La meilleure protection est le vaccin.
Problème majeur de santé publique, l’hépatite B touche 8 % de la population de l’Afrique subsaharienne. Diagnostic difficile, traitement coûteux, plusieurs raisons expliquent la situation.
L’hépatite B, qu’est-ce que c’est ?
L’infection est causée par le virus de l’hépatite B (VHB). Transmis au contact du sang, notamment à la naissance, ou d’autres fluides corporels (salive, sperme, sécrétions vaginales), le virus s’attaque aux cellules du foie où il se multiplie. Une faible proportion de personnes atteintes d’hépatite aiguë développent une insuffisance hépatique aiguë parfois mortelle. Si elle devient chronique, la maladie peut également causer le décès par cirrhose ou par cancer hépatique.
Pourquoi son diagnostic n’est-il pas évident ?
L’infection passe souvent inaperçue ou s’apparente à une grippe (perte d’appétit, nausées, fièvre). Un tiers des malades présente une inflammation aiguë du foie visible sous la forme d’une jaunisse ou d’urines foncées. Des tests sanguins confirment l’infection et différencient les infections aiguës des infections chroniques, mais leur mise en œuvre reste limitée dans les pays disposant de faibles ressources. Aussi, beaucoup de malades ne sont diagnostiqués qu’à un stade avancé.
L’hépatite B cause 650 000 décès annuels dans le monde.
Où sévit la maladie en Afrique ?
Selon l’OMS, l’hépatite B est responsable dans le monde d’infections chroniques chez 240 millions de personnes et cause 650 000 décès annuels. L’Afrique subsaharienne est l’une des régions du globe où l’hépatite B prévaut le plus, avec une proportion de la population adulte chroniquement infectée comprise entre 5 et 10%. Environ 2 à 5% de la population serait également infectée de manière chronique au Moyen-Orient et sur le sous-continent indien.
Pour quelles raisons l’hépatite B est-elle difficile à soigner ?
L’hépatite aiguë n’est pas curable et le malade doit compter sur son système immunitaire pour éliminer le virus, généralement au bout d’un an. Le foie retrouve alors un état normal et la personne est protégée à vie contre la maladie.
La forme chronique peut être guérie par des médicaments (Adefovir, Entecavir, etc.) parfois coûteux mais certains comprimés génériques reviennent à 5 dollars par mois. Le traitement ne rétablit toutefois que rarement de l’infection et s’avère souvent prescrit à vie.
Comment se prémunit-on du virus ?
La meilleure protection est le vaccin qui confère après trois injections une protection sur dix ans et plus. Alors que moins de 50% des nouveaux-nés en bénéficient, l’OMS recommande de lancer la vaccination de tous les enfants dès la naissance. Selon l’organisation, depuis les années 1980, le taux d’infection chronique chez les enfants a chuté dans de nombreux
pays de 15 % à moins de 1%.
La rédaction
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