Rising yoke of TB infections in Nigeria

Current reports that Nigeria has the highest burden of Tuberculosis (TB) in Africa and is the sixth worst-hit country in the world are worrisome and unacceptable. It depicts an inherent deficiency in her healthcare system, given that the disease is losing out in most other climes.

During this year’s commemoration of World Tuberculosis Day, the National Tuberculosis and Leprosy Control Programme (NTBLCP) raised fresh concerns over the high burden of TB in the country, declaring that Nigeria is sitting on a keg of gunpowder with 440, 000 new infections recorded yearly.

That Nigeria remains in a black spot on TB index rate is a sad and shameful commentary on the nation’s healthcare system, as the country already wears many badges of dishonour. Rather than declining as observed elsewhere, TB seems to be gaining ground in Nigeria. Statistics released also show that last year, 207, 000 new cases of TB were identified, while there are almost 300, 000 unattended cases of TB in the country yearly, that are not detected or reported and the carriers may be transmitting TB to others. The NTBLCP 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.

The identification of 207, 000 new cases of TB in 2021 raises questions as to the efficacy of the control measures contained in The National Strategic Plan for Tuberculosis Control: Towards Universal Access to Prevention, Diagnosis and Treatment 2015 – 2020, signed in July 2014, by the then Minister of Health, Prof Onyebuchi Chukwu. Is the plan mere beauty on paper? It is important for the NTBLCP to debrief Nigerians on the results achieved with the plan and the key lessons taken as inputs into the 2021–2025 Strategic Plan, which the National Coordinator of NTBLCP noted that Nigeria has finalised.

Tuberculosis is a chronic infectious disease caused by bacteria, which most commonly affects the lungs. It spreads from person to person through microscopic droplets released into the air and can happen when someone with the untreated, active form of TB coughs, speaks, sneezes, spits, laughs or sings. So, tuberculosis can be contracted from someone he or she lives or works with when such individual inhales droplets of respiratory secretions (droplet nuclei) containing the bacterium

Certain factors can increase the risk of the disease. They include a weakened immune system, which makes the human body ineffective in mounting defence. Weak immunity can be occasioned by a disease condition such as HIV/AIDS. Thus, experts say that since the 1980s, the number of TB cases has increased because of the spread of HIV, the virus that causes AIDS, as HIV infection suppresses the immune system. As a result, people with HIV are many times more likely to get TB.

Similarly, overcrowding and poor ventilation in places such as prisons, immigration centres or nursing homes increase the risk of the disease; not discounting the COVID-19 pandemic that may have hampered access to treatment for TB patients. Some of the signs and symptoms of TB are coughing that lasts three or more weeks; coughing out blood; chest pain, or pain with breathing or coughing; unintentional weight loss; fatigue; fever; night sweats; chills and loss of appetite. Unfortunately, the disease could remain latent and undiagnosed in many sufferers. Therefore, all citizens should be on the alert.

As a disease that primarily affects people in the most productive years of their lives, TB causes the loss of millions of productive workdays every year, depriving families and the Nigerian economy as a whole of the fruits of their labour. Therefore, TB remains a public health issue that the nation cannot afford to ignore. But it can be tackled effectively; through a three-prong strategy of prevention; effective and efficient diagnosis; and treatment.

As contained in the Strategic Plan, which is a call to action for all stakeholders in Nigeria, political leaders and government officials at all levels, religious leaders, business leaders, public and private health providers, communities and individuals affected should mount a massive and coordinated response to the challenges that Nigeria is facing in eliminating this life-threatening yet curable illness. Obviously, the efforts of the government alone or just throwing money at the issue by increasing domestic funding as recently canvassed by the Coordinator, NTBLCP cannot contain the disease.

To change the narrative, an awareness campaign should be intensified to educate Nigerians on the realities of TB and for them to know that it can be prevented, treated and cured if diagnosed early; and the services are free. Thus, there is a need for an improved working relationship between the media and the health sector to sensitise the citizens on the prevention and treatment of TB and where they can access free treatment.

Government should scale up diagnostic platforms to enhance access and early diagnosis. Individuals and parents should take personal responsibility for their health and that of their children, for instance through immunisation with BCG at birth. And it is free! Left untreated, TB can be fatal; but with increased understanding of TB, public-health initiatives, and treatment, Nigeria should soon be out of the black spot on Tuberculosis (TB) index rate.

Any measure that would enhance universal access to treatment and drugs for TB patients should be pursued. The world has committed to ending the TB epidemic by 2030; national actions in Nigeria should be seen to match the rhetoric, and this calls for more dedication and commitment.