Interventions for Acute Hepatitis B

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Education and awareness creation on Hepatitis B including transmission and prevention measures Education on safe sex practices among the mothers Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms) Condom distribution Mass awareness campaigns such as World Hepatitis Day and World immunization Week Maternal counseling Promote ANC attendance Distribution of IEC materials on Hepatitis B Community health workers training on Hepatitis B,including prevention measures	Hepatitis B vaccination Routine Maternal screening for Hep B.Encourage health-facility deliveries Follow up for infants born at home and link the mothers to the health facilities for vaccination	Recognition of symptoms and signs Testing with RDT	Provision of high caloric diet Adequate of fluids Restricted physical activity Exclusive Breastfeeding for the newborn Referral to a health facility
Primary Care
Education and awareness creation to mothers on Hepatitis B including transmission and prevention measures Provide education to mothers during antenatal care and enhance links with communities. Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms) Awareness among mothers on the importance on immunization Promote ANC attendance Maternal counseling condom distribution Distribution of IEC materials on Hepatitis B Health workers training on Hepatitis B, including prevention measures	Hepatitis B Vaccination for the pregnant women Prevent mother to child transmission of Hepatitis B through; anti-retroviral prophylaxis Integration of hepatitis B testing and treatment of eligible pregnant women with the prevention of mother-to-child transmission of HIV and congenital syphilis with antenatal care service. ‘Triple elimination approach Routine Screening for Hepatitis B for the pregnant women Hepatitis B vaccination for the newborn within 24 hours of birth Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes	• History • Physical examination • Viral hepatitis B serology • Point of care Viral load testing • Complete blood count • Liver function tests	Supportive management Provision of healthy diet Optimum fluid intake Enough sleep and rest Relieve pain with analgesics Exclusive Breastfeeding for the New-born Monitor any complications Referral to the next level
Referral Facility: General
Education and awareness creation to mothers on Hepatitis B including transmission and prevention measures Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms) Awareness among mothers on the importance on immunization Promote ANC attendance Health workers training on Hepatitis B, including prevention measures	Hepatitis B Vaccination for the pregnant women Routine Screening for Hepatitis B for the pregnant women Prevent mother to child transmission of Hepatitis B through; anti-retroviral prophylaxis Integration of hepatitis B testing and treatment of eligible pregnant women with the prevention of mother-to-child transmission of HIV and congenital syphilis with antenatal care service. ‘Triple elimination’ approach Hepatitis B vaccination for the newborn-preferably within 24 hours ( as it also help prevent mother to child transmission of Hepatitis B.) Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the mothers Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes.	• History • Physical examination • PCR (quantitative and qualitative) with genotype • Complete blood count • Liver function tests • Coagulation factors, including PTT, PT, and INR • Serum iron, ferritin and TIBC test • Alpha 1 antitrypsin test • Ultrasonography • Transient elastography (TE) • Upper GI endoscopy	Supportive management Healthy diet Optimum fluids Enough sleep/rest Relieve of pain with painkillers Admission for severe Acute Hepatitis B Anti-retroviral drugs for severe acute Hepatitis B Monitoring and management of any complications		Maternal counseling on perinatal risks and management options for Hepatitis B
Referral Facility: Specialist
Awareness among mothers on the importance on immunization Promote ANC attendance Education and awareness creation to mothers on Hepatitis B including transmission and prevention measures Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms) Health workers training on Hepatitis B, including prevention measures	Hepatitis B Vaccination for the pregnant women Routine Screening for Hepatitis B for the pregnant women Prevent mother to child transmission of Hepatitis B through; anti-retroviral prophylaxis Integration of hepatitis B testing and treatment of eligible pregnant women with the prevention of mother-to-child transmission of HIV and congenital syphilis with antenatal care service. ‘Triple elimination’ approach Hepatitis B vaccination for the newborn-preferably within 24 hours ( as it also help prevent mother to child transmission of Hepatitis B.) Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the mothers Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes.	• History • Physical examination • Viral hepatitis B and C serology • PCR (quantitative and qualitative) with genotype • Complete blood count • Liver function tests • Coagulation factors, including PTT, PT, and INR • Serum iron, ferritin and TIBC test • Alpha 1 antitrypsin test • Ultrasonography • Transient elastography (TE) • Upper GI endoscopy • Liver biopsy	Supportive management Healthy diet Optimum fluids Enough sleep/rest Analgesics Admission for severe Acute Hepatitis B Anti-retroviral drugs for severe acute Hepatitis B Monitoring and management of any complications		Maternal counseling on perinatal risks and management options for Hepatitis B

