On the world Tuberculosis Day

Sir: March 24 is recognised as World TB day. It commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the organism that causes tuberculosis. The theme of World TB day 2017 is “Unite to end TB: leave no one behind.” It focuses on actions to address stigma, discrimination, and marginalisation and overcome barriers to assess care.

Tuberculosis (TB) is one of the top 10 causes of death worldwide. In 2015, 10.4 million people fell ill with TB and 1.8 million people died from the disease. Nigeria ranks fourth among the six countries that have the highest burden of TB. Incidence of TB in Nigeria in 2015 is about 322 per 100,000 population. However, many cases still go undetected or are not reported.

TB is caused by bacteria (Mycobacterium tuberculosis) and is a contagious disease that is transmitted from person to person through coughing, spitting or sneezing and breathing in airborne droplets that contain the bacteria. TB primarily affects the lungs but can affect any parts of the body.

A person can have latent TB which means the individual has been infected by TB bacteria but is not ill with the disease or active TB disease where the patient is ill with the disease. Depression of the immune system which can occur from HIV infection, diabetes, malnutrition, kidney failure and use of certain immunosuppressive medications; and cigarette smoking increases the risk of developing active TB.

The typical symptoms of lung TB include cough usually lasting more than two weeks with sputum and sometimes coughing up of blood, unexplained weight loss, fever and night sweats. TB affecting other parts of the body may present with other symptoms. TB is diagnosed by detection of Mycobacterium TB in sputum samples. Traditionally this was done using dyes (Acid fast bacilli Stain). However, a rapid test Xpert MTB/ Rif is now recommended by WHO as the initial diagnostic test. This test is available in Nigeria, in government TB treatment (DOTS) centres. A chest x-ray is also an important useful tool in diagnosis.

TB is treatable and curable. Free diagnosis and treatment is available in most government hospitals and TB treatment centres in Nigeria. Active TB disease is usually treated with four anti-TB medications for six months. However, TB affecting certain parts of the body such as bones and brain require treatment for a longer period. Due to problem of adherence TB treatment should be given with support of health workers using the Directly Observed Treatment (DOTS) approach, in which the medications are taken under supervision.

People should cover the mouth and nose when coughing; this is an important way to stop spread of airborne disease including TB. Early detection and treatment of lung TB is the major way to reduce transmission of the disease. People should avoid overcrowding and cigarette smoking.

TB is a common disease. Persons with cough of two weeks or more duration should visit a health care facility for evaluation for TB. Free test and treatment is available in most government health care facilities. Discrimination and stigmatisation of persons with TB should be avoided as it is treatable and curable.

• M. G. Dania,
LUTH, Lagos