The Silent Killer Among Us: How Hepatitis Is Spreading Unnoticed Across Nigeria
Oluwatobi Adu 
IBADAN, Nigeria – Millions of Nigerians may be living with hepatitis without knowing it. As stigma, poor awareness and weak health systems fuel transmission, experts warn that the country risks a worsening public health crisis unless urgent action is taken. Oluwatobi Adu, writes.
When Mr Sunday was diagnosed with hepatitis B in 2015, the virus was already quietly attacking his liver. The 36-year-old had never heard much about hepatitis, had no obvious symptoms and could not understand how he became infected. What followed was not only a health battle but also a painful experience of stigma, misinformation and isolation—an ordeal that reflects the reality facing millions of Nigerians living with one of the country’s most overlooked public health threats.
“I was diagnosed with hepatitis B in 2015. I was really sick and had to go to a neighbour who was a lab technician at Oke-Ado Hospital in Ibadan. He ran some tests, and that was how I discovered I had hepatitis B,” he recalled.
The diagnosis shocked him.
“When my family found out, I was stigmatized. My eating plates were separated. Some neighbours even gossiped that it was an accumulation of malaria that causes hepatitis and that I had neglected my health for too long. Parents warned their children not to come close to me because they thought I could infect them.”
For years, Mr Sunday struggled to understand how he became infected.
Later, health workers explained that hepatitis B can be transmitted from mother to child during childbirth—a route responsible for many infections across Africa.
“I was educated that it could have been through my mother. I was shocked because I was already 36 years old then,” he said.
His experience highlights a troubling reality: millions of Nigerians may be carrying hepatitis for decades without knowing it.
A Hidden Epidemic in Plain Sight
While malaria, HIV and tuberculosis often dominate public health discussions, hepatitis B and C continue to spread largely unnoticed.
According to the latest World Health Organisation (WHO) Global Hepatitis Report 2026, hepatitis B and C caused approximately 1.34 million deaths globally in 2024, making viral hepatitis one of the world’s deadliest infectious diseases.
The report places Nigeria among the 10 countries accounting for the majority of hepatitis-related deaths globally.
Worldwide, an estimated 287 million people are living with chronic hepatitis infections, while nearly 1.8 million new infections occur every year.
Africa remains at the centre of the crisis.
The WHO estimates that 68 per cent of new hepatitis B infections occur in Africa, yet only about 17 per cent of newborns across the continent receive the crucial hepatitis B birth-dose vaccine within 24 hours of birth.
Public health experts warn that this gap is helping sustain transmission across generations.
In Nigeria, the burden is particularly severe.
Health experts estimate that about 20 million Nigerians are living with hepatitis B, making the country one of the highest-burden nations globally.
Many remain undiagnosed.
Many more do not receive treatment until severe complications such as liver cirrhosis, liver failure or liver cancer emerge.
Born With a Virus
For healthcare workers, one of the most worrying routes of transmission remains mother-to-child infection.
Mrs. Adegbite, a Primary Health Care official, said many newborn infections could be prevented through routine screening and timely vaccination.
“An infected pregnant woman can transmit hepatitis to her child during birth. We recently had to refer a mother to a state hospital for treatment and advised the family to purchase the hepatitis B vaccine for the newborn to help prevent infection.”
She emphasised that testing pregnant women and ensuring newborns receive vaccines immediately after birth could dramatically reduce new infections.
Yet many health facilities still struggle with vaccine availability, awareness and affordability.
The result is a preventable cycle of transmission that continues silently across communities.
The Cost of Silence
For Dr Sunday Adeyemo, a UK-based pathologist and university lecturer, the greatest danger posed by hepatitis is that it often remains invisible for years.
“Honestly, it is very serious. We are talking about roughly 20 million Nigerians living with hepatitis B alone, and most of them do not even know it. That is the scary part,” he said.
“What I keep seeing is patients coming in when things have already gone wrong — liver damage, swollen abdomen, yellowing of the eyes. By that point it has been inside them for maybe 20 years. They never felt sick, so they never tested.”
Unlike many infectious diseases that produce immediate symptoms, hepatitis can silently damage the liver for decades.
By the time symptoms appear, treatment options may be limited.
