Management of liver disease in Nigeria.

Nigeria is the most populous country in Africa but, despite extensive oil deposits, little of the country's recently found wealth has filtered through into the healthcare sector. Nigerian hospitals are poorly equipped and infrastructure for interventional procedures is mostly lacking. Liver disease is common, owing to the high prevalence of hepatitis B and hepatitis C, which often coexist with HIV infection. Antiviral treatments are expensive and drugs are commonly unavailable, even if they can be afforded. Therapy for end-stage liver disease is difficult, since endoscopic services are not widespread. A new training programme for oesophageal variceal band ligation at Jos University Teaching Hospital, Central Nigeria, aided by educational bursaries from the Royal College of Physicians, however, provides some promise in improving healthcare standards. The work of agencies, such as the Tropical Health and Educational Trust has fostered direct one-to-one links between UK hospitals and healthcare workers in a variety of African countries and offers a model for future development, albeit on a local, rather than a national or international, basis.