A seemingly harmless visit to the barber, beauty salon or tattoo centre could expose people to Hepatitis B if equipment contaminated with infected blood is reused without proper sterilisation, the Programme Manager of the National Viral Hepatitis Control Programme, Dr. John Gerald Adiiboka, has warned.
Dr. Adiiboka said the virus, which is transmitted primarily through contact with infected blood and certain body fluids, could be spread through practices involving shared or inadequately sterilised blades, needles and other instruments.
He specifically mentioned barbering, tattooing and circumcision among activities where people could unknowingly be exposed to infected blood. “You can get one person who would use one blade to circumcise or give tribal marks or probably carry out a procedure on different people,” Dr. Adiiboka said.
He explained that tattooing could also pose a risk, particularly where the procedure causes bleeding and the equipment is merely cleaned rather than properly sterilised before being used on another person.
“There are some tattoos where you bleed. If you are bleeding from the accident, you just clean the machine. You don’t sterilise it. And they are going to use it for another person,” he cautioned.
The same concern, he said, applied to barbering shops, where customers could suffer minor cuts during shaving and grooming. According to Dr. Adiiboka, if equipment used on a bleeding customer is not adequately sterilised before being used on another person, infected blood could provide a route for transmission.
He, therefore, advised people to take precautions when patronising barbering services, including ensuring that equipment is properly sterilised or using personal equipment where possible.
“I always advise people you have to modify your own barbering machine or you go to a place where the barber is [properly sterilising the equipment],” he said, disclosing that he personally owns his barbering equipment.
Dr. Adiiboka’s warning comes amid what he described as a significant hidden Hepatitis B burden in Ghana, with an estimated three million people believed to be infected. He said the country had, however, diagnosed only about one percent of the estimated infected population, leaving a vast majority unaware of their status.
Explaining how the estimated number was derived, he said prevalence studies were used alongside Ghana’s population data to arrive at an estimated national burden.
He said Ghana’s Hepatitis B prevalence was estimated at between eight and nine percent, meaning that in a population of 100 people, roughly eight or nine could be infected in a population reflecting that prevalence.
Dr. Adiiboka said the low diagnosis rate posed a major obstacle to Ghana’s efforts to control and eventually eliminate viral hepatitis. “If you say three million Ghanaians are infected, and then you want to equate it to percentagewise, the prevalence in Ghana is between eight to nine percent,” he explained.
He identified lack of awareness and stigma as some of the major barriers preventing people from seeking testing. “There are a lot of people who are walking about, they don’t know. They get it. So they are not aware,” he said.
According to him, some people also associate Hepatitis B with sexually transmitted infections and consequently avoid testing because of the stigma attached to such diseases. He, however, clarified that sexual transmission was not the main mode of transmission of Hepatitis B in Ghana.
Rather, he said, mother-to-child transmission was the dominant route, accounting for about 95% of infections in Ghana. Dr. Adiiboka explained that babies exposed to the virus during childbirth were particularly vulnerable because their immature immune systems were less capable of clearing the infection.
“When a baby is born and is exposed to the virus during childbirth, the child has 95% chance of getting the virus,” he said. Adults, he explained, were more likely to clear the virus following exposure because of their stronger immune systems.
However, blood-to-blood exposure, sexual contact and the sharing of contaminated needles or instruments remain possible routes of infection. He also sought to dispel misconceptions about ordinary social interaction with people living with Hepatitis B.
According to him, hugging, sharing food or utensils and ordinary kissing do not constitute common routes of transmission. He said the concern with kissing would arise where there was blood-to-blood contact, while saliva itself contained only a minimal amount of the virus. Beyond transmission, Dr. Adiiboka raised concerns about the financial burden confronting people who test positive for Hepatitis B.
He said while screening tests could be covered under the National Health Insurance Scheme (NHIS), several advanced investigations required after a positive diagnosis were not covered. Patients may require liver and kidney function tests, viral-load testing, imaging and other investigations before treatment can begin.
He estimated that the initial process from testing positive through the investigations required to start medication could cost between GH¢800 and GH¢1,500, depending on the tests required. The financial burden could continue because some people with chronic Hepatitis B require long-term antiviral medication.
Dr. Adiiboka said some medicines could cost between GH¢150 and GH¢300 a month, with certain brands reaching about GH¢400. He said efforts were underway with non-governmental organisations and other partners to make the medication more affordable, with an option costing about GH¢70 per month currently being worked on.
Unlike Hepatitis C, which can be cured, chronic Hepatitis B is generally managed with long-term medication for patients who require treatment. “If you put [the patient] on the medication, you don’t stop. As long as you are on the medication, you are fine. But once you stop the medication, it means that the virus is likely to come back,” he said.
Dr. Adiiboka warned that failure to diagnose and properly manage chronic Hepatitis B could result in serious complications, including liver cirrhosis, liver failure and liver cancer.
He said liver cancer was a major cause of cancer deaths in Ghana and ranked among the leading cancers affecting men. More worrying, he said, was that serious complications often emerged when people were still in their productive years.
“The average is about 42 years,” he said, referring to the age at which complications such as liver failure, liver cancer and cirrhosis could develop. He warned that when a breadwinner or economically productive person develops severe complications, the consequences extend beyond the individual to families, communities and the national economy. “The negative burden is quite heavy,” he stressed.
Dr. Adiiboka said Ghana would need to dramatically expand testing and treatment to move closer to the World Health Organisation’s 2030 viral hepatitis elimination target.
He said the global target requires countries to diagnose at least 90% of people living with chronic viral hepatitis and ensure that at least 80% of those diagnosed receive appropriate treatment.
Ghana, he acknowledged, remains far from the target, with diagnosis estimated at only about one percent. He said expanding population-wide screening, improving access to affordable medicines and strengthening prevention would therefore be critical.
Dr. Adiiboka also highlighted Ghana’s efforts to prevent mother-to-child transmission through vaccination, including the introduction of Hepatitis B vaccination into the routine childhood immunisation programme and efforts to provide a birth dose within 24 hours of delivery.
For the public, however, his warning extends beyond hospitals and vaccination centres: instruments that cut, pierce or come into contact with blood must be properly sterilised.
A barber’s blade may appear to be just another tool of grooming, but if contaminated with infected blood, Dr. Adiiboka’s warning suggests, it could become a vehicle for a virus that a person may carry for life.
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The post Hepatitis B: Your Barber’s Blade Could Put You At Risk appeared first on The Ghanaian Chronicle.
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