According to Dr Adeyemo, the disease affects all segments of society.
“And it cuts across everyone. Market traders, teachers, healthcare workers, mothers. Hepatitis does not care about your status or your lifestyle.”
How Nigerians Are Becoming Infected
Experts say hepatitis transmission in Nigeria is driven by a combination of medical, social and cultural factors.
Unsafe blood transfusions, poor infection prevention practices, inadequate screening and unsterilised instruments continue to pose risks.
Dr Adeyemo highlighted the dangers.
“On the medical side, the biggest issue is that for a long time, blood was not properly screened before transfusions. So people received infected blood and had no idea.”
“Some facilities today still struggle with proper infection control — needles, equipment, all of that.”
Beyond hospitals, community practices remain a concern.
“On the community side, think about your regular barber. Is he changing the blade for every customer? Most times, no.”
Experts also cite shared sharp objects, tattooing, traditional scarification procedures and unprotected sex as important transmission routes.
However, they stress that ignorance remains one of the biggest risk factors.
“People also just do not know enough about it. If you do not know hepatitis exists or how it spreads, you cannot protect yourself.”
Stigma: The Barrier Fueling Transmission
Beyond medical challenges, stigma continues to undermine efforts to control hepatitis.
Many people avoid testing because they fear discrimination.
Others conceal their status after diagnosis.
According to Dr Adeyemo, this secrecy can inadvertently increase transmission within families.
“Stigma is doing real damage. I have had patients who tested positive and hid it from their spouse for over a year.”
“When patients cannot disclose, partners are not tested or vaccinated. So transmission continues quietly within households.”
He believes misinformation remains the root cause.
“The root problem is the wrong belief that hepatitis only comes from sleeping around or using drugs.”
“A baby can get it at birth. A patient can get it from a hospital procedure. Stigma is built on ignorance, and it is killing people.”
The stigma surrounding hepatitis often mirrors the discrimination once associated with HIV, discouraging people from seeking care until it is too late.
Treatment Exists—But Access Remains Limited
One of the greatest tragedies of Nigeria’s hepatitis crisis is that many infections are preventable and manageable.
Vaccines can prevent hepatitis B.
Modern medicines can effectively suppress the virus and prevent complications.
Hepatitis C can be cured in more than 95 per cent of cases.
Yet access remains a major challenge.
The WHO estimates that fewer than five per cent of people living with chronic hepatitis B globally are receiving treatment.
In many Nigerian communities, testing remains expensive, treatment costs are prohibitive and specialised care is often unavailable.
Dr Adeyemo warned against reliance on unproven remedies.
“And please — if anyone tells you that a particular herb or agbo drink cures hepatitis, ignore them.”
“I have lost patients who wasted months on those things instead of coming for real treatment.”
A Public Health Emergency Hiding in Plain Sight
Experts say Nigeria cannot achieve its broader health and development goals while hepatitis remains neglected.
Untreated hepatitis contributes significantly to liver cancer, liver failure and premature deaths among working-age adults, creating economic and social burdens for families and communities.
The disease also places additional pressure on an already stretched healthcare system.
For Dr Adeyemo, the path forward is clear.
“First, every pregnant woman in Nigeria must be tested for hepatitis B.”
“Second, the government needs to make hepatitis drugs available and affordable in public hospitals — the way HIV drugs are now accessible.”
“Third, we need honest, clear public campaigns. Hepatitis is a medical condition, not a moral failure.”
He also stressed the importance of better data.
“And finally, we need proper data. We need to know exactly how many people are affected, where, and why. Without that, everything else is guesswork.”
Beyond Awareness
The stories of survivors, healthcare workers and experts reveal a troubling reality.
Hepatitis is no longer a hidden threat because it is rare.
It remains hidden because too many infections go undetected, too many people remain uninformed and too many health systems fail to identify patients before serious complications develop.
Nigeria has the tools to reduce transmission, prevent deaths and move closer to the WHO goal of eliminating viral hepatitis as a public health threat.
But doing so will require stronger political commitment, expanded vaccination, routine testing, affordable treatment and sustained public education.
For millions of Nigerians living unknowingly with hepatitis, time is running out.
The silent epidemic is already here.
About the Author
Otamere Gladness 
Oluwafunbi Bello 