Jakarta, IO – Indonesia is the country with the highest prevalence of hepatitis B, and third-highest prevalence of hepatitis C, in the Southeast Asian Region. According to the 2013 Health Baseline Study, the prevalence of hepatitis B in our country is 7.1%, while that of hepatitis C is 1%. Indonesia is a country with medium-high endemicity of hepatitis B, with the biggest proportion of infection occurring with pregnant mothers transmitting the disease to their fetuses. In 2022, out of a total of 50,744 pregnant women suffering from hepatitis B, 35,757 of their babies were born positive with an infection.
By educating the people concerning the symptoms, means of infection, prevention methods, and early detection, the Government plans to eliminate hepatitis, or having zero cases, by 2030. “There are five types of Hepatitis, i.e. A, B, C, D, E. Hepatitis is an inflammation of the liver, which can develop into fibrosis (scar tissue), which in turn might worsen into cirrhosis or even cancer of the liver. Different types will generate different illnesses. For example, hepatitis A and E are acute, caused by foodstuffs contaminated by virus, while hepatitis B and C are both acute and chronic, and infection occurs through the blood or other bodily fluids,” declared dr. Imran Pambudi, MPHM, the Ministry of Health’s Director of the Prevention and Control of Communicable Diseases in the “Hepatitis-Free Generation: We’re Not Waiting” Sehat Wicara talk show held on Thursday (20/7/2023).
Hepatitis A infection occurs through fecal-oral transmission. This is when the pathogens in a person’s fecal particles somehow get transferred into another person’s mouth. This is directly traceable to bad hygiene practices and insufficient sanitation facilities.
“The best way to prevent fecal-oral transmission is a clean and healthy lifestyle. We need to make sure that the food and drink we consume are clean and satisfy health requirements. The incubation period of hepatitis A is 15-50 days with variable symptoms, including the yellowing of the skin and the eyes sclera, fever, debility, and nausea. Because they feel these symptoms, sufferers usually immediately go to the nearest health facilities to get treated, which prevents the disease from becoming chronic. On the contrary, hepatitis B patients generally feel no symptoms enough to alarm them. They tend to ignore their condition, which in the long term may trigger hepatic cirrhosis and cancer,” dr. Imran said.
Three Infection Methods, Three Vaccination Doses
During the same event, Dr. dr. M. Alamsyah Aziz, Sp.OG, Subsp.KFM, KIC, M.Kes, Head of the Indonesian Society of Obstetricians and Gynecologists (Perkumpulan Obstetri dan Ginekologi Indonesia–POGI) Scientific Division, reported that there are three routes for an infection from a pregnant woman to her baby: “First, transplacental infection. This is when the virus enters the fetus through the placenta. Second, during birth, through an open injury or the blood. Third, during postnatal care, or when the baby drinks their mother’s milk. Therefore, mothers should undergo screening for the disease at the start of their pregnancy,” he said.
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Hepatitis B vaccine for babies must be administered as early as possible, less than 24 hours after the baby was born, to cut off the chain of infection. The next two doses for vaccination are administered when the baby is 1 and 6 months of age.
Meanwhile, in a press briefing commemorating the 14th World Hepatitis Day, themed “Immediately Test and Treat, Hepatitis Does Not Wait” held on Wednesday (26/7/2023), Prof. dr. David Handojo Muljono, Sp.PD, FINASIM, Ph.D, Head of the Ministry of Health’s Hepatitis and ISPA Experts Committee, declared that hepatitis treatment procedure in Indonesia covers a wide spectrum, starting from prevention, to early detection, to treatment. “Pregnant women found positive for hepatitis B are given the drug Tenovofir, for free, starting their third trimester. The pilot project is being performed in six provinces: SCR of Jakarta, West Java, East Java, Bandar Lampung, South Kalimantan, and South Sulawesi. It will be expanded into 11 more provinces. Again, our target is to ensure that our new generation is free from hepatitis B.” (est)