THE TUBERCULOSIS BURDEN
Health authorities should devote more efforts to containing the disease
Tuberculosis, better known by its acronym TB, still constitutes a major health problem in Nigeria. This much was brought to the fore last week at the World TB Day in Abuja. The World Health Organisation (WHO) 10-year strategy (2006-2015) to cut down the burden of TB in the world worked elsewhere as it reportedly saved some 37 million lives while some countries succeeded in halving the prevalence of the disease. But in Nigeria, the reverse is the case.
According to the National TB and Leprosy Control Programme (NTBLCP), over 600,000 new cases of tuberculosis have occurred in Nigeria, the highest in Africa, from a global report conducted in 2014. Indeed, WHO has ranked Nigeria third out of 22 countries with high prevalence of TB in the world.
The world health body is particularly worried because a substantial number of the people infected in Nigeria are unreported or undiagnosed.
Dr. Rui Gama Vaz, WHO country representative in Nigeria said some 15 per cent of the three million people undiagnosed for TB around the world are in Nigeria, most of them women and children in slum neighbourhoods where poor ventilation and squalor abet the spread of the disease. “If you do not reach those women and children infected”, said Vaz, “they will continue to spread TB
CURRENT EFFORTS ARE NOT ENOUGH TO FIND, TREAT AND CURE PEOPLE SUFFERING FROM THE AILMENT EVEN THOUGH TREATMENT CENTRES FOR DRUG-RESISTANT TB HAVE GROWN FROM ONE IN 2010 TO 12 IN 2014
in their communities.”
Tuberculosis is perhaps the single leading cause of death from any single infectious agent. It is caused by a bacterium which most commonly affects the lungs and transmitted from person to person through air droplets. TB affects all species of vertebrates and though control measures had reportedly limited the spread through animals, they (particularly cattle) still constitute a significant source of risk in countries like Nigeria where meat and milk inspection by health officials are often overlooked. “You cannot have good public health unless you have good animal health,” said James Steele. “And you cannot have good animal health unless you have good public health”. Globally, some 13 per cent of TB patients are also afflicted with HIV, and said to be the leading cause of death among people living with HIV. B ut tuberculosis is a curable disease. However, that is dependent on early detection and correct diagnosis aided with proper treatment. Many patients afflicted with TB do not complete the TB therapy and even worse, many do not make themselves available for treatment. Indeed, failure to complete the treatment and the mismanagement of drugs had led to the death of many patients and the increase in variants of the disease that are drug-resistant. Nigeria has the second highest multi-drug resistance tuberculosis (MDR-TB) burden in Africa and the 13th highest in the world.
Ironically, current efforts are not enough to find, treat and cure people suffering from the ailment even though treatment centres for drug-resistant TB have grown from one in 2010 to 12 in 2014. Some 15 states are said to have initiated treatment of drug-resistant TB patients in their communities. Dr. Gabriel Akang, National Coordinator, NTBLCP said the directly observed treatment short course (DOTS) services are currently provided in about 6000 health facilities in the country, and diagnosis in 1515 microscopy laboratories.
DOTS is said to be a cost-effective strategy that consists of physically observing patients as they take the TB medications to ensure treatment compliance. It reportedly has shown cure rates of up to 95 per cent in relatively poorer countries.
Last week, the Minister of Health, Dr. Khaliru Al-Hassan said the NTBLCP and the National Agency for the Control of AIDS (NACA) in collaboration with partners have increased capacity for diagnosis of TB among persons living with HIV and drugs-resistant TB through the installation of new diagnostic machines across the nation. But also heartening is the promise to search the urban slums and communities to fish out the patients.