On The Rising Scourge Of Tuberculosis

THE recent revelation by the National Tuberculosis and Leprosy Control Programme (NTBLCP) that 600,000 new cases of tuberculosis (TB) currently rage in Nigeria should put all citizens on the alert. It is a very deadly disease and not many people are aware of the potential danger they face daily from the disease given its highly infectious nature. This should change with all citizens imbibing the culture of better hygiene and prevention. What is worrisome is the fact that rather than declining as observed elsewhere, the disease seems to be gaining ground in Nigeria. This raises question as to the efficacy of the control measures being applied and calls for more dedication and commitment.

According to Gabriel Akang of the NTBLCP, the World Health Organisation (WHO) has ranked Nigeria three among the 22 countries with the highest prevalence of TB in the countries that did not meet the Millennium Development Goals’ (MDG) targets of reducing TB incidence, prevalence and mortality rates. This is despite the control efforts of institutions like the Nigeria Institute of Medical Research (NIMR), which is dedicated to the research and treatment of TB in the country.

Akang said the appropriate services are currently provided in about 6000 health facilities in the country with diagnosis in 1,515 microscopy laboratories. DOTS (Direct Observed Treatment, Short-Course,) recommended by WHO, is the best option in the treatment of TB in Nigeria and globally. The TB programme in Nigeria has also adopted new molecular technology known as GeneXpert, an automated diagnostic test that can identify Mycobacterium tuberculosis and resistance to rifampicin in two hours.

The programme has also commenced community direct TB services to initiate treatment at the community level and this has helped in mopping up backlog of cases, which could not be admitted in hospital due to limited bed space.

TB certainly remains a public health issue in Nigeria, having been ranked as the second cause of death after HIV/AIDS. Unfortunately, the disease could remain latent and undiagnosed in many sufferers. As a matter of fact, infection in healthy sufferers doesn’t show any symptom, as the immune system builds a “wall off” the bacteria. This is a factor in the spread and apparent rise in the number of cases in Nigeria.

Besides, there is indication that a number of people are falling ill with the highly resistant strains of TB that resist conventional treatment and kill rapidly when left untreated. The multi-drug resistant tuberculosis, reportedly, has a mean annual percentage increase exceeding 100 in Nigeria, which is frightening. Given that scenario, any measure that would enhance universal access to treatment and drugs for TB patients should be pursued.

TB is caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted through droplets from the throat and lungs of people with active respiratory disease. Before now, TB used to be a big problem in different parts of the world, but the discovery of effective treatment drugs has, luckily raised the awareness that the disease is curable. Yet, unfortunately, the disease still kills three people every minute.

The “Stop TB Partnership”, founded in 2001 in Geneva, Switzerland, is leading the way in the struggle for a total eradication of the disease. With 1,300 partners worldwide, the Partnership’s mission is to serve every person who is vulnerable to TB and ensure that high-quality treatment is available to all who need it. Incidentally, TB mostly affects HIV/AIDS patients as lack of immunity predisposes the patients to opportunistic infections like TB.

Here in Nigeria, lack of research, effective treatment and public enlightenment are among the factors that compound the problem. Therefore, whatever can be done to help people prevent infection should be encouraged. In the past, sufferers were taken into isolated locations but now with the availability and advances in the treatment methods, sufferers are no longer isolated. Consequently, people should be careful and basic hygiene is crucial to prevention. Nigerians are wide travelers and the borders are porous. There is a need to have infectious disease hospitals across the country.

Sadly enough, the only infectious disease hospital in Lagos has been abandoned. It was only remembered for refurbishment recently in the wake of the outbreak of Ebola fever. The authorities should, therefore, re-visit the need for infectious disease hospitals and not wait until there is a public health crisis like Ebola before appropriate facilities are put in place.