How three deaths set a scientist on a lifelong mission to unravel Hepatitis B

Dr Missiani Ochwoto during the interview in Nairobi. [Benard Orwongo, Standard]

The tragic loss of a woman and her two children to Hepatitis B virus shocked Dr Missiani Ochwoto, ultimately changing the course of his scientific career.

The woman, his neighbour, had been divorced by her husband after she was diagnosed with Hepatitis B, a disease that she contracted while working in northern Kenya. She returned home to her parents with her three children.

For Dr Ochwoto, then a young graduate with only a budding interest in viruses, the tragedy raised more questions.

Being young in his career, he knew HIV as the only infectious virus. But the death of his neighbour from Hepatitis B made him realise there was another virus capable of devastating not only an individual, but sweeping an entire family: Hepatitis B virus.

The woman had developed an enlarged liver and abdomen, a condition clinicians refer to as Hepatosplenomegaly, but it was only at her burial that the family and neighbourhood learned that Hepatitis B had been responsible for her illness.

“I was so much curious to know more about this devastating Hepatitis B virus. So I developed interest in it,” recalls Dr Ochwoto.

What began as curiosity eventually became a career-long goal.

Today, Dr Ochwoto, a senior research scientist at the Kenya Medical Research Institute (KEMRI), has spent years knocking on the doors of affected individuals in villages and towns and spending sleepless nights in laboratories searching for answers to the disease.

He has trained health workers, contributed to national guidelines, and worked directly with communities to prevent infections—particularly among mothers and their babies.

“I developed an interest in Hepatitis because it was highly infectious and it can kill, break families, be highly stigmatised, and also infect young innocent children,” he says.

The memory of that family remains central to his work.

Dr Ochwoto studied medical biotechnology at Maseno University before joining research.

His early work exposed him to malaria and HIV, but it was during his master's studies that Hepatitis B virus became the focus of his scientific career.

He received his first scholarship to work on Hepatitis from Dr Yano Koji, a Japanese scientist whose own interest was in viral hepatitis and HIV co-infection.

But before Dr Ochwoto could fully implement the work they had planned, Dr Koji died of Hepatitis B.

The loss was compounded by what Dr Ochwoto witnessed while collecting blood samples from patients at Kenyatta National Hospital during his master's research.

At least five of the patients whose blood he was collecting for viral Hepatitis analysis died.

“One morning, I was headed to collect blood samples for Hepatitis analysis from infected patients during my masters. I found empty beds, and when I asked the nurses and my phlebotomist, they broke the sad news; the patients died of liver cancer,” he recalls.

The multiple deaths pushed him into further research.

He began asking a fundamental question about why 90 percent of people infected with Hepatitis B clear the virus during acute infection, within six months, without medication or intervention, while others develop chronic disease that can progress to cirrhosis, liver cancer, and death.

This became the foundation of his PhD research.

His research work examined possible explanations, including differences in the viral genome, the host, and environmental factors.

Nevertheless, another profound change was unfolding in his scientific journey. This was ignited by his mother in 2014, during a casual conversation.

Dr Ochwoto had just received news that one of his scientific papers had been published in a high-impact journal. As a young research scientist, He was excited.

His mother, who seemed not to understand the excitement that comes with scientific publication, was less bothered and asked what the published work would earn him. Further, she asked a more difficult question: "How would that publication help people who had not gone to school?" His mother had studied only up to Standard Eight.

She wanted to know whether his scientific work would improve people's health.

The question became a turning point in his scientific career “If my publications were to be of interest, my mum, who studied to Standard Eight, could be excited,” he says. “Research done in laboratories has no meaning if the people most affected by the disease cannot benefit from it” he emphasized

“I knew my projection in science was wrong. “Publishing research without translating its findings into meaningful community impact is a missed opportunity.”

From then on, he began deliberately taking his research beyond the laboratory.

He started working with communities and health workers, determined to translate scientific knowledge into practical interventions.

During his PhD research, which was based on outpatient departments at Moi Teaching and Referral Hospital, he collected blood samples from patients presenting with jaundice.

Here, patients were coming from different communities. However, he observed a pattern that eventually pointed him towards Marigat in Baringo, where he noticed a trend of people with chronic Hepatitis B virus. He inquired and followed the patients to their community.

It was here that the scientist recognized that some of the factors driving transmission and stigma could not be fully understood within hospital or laboratory settings.

