5 February 2018

Namibia: Hepatitis E Claims a Third Victim

Photo: New Era
Namibia's Goreangab residents use contaminated water.

HEPATITIS E has claimed its third victim, some two months since the disease outbreak was declared in Windhoek late last year.

This was confirmed to The Namibian last week by Lilliane Kahuika, an epidemiologist with the health ministry. The victim was a woman who died a day after giving birth on 25 January, but her baby survived.

The Namibian reported last month that two pregnant women also died from hepatitis E-related illnesses in December and early January.

This brings the number of deaths attributed to the disease to three since the outbreak late last year.

So far, all those who have died from the disease were post-partum women.

"All the three victims were women, and all of them died shortly after giving birth [...] in the post-partum period. The third one died a day after giving birth," Kahuika said, adding that they were still waiting for the test results of samples from the victim to confirm the details. Hepatitis E is a liver disease caused by ingesting faecal contaminated water and environmental contamination due to poor sanitation.

The number of hepatitis E-related cases has also increased to over 553, with about 314 males and 239 females affected. Five patients are currently admitted at the Katutura Intermediate Hospital and the Windhoek Central Hospital, including one post-partum mother.

According to the latest statistics provided by the health ministry, the disease is highly concentrated in the informal settlements, with Havana being the most-affected area, accounting for about 280 of the total cases, followed by Goreangab with 144 cases recorded. The statistics also indicated that over 2 500 households have been reached and provided with health education and water purification tablets to date.

Some of the findings indicate that about 62% of the community in the affected areas of Havana and Goreangab use open defecation, 89% use communal taps, and 1% use a public source like a river or stream to draw water for consumption.

Cases of hepatitis E-related illnesses have also been confirmed elsewhere in the country. One example was reported in the Oshikoto region, two in Oshana and four cases in the Omusati region. Despite numerous efforts from various interested parties to contain the disease, the health ministry stated that transmission continues due to limited access to safe water and proper sanitation.

Limited resources to scale up the response to cases likewise remains a challenge. Currently, the ministry sends samples to a South African laboratory for genotyping.

The ministry has since received assistance and funding support from various local and international organisations such as the World Health Organisation, the United Nations Children's Fund, the United Nations Population Fund and many others.

The health ministry's spokesperson, Manga Libita, on Friday said the ministry has also established national, regional and district "task force committees" with the support of the Namibia field epidemiology and laboratory training programme to coordinate outbreak response activities, and conduct active searches and referrals to health facilities for treatment.

"An integrated response under a multi-sectoral approach is being implemented ensuring strong coordination, effective surveillance as well as quality case management," she said.

The ministry is also conducting social mobilisation and health education programmes to ensure "increasing access to safe water and adequate sanitation facilities to the population at risk".

The City of Windhoek has since pledged to clean up the informal settlements, and improve sanitation to contain the spread of the disease.

Mary-Anne Kahitu, the city's health inspector, this week said about 116 new toilets would be constructed during the current financial year, and within the next four months.

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