Anxiety as Nigeria records 440,000 new TB infections yearly

There are fresh concerns over the high burden of tuberculosis (TB) in the country as the National Tuberculosis and Leprosy Control Programme (NTBLCP) has declared that Nigeria is sitting on a keg of gun powder with 440, 000 new infections recorded yearly.

National Coordinator of NTBLCP, Dr. Chukwuma Anyaike, said it is very worrisome and unacceptable that Nigeria has the highest burden of tuberculosis in Africa and the sixth in the world and urgent action needs to be taken to reverse the trend.

TB is a chronic infectious disease caused by the group of bacteria generally referred to as Mycobacterium tuberculosis complex and infection of a susceptible individual occurs when such individual inhales droplets of respiratory secretions (droplet nuclei) containing the bacterium (Mycobacterium tuberculosis). These droplets are released into the air by an infectious patient when s/he coughs, sneezes, spits, sings or talks.

An infectious, untreated pulmonary TB patient will infect an average of 10-15 people every year.

Speaking at a two-day media engagement with health correspondents in Abuja, Anyaike revealed that Nigeria for the first time, in 2021 identified 207, 000 new cases of TB adding that there are almost 300,000 missing cases of TB in the country yearly.

Anyaike cautioned that one un-intervened case of TB has the capacity to affect 25 people adding that only 27 per cent of Nigerians even know that they have tuberculosis.

He said, “Nigeria is one of the 30 high TB burden countries for TB, intravenous anti-tuberculosis drugs (TB/IV) and Multidrug-resistant tuberculosis (MDR-TB) accounted for 86 per cent of all estimated incident cases worldwide. Nigeria is one of the eight of these countries accounting for two-thirds of the global total TB cases, Nigeria alone accounting for 4.6 per cent of the estimated total TB cases globally.

Nigeria is also one of the 10 countries that account for about 70 per cent of the global gap between the estimated global incidence of multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) each year and the number of people enrolled in treatment in 2020. The incidence rate is 219/100,00 giving an estimated 452,000 TB cases in 2020.

“This means Nigeria is sitting on a keg of gun powder when it comes to TB. So we are working on three-prong strategies, one is prevention and that is why we gathered all of you here to, let people know that TB is preventable and what to prevent themselves, the second one is the effective and efficient diagnosis, we are scaling up diagnostic platforms to enable us to detect more cases and place them on treatment because TB is curable and treatment is free. We need to break the chain of transmission and end TB in Nigeria.”

The National Coordinator noted that Nigeria has finalized the 2021 – 2025 Strategic Plan, which is in tandem with the global strategic plan for ending TB.

He observed that there is a huge funding gap of 70 per cent in the fight against the disease adding that 24 per cent of funding comes from donor organisations, while only six per cent is from the Federal Government of Nigeria.

Anyaike observed that the government is running a national programme to address TB, leprosy and Buruli ulcer.

Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic debilitating disease that affects mainly affects the skin and sometimes bone.

He explained that Buruli ulcer is affecting so many children in rural communities but most times people interpret it to be poison.

According to him, Buruli ulcer is predominant in the rural areas due to poor health seeking behaviours, poor environmental and sanitary conditions and poverty among others.

Also speaking, Assistant Director, Childhood TB, National Tuberculosis, Buruli Ulcer and Leprosy Control Programme (NTBLCP), Dr. Urhioke Ochuko, noted that people with TB disease of the lungs or throat could spread bacteria to others with whom they spend time every day.

Ochuko stated that Nigeria has the 3rd highest burden of childhood TB globally stressing that TB incidence rate – 219/100,000 population –138,591 notified out of estimated 452,000 cases–8,441 (six per cent) children notified out of reported TB cases–8,441 (11 per cent) notified out of estimated 77,000 Child TB cases–TB mortality rate – 62/100,000 population (13/100,000 among TB/HIV cases only). Malnutrition and HIV are key risk factors for TB. About 25 per cent of Nigerians have correct knowledge of TB in children from untreated adult TB patients.

He listed challenges facing Childhood TB Control to include low childhood TB awareness among the general population, poor health-seeking behaviour, stigma and discrimination, limited media engagement in TB awareness creation, low index of suspicion for child TB by healthcare providers and low funding for childhood TB control among others.

He observed that NTBLCP’s Interventions for Childhood TB Control are in the areas of rapid diagnostic tests for TB in children, active TB case finding through outreaches in communities across 24 states, task shifting for other HCWs to diagnose child TB in hard to reach areas of support for contact investigation (CI) of diagnosed TB cases of screening of OPD attendees in all tertiary/some secondary health facilities for a free chest x-ray and transport voucher to support child TB diagnosis

On her part, Deputy Director, Malaria and Tuberculosis, Breakthrough ACTION, Nigeria, Dr. Bolatito Aiyenigba, stressed the need to find the missing TB cases as the current case finding is only around 26 percent,

She pointed out that about 74 percent TB cases in the country are not detected or reported, adding that these people may be transmitting TB to others in the communities.

Aiyenigba stressed the need to close the gap for Nigeria to end TB transmission adding that the organisation would continue to partner with the Nigerian government to accomplish the goal of the NTBLCP.