Halting tuberculosis’ dangerous march


TUBERCULOSIS, a lung disease that afflicts millions of people worldwide, is dangerously on the march in Nigeria. A recent figure from “A recent figure from the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme” detailing over 2,000 new positive cases in the first half of 2023 in Plateau State underscores the problem and the need for improved preventive and curative responses. The federal and state governments should revitalise ongoing mitigation programmes to meet this national challenge.

Shedrack Dimang, NTBLCP’s Zonal Medical Officer covering the North-Central region, said in Jos, the Plateau capital, at the commencement of the national TB testing week that the positive cases were detected in hospitals and from outreaches. In 2022, 3,670 cases were detected in the state.

But TB is pervasive nationwide. Anambra detected over 8,000 cases in 2022 from an estimated 13,000 persons believed to be infected in the state. Kano reported a TB burden of 34,547 cases (one of the five highest in Nigeria) and said it had placed 8,277 patients on treatment early this month. With almost 54,000 cases, Lagos accounts for 11 per cent of Nigeria’s TB burden and alarmingly, most of the infected have not been identified and placed on treatment.

No state is free of the burden. The national and sub-national governments should intensify mitigation efforts.

A contagious lung disease, TB is caused by a bacterium, Mycobacterium tuberculosis, which can attack any part of the human body such as the spine, the brain or the kidney. Infection creates either of two conditions: the TB disease, and Latent TB Infection that luckily, may not result in sickness. But the TB disease, if untreated or not treated properly, can be fatal, warns the US Center for Disease Control and Prevention.

Symptoms include persistent cough, chest pain, tiredness, night sweats, fever, and appetite and weight loss, according to the Global TB Report.

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An estimated 10.6 million people fell ill with TB worldwide in 2021, said the World Health Organisation, of which 1.6 million died. About 3.4 million of those who fell ill were women, 1.2 million were children and six million were men. Globally, TB is now ranked the leading cause of death and second leading infectious disease killer after COVID-19.

Nigeria, as usual, is not faring well. With about 467,000 infected (from 269,000 in 2000), it is ranked the sixth highest among the 30 TB-burdened countries, and the first in Africa. It is among eight countries combined, says the WHO, which accounted for over two-thirds of global TB cases in 2021, the others being India, Indonesia, China, the Philippines, Pakistan, Bangladesh, and Congo DR. TB accounts for 10 per cent of all deaths in Nigeria, says Copenhagen Consensus, a think tank. The Nigerian Thoracic Society reportedly puts annual TB deaths in Nigeria at 240,000.

Thankfully, TB is both preventable and curable. National and sub-national initiatives should therefore step up efforts to locate all infected persons through increased testing and place them on treatment.

Public awareness programmes should feature collaboration among the three tiers of government, NGOs, international aid agencies, faith-based organisations, communities and educational institutions. The Federal Ministry of Health in its 2019 Annual TB Report bemoaned the low treatment coverage of 27 per cent nationwide and the huge number of missing TB cases. It should partner with its 36 state counterparts to reverse this trend.

There should be increased funding, training of health workers and outreach activities. As persons living with HIV are more susceptible due to weakened immunity, special attention should be paid to them. Children should be regularly tested. States and local governments should revive the primary heath care centres.

Furthermore, the government should support local manufacturing of TB drugs in Nigeria to reduce dependence on importation and the proliferation of fake medicines. Through concerted efforts, the TB advance must be halted.


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