“By working with the community, you understand some things that cannot be explained, for example, cultural aspects that fuel transmission,” he says.

“Some of these things, practices, you cannot learn when sitting in a hospital or analysing samples in the laboratory. It is while interacting with the community you will understand stigma, why the transmission is high, why there is low uptake of drugs, and get scientific solutions to infectious diseases.”

Since 2015, Dr Ochwoto has trained several health workers on Hepatitis, bringing together nurses, laboratory officers, clinicians, pharmacists, and counsellors.

So far, the training has been held in Kajiado, Nyanza region, North Rift and Marigat in Baringo, as well as Mombasa, Machakos and Nairobi, where much of the earlier work focused on Hepatitis C.

His biggest concern remains innocent babies.

For Dr Ochwoto, one of the most painful parts of his work has been seeing children infected with Hepatitis B when their infections could potentially have been prevented.

During his PhD work, he encountered four children infected with Hepatitis B, whose parents were also infected.

The sight took him back to the mother and two children whose deaths had first pushed him towards Hepatitis research.

The parents were desperate. There were limited national guidelines on how to manage Hepatitis B in children, leaving clinicians to use their best approach.

“I looked at children infected; they were so innocent of the infection that has no cure,” he recalls.

“As a scientist, I looked at how best to handle this, to prevent infections in children.”

That experience motivated him to help mothers living with hepatitis B prevent transmission of the virus to their children.

He has since assisted pregnant women who were diagnosed with Hepatitis B while attending antenatal clinics in Marigat and Muhoroni in Kisumu to have their babies vaccinated against hepatitis B within 24 hours of birth.

Through the project dubbed "A clean generation", the scientist has also supported mothers and their newborns from his own pocket.

He trained midwives at ANC to document mothers who test positive for Hepatitis B. The mothers receive antiretroviral treatment to help them suppress the virus.

At delivery, he encourages the mothers to deliver at a hospital facility to prevent contact with body fluids that risks infections. He then mobilized transport to ensure the baby receives a hepatitis B birth-dose. In a facility that can offer this vaccine, he makes it available to be administered to newborns within 24 hours of birth, to prevent them from acquiring the Hepatitis B virus.

In some cases, he sends about Sh5,000 to cover transport, consultation and vaccination costs.

In Marigat, he worked with a passionate hepatitis B health practitioner, Gladys Tuitoek, to ensure that birth-dose vaccines are available by arranging for vaccines to be bought from Eldoret and stored for use. The vaccinated children tested negative at 9 months of age. Where necessary, his team uses molecular DNA testing, including PCR-based viral load testing, which he says can cost between Sh15,000 and Sh20,000 when accessed outside programmes that provide the reagents.

His motivation is simple “Babies are innocent, and they should not be infected.”

He believes Kenya should set clear targets for preventing hepatitis B mother-to-child transmission, just as it has done for HIV.

“The same way we have mother-to-child prevention of HIV, we should also come up with very nice indicators on how to ensure there is also cut-off transmission. We should set such targets for Hepatitis.”

From community work to policy, Dr Ochwoto's work has also moved into health policy.

In 2018, he joined Kenya's Hepatitis technical working group and was involved in the development of the first Hepatitis guidelines in 2018, covering prevention, care and management, which were subsequently updated in the 2026 guidelines.

Together with a team of other scientists, Dr Ochwoto has also worked with the World Health Organisation on a roadmap towards Hepatitis elimination and contributed to Kenya's strategic planning for the disease.

Despite years of laboratory work, community mobilisation and policy engagement, Dr Ochwoto says, “There is nothing as good as when you see a patient walk to a hospital with a very high viral load, put them on ARV treatment, and watch the viral load go down, becoming undetectable. This is my biggest achievement," says Ochwoto.

Viral suppression, he observes, improves the patient's quality of life while reducing the risk of complications and transmission within households.

However, despite his efforts to eliminate the virus, mutation and recombinants is a major concern, particularly occult Hepatitis B, where a person may have signs or evidence of infection but may not be detected by routine rapid testing.

He is also investigating why some communities appear to have higher levels of chronic Hepatitis B than others, examining possible biological, human and environmental factors.

His ultimate goal is to bring Hepatitis screening, diagnosis and treatment closer to the people who need them.

"The family I watched disappear cannot be brought back. But I hope through science, community work and prevention, other families will not suffer the same fate," he says. "I will not rest until we've zero child infections and zero premature Hepatitis deaths".