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community health workers training on Hepatitis B, including prevention measures among children Health Education to parents/families /communities on Heaptitis B Awareness creation among parents/communities on Hepatitis B including transmission and prevention measures Distribution of IEC materials on Hepatitis B Create awareness on the importance of Hepatitis B vaccination for the children Mass awareness campaigns such as World Hepatitis Day and World immunization Week Promote Child Welfare Clinics CWC attendance	Catch-up immunization for older children who missed immunization as infants / ie hepatitis B vaccine for: Children not vaccinated at birth. Screening for Hepatitis B especially among under 5s at risk i.e those living with someone with Hepatitis B Linkage to health facilities	Recogition of symptoms and signs Testing with RDT	Supportive management Relieve of pain Optimum fluid Healthy diet Promote breastfeeding Referral to the next level health facility
Primary Care
Education and awareness creation among parents/communities on Hepatitis B including transmission and prevention measures Create awareness on the importance of Hepatitis B vaccination for the children Promote CWC attendance Health workers training on Hepatitis B, including prevention measures among children	Hepatitis B Vaccination for those not vaccinated at birth Screening for Hepatitis B for those at risk ; those living with someone who has hepatitis B Safe injection practices, including eliminating unnecessary and unsafe injections,- Avoid re-use of needles and syringes	• History • Physical examination • Viral hepatitis B serology • Point of care Viral load testing • Complete blood count • Liver function tests • Liver ultrasound	Provision of high caloric diet Adequate of fluids Restricted physical activity Avoid hepatotoxic drugs Referral to next level health facility
Referral Facility: General
Education and awareness creation among parents/c on Hepatitis B including transmission and prevention measures Create awareness on the importance of Hepatitis B vaccination for the children Promote CWC attendance Guidance to parents on nutrition for the children Health workers training on Hepatitis B,including prevention measures among children	Hepatitis B Vaccination for under 5 years children not vaccinated at birth Screening for Hepatitis B for under 5s at risk ; those living with someone who has hepatitis B Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the under 5s Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes		Supportive management Healthy diet Plenty of fluids Enough sleep/rest Pain reliefe Admission for severe Acute Hepatitis B Anti-retroviral drugs for severe acute Hepatitis B Monitoring and management of any complications
Referral Facility: Specialist
Create awareness on the importance of Hepatitis B vaccination for the children Education and awareness creation among parents/c on Hepatitis B including transmission and prevention measures Guidance to parents on nutrition for the children Health workers training on Hepatitis B,including prevention measures among children Promote CWC attendance	Hepatitis B Vaccination for under 5 years children not vaccinated at birth Screening for Hepatitis B for under 5s at risk ; those living with someone who has hepatitis B; Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the under 5s Safe injection practices, including eliminating unnecessary and unsafe injections, -Avoid re-use of needles and syringes		Supportive management Healthy diet Optimum fluids Enough sleep/rest Pain relief Admission for severe Acute Hepatitis B Anti-retroviral drugs for severe acute Hepatitis B Monitoring and management of any complications

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Distribution of IEC materials on Heaptitis B Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Community health workers training on Hepatitis B,including prevention measures	Catch-up immunization for older children who missed immunization as infants /The hepatitis B vaccine for:the primary school age not vaccinated at birth Screening the children at high risk –I,e children living with persons infected with Hepatitis B Linkage to health facilities	Recognition os symptoms and signs Testing with RDT	Recognition of features on Hepatitis B infection in primary school age children such as yellowing of the skin and eyes (jaundice), dark urine, tiredness, nausea, vomiting and abdominal pain. Supportive management Relieve of pain with painkillers such as paracetamol Provision of plenty of fluids Provision of Healthy diet to the child Promote breastfeeding Encourage plenty of sleep Encourage Exercises Referral of a child suspected to have Hepatitis B to a health facility
Primary Care
School health education on risk factors for viral hepatitis and preventive measures	Universal precaution Hepatitis B Screening for high risk persons Hepatitis B vaccination Safe blood donation Safe injection practices Eliminate unnecessary injections Avoiding re-use of needles and syringes	• History • Physical examination • Viral hepatitis B serology • Point of care Viral load testing • Complete blood count • Urine test • Liver function tests • Liver ultrasound	Provision of high caloric diet Adequate of fluids Restricted physical activity Avoid hepatotoxic drugs Referral to next level health facility
Referral Facility: General
Education and awareness creation on Hepatitis B including transmission and prevention measures Education on safe sex practices among the primary school age children Distribution of IEC materials on Hepatitis B through schools Health workers training on Hepatitis B,including prevention measures	Hepatitis B Vaccination Screening for Hepatitis B for primary school age children at risk, e.g. those living with someone who has hepatitis B Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes		Physical examination,Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B - Provision of Healthy diet - Plenty of fluids - Encourage Exercises - Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months - Test for Hepatitis A and C - Liver ultrasound - Liver Biopsy
Referral Facility: Specialist
