Rwanda: Hepatitis – Rwanda on Course to Reach Last Mile

The first time Alice Mukabalisa, 53, discovered that she had hepatitis was when she went to take a vaccination shot in 2018.

Rwanda Biomedical Centre (RBC) had put out an announcement that there were ongoing screenings for hepatitis C and vaccination for hepatitis B.

“When I heard the announcement I really wanted to know how my status was, so I told myself that I should go there and get screened. Luckily, the screening was taking place in Remera near my home. After my samples were taken, they unfortunately came back positive. I had hepatitis C,” she told The New Times.

Mukabalisa was overwhelmed with emotions as the doctor broke to her the bad news. As it began to sink in, the doctor reassuringly told her that it was not all lost, and that she would be immediately put on treatment.

“I actually had some symptoms, but I never knew they could be something bad, I would feel weak and nauseous sometimes and also my right arm wasn’t working properly, as well as some of my joints. I was transferred to the University Teaching Hospital of Kigali (CHUK), where I was put on medication for three months,” she said.

After three months of being on medications, Mukabalisa started feeling better and her arm started working properly again… the joint pains subsided too and this is when she decided to go for a follow up check-up which returned a negative result.

“I got better but only for about two years when I started experiencing similar symptoms. I went to the hospital for a check-up again I found out that I had hepatitis C! This time I was put on medication for six months. I was devastated and I had no hope of getting cured,” she said.

After completing her six-month treatment, she waited three months before doing a check-up again, she had no hope but when she went back to the hospital, doctors told her that she was completely cured.

Mukabalisa is now one year free from the disease.

What are the main causes of hepatitis?

According to RBC, and World Health Organization (WHO), blood transmission and body fluids are the main leading cause of Viral Hepatitis C and B in Rwanda and globally.

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis, or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances like alcohol, certain drugs, and autoimmune diseases can also cause hepatitis.

According to WHO, hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids, Dr Janvier Serumondo, the Director of Sexually Transmitted Infections and Viral Hepatitis Unit at RBC, said that hepatitis B and C can cause severe diseases but they are still curable.

“There are five types of hepatitis; A, B, C, D, and E. Hepatitis A and E are not very severe and don’t cause any complications, they can also cure with no medication. They normally are caused by ingestion of contaminated food or water,” he said in an interview held on the margins of the event to mark World Hepatitis day last week on July 28.

He however said that hepatitis C and B can cause severe disease to the patient.

According to Serumondo, hepatitis C is transmitted through blood and sexual contact, while B is contracted through several transmissions, either blood contact, sexual contact, body fluids contaminated blood or blood products, invasive medical procedures using contaminated equipment, mother to child transmission at birth, among others.

He said that hepatitis B is transmitted 10 times faster than hepatitis C.

“However, all these types can cure themselves within six months if the patient has a strong immune system. For an adult, hepatitis B can cure itself at a percentage of 90, and other 10 per cent get severely sick, but with hepatitis C, only between 15 and 45 per cent can heal without any medical assistance,” he added.

State of Rwanda

Rwanda has set a target to eliminate hepatitis C by 2024, and so far they have screened 7 million people including children and adults, and treated close to 60,000 people, as part of the national plan to eliminate Viral Hepatitis C (HCV), according to RBC.

And the prevalence of chronic HCV and HBV has since dropped from 4 per cent and more than 3 per cent in 2015 to less than 0.39 per cent and 0.35 per cent respectively in 2022.

The numbers were presented during the national celebration of the World Hepatitis Day on June, 28, which coincided with marking of the last mile made by Rwanda in eliminating the virus.