mohammad Shahinul Alam, chairman of the Department of Hepatology at Bangladesh Medical University and president of the Hepatology Society, said, "The greatest obstacle to preventing or eliminating hepatitis is ignorance and a lack of awareness. Ninety per cent of infected people do not even know that they carry the virus. Around 8.5 million (85 lakh) people in Bangladesh are infected with hepatitis B, while another 1.5 million (15 lakh) are living with hepatitis C. However, treatment is available, and effective medicines exist."
He added, "Preventing and controlling hepatitis requires social participation. Social participation means the involvement of all stakeholders, including physicians, the government, the state, the media, professional organisations and researchers."
Firoz Choudhury, assistant editor of Prothom Alo, moderated the roundtable discussion.