Education and awareness creation on Hepatitis B including transmission and prevention measures Education on safe sex practices among the primary school age children Distribution of IEC materials on Hepatitis B through schools Health workers training on Hepatitis B,including prevention measures	Hepatitis B Vaccination Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes Screening for Hepatitis B for primary school age children at risk, e.g. those living with someone who has hepatitis B; Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion		Physical examination Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B Provision of Healthy diet Plenty of fluids Encourage Exercises- Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months Test for Hepatitis A and C - Liver ultrasound- Liver Biopsy

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Distribution of IEC materials on Heaptitis B condom distribution Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Community health workers training on Hepatitis B,including prevention measures	Hepatitis B vaccination for adolescents not vaccinated at birth Screening the adolescents at high Risk. - Adolescents living with someone who has hepatitis B - Those with a sexually transmitted infection, including HIV - Gay adolescents - Adolescents with multiple sexual partners. - Those who inject illegal drugs or share needles and syringes - Adolescents planning to travel to an area of the world with a high prevalence of Hep B	Recognition of symptoms and signs Testing with RDT	Recognition of features on Hepatitis B infection in adolescents such as yellowing of the skin and eyes (jaundice), dark urine, tiredness, nausea, vomiting and abdominal pain. Supportive management F adolescents with Hepatitis B Relieve of pain with painkillers Provision of Healthy diet to the adolescents. Plenty of fluids. Encourage Exercises. Encourage the adolescent with suspected Hepatitis B to have Enough sleep/rest Referral to a health facility
Primary Care
Health education on risk factors for viral hepatitis and preventive measures	Universal precaution Hepatitis B Screening for high risk persons Hepatitis B vaccination Safe blood donation Safe injection practices Eliminate unnecessary injections	History Physical examination Rapid diagnostic tests Urine tests	Provision of high caloric diet Adequate of fluids Restricted physical activity Avoid hepatotoxic drugs Referral to next level health facility
Referral Facility: General
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Distribution of IEC materials on Heaptitis B condom distribution Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health workers training on Hepatitis B,including prevention measures	Hepatitis B Vaccination Screening for Hepatitis B for adolescents at risk e.g those living with someone who has hepatitis B, those with multiple sexual partners, with STIs Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes		Physical examination,Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B Provision of Healthy diet - Plenty of fluids - Encourage Exercises- Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months - Test for Hepatitis A and C - Liver ultrasound - Liver Biopsy
Referral Facility: Specialist
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Distribution of IEC materials on Heaptitis B condom distribution Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health workers training on Hepatitis B,including prevention measures	Hepatitis B Vaccination Screening for Hepatitis B for adolescents at risk e.g those living with someone who has hepatitis B; those with multiple sexual partners; with STIs; Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Safe injection practices, including eliminating unnecessary and unsafe injections Avoid re-use of needles and syringes		Physical examination Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B Provision of Healthy diet Plenty of fluids Encourage Exercises- Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months Test for Hepatitis A and C - Liver ultrasound- Liver Biopsy

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness creation on Hepatitis B transmission, prevention measures and treatment	Safer sex practices, Barrier protective measures (condoms) Avoiding harmful traditional practices and blood contaminated sharp objects	Recognition symptoms and signs Testing with RDT	Provision of high caloric diet Adequate of fluids Restricted physical activity Referral to next level health facility
Primary Care
Community awareness creation on Hepatitis B transmission, prevention measures and treatment	Universal precaution Hepatitis B Screening for high risk persons Hepatitis B vaccination Safe blood donation Safe injection practices Eliminate unnecessary injections	History Physical examination Rapid diagnostic tests Urine tests	Provision of high caloric diet Adequate fluids Restricted physical activity Avoid hepatotoxic drugs Referral to next level health facility
Referral Facility: General
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms) Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Distribution of IEC materials on Heaptitis B condom distribution Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health workers training on Hepatitis B,including prevention measures	Hepatitis B Screening for adults at high Risk i.e. adults who live with someone who has hepatitis B, Health care workers, those with a sexually transmitted infection, including HIV, Men who have sex with men, Adults who have multiple sexual partners, those who inject illegal drugs or share needles and syringes, Adults with chronic liver disease, Adults with end-stage kidney disease, Adults planning to travel to an area of the world with a high prevalence of Hepatitis B Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Hepatitis B vaccination for those at risk Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes		Physical examination,Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B - Provision of Healthy diet - Plenty of fluids - Encourage Exercises- Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months - Test for Hepatitis A and C - Liver ultrasound - Liver Biopsy
