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Combating Tuberculosis: Children Need Vaccination, Adults Regular Check-up

24 May 2015   |   3:23 am
Recently, a chest clinic was set up in Alimosho General Hospital, Igando, Lagos, with the support of Chevron Nigeria Plc. In this interview with Medical Director of the hospital, Dr. Bolaji Adebiji, he spoke to PAUL ADUNWOKE, on the challenges and management of tuberculosis.
Some available tuberculosis drugs

Some available tuberculosis drugs

What are the major challenges in managing tuberculosis?
THERE are many challenges we face in managing tuberculosis cases. Nigerians do not come to hospital on time for general check up until they are at the point of death. Again, some people that have tuberculosis infection don’t comply with the instruction to finish the drugs prescribed for them. People who have tuberculosis are always being stigmatized in their family because they feel that it can affect other members of the family. It is consistently true, but that doesn’t mean that they should be stigmatized.

What are the possible ways of managing the disease?
Management of tubercluosis starts with diagnosis, when a patient is diagnosed with tuberculosis, there are procedures we go through during treatment. Luckily, it is curable and if a patient is placed on a medication and the patient continues taking this combination therapy on regular basis, time would come when the infection would totally clear in the system. We do mantoux test, and chest x-ray to go through the lumps and once the diagnosis is made the treatments would start.

The kind of exercise they would engage, environment to live and how to relate with people among others. How do you manage the cough? You need to be with handkerchief all the time and of corse, keeping appointment is very important in managing tuberculosis. A Patient who has been diagnosed or who is on medication should keep appointments. Drugs are given for complete three months free of charge and before those drugs would finish the patient would come back to refill for the treatment to continue. It takes a while for the treatment to be completed. For one to be declared tuberculosis free, the patient must be regularly keeping the appointment because non compliance is the major challenge in treating tuberculosis.

Is tuberculosis disease hereditary?
It is not hereditary, but it is transmittable; it can be transferred from an infected mother to a child, but it is not in the gene of the mother. It cannot be transferred through gene, but through droplets. If a person that is affected coughs and a person who is tuberculosisfree gets this cough through droplet, he or she can be infected. A person can be affected of tuberculosis through contact.

What is the level of support from Chevron?
Chevron has done wonderfully well and they have set up a standard chest clinic. One modern equipment meant to manage tuberculosis is already provided in this hospital. The chest clinic has solid structures and quality treatment facilities.

Is the treatment for the tuberculosis free?
The treatment for tuberculosis here is 100 per cent free. No body collects money from any tuberculosis patient, including all the processes and procedures are free.

What services and tests does the hospital offer for tuberculosis patients?
When a patient comes with complain suggestive of tuberculosis, we run general blood test. We want to know the blood volume, blood group, genotype of the patient then we go ahead to see whether the person has tuberculosis by doing chest x-ray. After chest x-ray, we go ahead to do mantoux test, where the injection is given in the arms and then we see the reaction of the injection. When all these are combined we achieve a diagnosis whether it is a case of tuberculosis or not. It is combination of radiology and dermatology to be able to diagnose tuberculosis.

There is also a new machine called gene experts that perfectly help us in the diagnosis of tuberculosis.

What are the needs and gaps in the clinic?
The only gap we see in the clinic presently is high number of patients in relation to personnel available. Lagos State is over populated and of course the number of patients that we see is so high. Alimosho General Hospital is the busiest general hospital in Lagos and perhaps, the busiest in the country as well. So, what we see as major gap is ratio of patients to staff members of the hospital. We do not have enough personnel to cope with the high volume of patients we have on daily basis. Equipment is here, structures are on ground, the staff members also are doing their best, but the pressure is so much on them. I wish government can employ more staff memebers in order to manage the patients we have.

What kind of food and environment does a tuberculosis patient require?
For environment, a tuberculosis patient is expected to stay in an airy environment so that there would be cross ventilation and free flow of air. When they come to the hospital for treatment, we do not treat them in a consulting room. We do not allow them to sit in an enclosed environment when they are waiting for doctors, but we provide an open place, where there is free flow of air. When they are at home we encourage them to stay with windows left open and under mosquito treated nets. We ask them, if possible to live alone and they need to always have an hanckerchief with them incase if they want to cough. They are expected to use handckerchief to cover their mouths, when coughing.

For food, we ask them to eat balanced diet, enough fruits, vegetables and to avoid eating only carbohydrates.

My advice to Nigerians, they should learn to visit hospitals for medical check up. Nigerians do not visit hospitals until there is pain. The pains must be severe in such a way that paracetamol tablet can not eliminate it.. Let us cultivate the habit of going for medical check up at least once in a year. We need to check our blood sugar and blood pressure level, women need to check their breasts on regular basis. Women over 40 years need to check their private parts to prevent cancer infection. Expecially for tuberculosis, if you have anybody who coughs in your area, tell the person to go for medical check up and you who are close to a person who coughs needs to go for medical check up. It does not cost much to have a medical check up.

In what aspect do you think government can support to improve quality healthcare delivery, especially in tuberculosis cases?
Education is the major aspect of health promotion, of which Lagos state government is at the fore front. On regular basis, we hear jingles advising us on what to do about our health. In Lagos, we have blood sugar and bood pressure tests in all the local governments. Government should promote health through school health education. We need to have our school health promotion from primary school level, when these young ones understand the importance of monitoring our health. Then we run these programme through secondary school so that when these kids would graduate and become men and women in future, they already know what it takes to maintain one’s health. Health promotion should also be done for market women, artisans, taxi drivers, motor parks, and mainmarkets.

What are the burdens of tuberculosis?
We always have large number of patients who come down here for tuberculosis treatment. Everyday the volume of patients with tuberculosis get higher; we have seen cases of younger children, old adult, men and women some time one would be wondering if one would not contract the disease.