NIGERIA’S TUBERCULOSIS BURDEN
The major stakeholders could do more to contain the tuberculosis epidemic
THE PROBLEM OF TUBERCULOSIS IN NIGERIA HAS BEEN MADE WORSE BY THE ISSUES OF DRUG RESISTANT TB AND THE HIV/AIDS EPIDEMIC
The health authorities should be worried against the background that some 18 persons die every hour from tuberculosis in Nigeria. According to the World Health Organisation (WHO) Country Representative, Dr. Wondimagegnehu Alemu, no fewer than 420 Nigerians die on a daily basis to the highly preventable and curable disease. Indeed, the country now has the second highest burden of the disease in Africa and seventh highest globally.
This is a major public health issue that needs to be addressed especially when it is fuelled largely by undetected cases. For every 400,000 cases in Nigeria, only 100,000 are detected while the remaining 300,000 are missed. Statistics on tuberculosis in Nigeria from an online tracking platform – TBFacts. org – also indicate that the country is among the 14 high burden countries for TB, TB/HIV and MultiDrug Resistant TB. The online platform also added that the problem of tuberculosis in Nigeria has been made worse by the issues of drug resistant TB and the HIV/AIDS epidemic.
In most cases, Alemu explained that the highly infectious disease is transferred from these undetected cases because those that have been detected have the potential to be successfully treated while a missed case has the potential to infect 15 other persons per year. This, to us is frightening especially when it is considered that the 300,000 reportedly undetected cases could infect as many as 4.5 million people annually going by the possibility of one undetected case. Also from Alemu’s perspective, millions of Nigerians could access healthcare in private hospitals, but only 14 per cent of private health institutions in our country actually collaborate with the National Tuberculosis Programme to tackle the disease. Again, there is the National Tuberculosis and Leprosy Control Programme (NTLCP) which was established in 1989 but officially launched in February 1991, with a mandate to coordinate tuberculosis and leprosy control activities in the country. The real mandate of the NTLCP is to help significantly reduce the public burden of the two diseases. Clearly, the figures and facts show the NTLCP is perhaps challenged to undertake its responsibilities. We will like to see NTLCP strengthened beyond what exists at the moment to do its job of scaling down the burden of tuberculosis on Nigeria.
We recognise that there could be such challenges as inadequate funding, access to the hard-to-reach parts of the country, unreported cases of tuberculosis, and of course inadequate human resources technical capacity. But then, that is where collective participation of all stakeholders in both the public and private sector comes into play in the fight against tuberculosis. Religious and traditional institutions should also be mobilised to further educate people within their reach on the need to report potential cases of tuberculosis for treatment. It is also important for the authorities to underline the need to intensify efforts to always find all missed cases of tuberculosis for proper management. As things stand, until we are able to frequently find and treat missed TB cases, the prevalence of the disease and the high death rate from it will not diminish.
Finally, there should be more political commitment from governments at all levels to fund activities against tuberculosis. Active house-to-house case searching should be initiated to educate the public and detect potential cases, while people living with HIV, urban slum dwellers, prisoners, migrants from conflict-ravaged communities, internally displaced people and facility based health care workers, should be monitored intensely to ensure they are fit and free from the disease. We fear that if no proactive measures are collectively taken, we may continue to have high death rates from tuberculosis.