Referral Facility: Specialist
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Distribution of IEC materials on Heaptitis B condom distribution Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health workers training on Hepatitis B,including prevention measures	Hepatitis B Screening for adults at high Risk i.e. adults who live with someone who has hepatitis B; Health care workers; those with a sexually transmitted infection, including HIV; Men who have sex with men; Adults who have multiple sexual partners; those who inject illegal drugs or share needles and syringes; Adults with chronic liver disease; Adults with end-stage kidney disease ; Adults planning to travel to an area of the world with a high prevalence of Hepatitis B Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes Hepatitis B vaccination for those at risk		Physical examination Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B Provision of Healthy diet Plenty of fluids Encourage Exercises- Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months Test for Hepatitis A and C - Liver ultrasound- Liver Biopsy

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness creation on Hepatitis B transmission, prevention measures and treatment	Safer sex practices, Barrier protective measures (condoms) Avoiding harmful traditional paractices	Recognition symptoms and signs Testing with RDT	Provision of high caloric diet Adequate of fluids Restricted physical activity Referral to next level health facility
Primary Care
Awareness creation on Hepatitis B including transmission and prevention measures Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Distribution of IEC materials on Heaptitis B condom distribution Health workers training on Hepatitis B,including prevention measures	Hepatitis B screening and Vaccination for elderly at risk including People who frequently require blood or blood products - Dialysis patients - Recipients of solid organ transplantation - People in prisons - People who inject drugs - Household and sexual contacts of people with chronic HBV infection, - Elderly with multiple sexual partners, Healthcare workers and others who may be exposed to blood and blood products through their work - Travelers who have not completed their HBV series, who should be offered the vaccine before leaving for endemic areas Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes.		Recognition of features on Hepatitis B infection in the elderly such as yellowing of the skin and eyes (jaundice),dark urine, tiredness, nausea, vomiting and abdominal pain Supportive management Provision of Healthy diet to the elderly with hepatitis B-Plenty of fluids- Encourage Exercises Encourage the elderly with suspected Hepatitis B to have Enough sleep/rest Monitoring for any complications/worsening of the symptoms Relieve of pain with painkillers such as paracetamol Referral to a hospital
Referral Facility: General
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Distribution of IEC materials on Heaptitis B condom distribution Health workers training on Hepatitis B,including prevention measures	Hepatitis B Screening for elderly at high Risk i.e. adults who live with someone who has hepatitis B; Health care workers, those with a sexually transmitted infection, including HIV, Men who have sex with men, Adults who have multiple sexual partners, those who inject illegal drugs or share needles and syringes, Adults with chronic liver disease, Adults with end-stage kidney disease, Adults planning to travel to an area of the world with a high prevalence of Hep B Hepatitis B vaccination for elderly at risk Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Safe injection practices, including eliminating unnecessary and unsafe injections Avoid re-use of needles and syringes	History Physical examination Serological markers Liver function tests Basic metabolic pane Virological markers Ultrasound	Physical examination,Clinical examination and diagnosis of Hepatitis B Supportive management for patients with Acute Hepatitis B Provision of Healthy diet - Plenty of fluids - Encourage Exercises- Encourage the patient with Hepatitis B to have Enough sleep/rest Relieve of pain with painkillers Admission for patient with severe Acute Hepatitis B Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications Monitoring and management of any complications including acute Liver failure Follow up Investigations Blood tests to detect Hepatitis B surface antigen (HBsAg) Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months - Test for Hepatitis A and C - Liver ultrasound - Liver Biopsy
Referral Facility: Specialist
Awareness creation on Hepatitis B including transmission and prevention measures Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items Distribution of IEC materials on Heaptitis B condom distribution Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health workers training on Hepatitis B,including prevention measures	Hepatitis B Screening for elderly at high Risk i.e. adults who live with someone who has hepatitis B; Health care workers; those with a sexually transmitted infection, including HIV; Men who have sex with men; Adults who have multiple sexual partners; those who inject illegal drugs or share needles and syringes; Adults with chronic liver disease; Adults with end-stage kidney disease ; Adults planning to travel to an area of the world with a high prevalence of Hep B Hepatitis B vaccination for elderly at risk Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion Safe injection practices, including eliminating unnecessary and unsafe injections Avoid re-use of needles and syringes