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Escalating ‘keke’ initiative to fight TB

by Haruna Gimba
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By Hassan Zaggi

KNCV Tuberculosis Foundation Nigeria has flagged-off the use of Wellness on Keke (WoK) for the fight against Tuberculosis (TB) in Anambra and Kano States.

KNCV Tuberculosis Foundation Nigeria, is a local non-profit organization dedicated to the fight against tuberculosis (TB) and human immunodeficiency virus (HIV), the deadliest infectious disease in Nigeria.

The WoK is an initiative aimed at using the popular ‘Keke’ (tricycle) to take the fight against TB and other diseases to the rural populace.

The WoK initiative is funded by USAID under the KNCV Nigeria GloVax Project and drives access to TB and other chronic diseases screening (Hypertension and Diabetes) to the hard-to-reach communities.

Each WoK comes fitted with a TB LAMP and portable digital X-ray with artificial intelligence for on-the-spot TB diagnosis and COVID -19 vaccination cold boxes.

The WoK initiative is different from the Wellness on Wheels (WoW) trucks earlier introduced by the KNCV meant to provide quick diagnosis and state-of-the-art treatment to patients stricken with TB in the most vulnerable communities in the country.

Ogun and Kaduna states, among many others already have many WoW trucks which have proved very useful not only in the fight against TB, but also helped in the fight against COVID-19.

It was observed that TB being mostly a disease of the poor, the introduction of the use of Keke to reach to almost unreached settlements across Anambra and other states is not only commendable but timely.

Speaking at the flag-off ceremony, Executive Director, KNCV Nigeria, Dr Bethrand Odume, applauded the Anambra state government for the support since the start of its TB projects in the state.

“Just recently, KNCV received another global grant from USAID to scale up COVID-19 vaccination across seven states in Nigeria of which Anambra State is inclusive.

“In most of our interventions, Anambra State has been prioritised because of the relationship and result received since the start of the global and TB long project.

“Now, the package we have here is called Wellness On Keke (WOK). It is a local initiative concept by KNCV with funding from USAID to enable us deliver adequate healthcare to people in very hard to reach communities.

“The beauty of this project is that, it could be seen as a one-stop-shop for TB diagnosis, chronic disease screening and COVID-19 vaccination,” Dr Odume explained.

On his part, the Anambra State Commissioner for Health, Dr Ben Afam Obidike, commended KMCV for the concept which has the capacity to screen other chronic diseases apart from TB.

“I am glad that screening for Diabetes, Hypertension and even COVID-19 vaccination are all integrated into the WOK project and that it is mainly for rural areas.

“It is an aim of the government for Ndi Anambra to have access to adequate healthcare and this project will give people easy access to know their numbers and receive their COVID-19 vaccination while screening for TB.

“It is good that we work closely in the project, to ensure that people benefit from it extensively,” Dr Obidike noted.

The introduction of the WoK is not only timely, but an initiative that will definitely bring the needed improvement in the fight against TB in Nigeria by increasing the case finding. It should be replicated in all parts of the country.

It regrettable that despite huge number of people affected by TB in Nigeria, Direct Observation Therapy (DOTs) clinics are only available in 44 per cent of health facilities in Nigeria. Only 9 per cent of them have TB diagnostic services.

To say that the war against TB in Nigeria needs highly innovative approach, is an understatement. This is because, the case detection effort is slow due to lack of adequate funding.

At the moment, Nigeria has 70 per cent funding gap and equally, 70 per cent gap in TB case finding.

Nigeria is among the 30-high burden countries for TB, TB/HIV and Multi Drug Resistant TB (MDR-TB).

Nigeria is also said to rank sixth among the 30-high burden countries globally and number one in Africa.

On the other hand, Nigeria accounts for 11 per cent of the global gap between TB incidence and notified cases and out of the 452,000 estimated new TB cases in Nigeria in 2020, only 138,591 were notified to the National Tuberculosis and Leprosy Control Programme (NTBLCP) with only 30 per cent treatment coverage.

This, therefore, underscores the timeliness and importance of the launch of the Wellness on Keke initiative.

It is therefore, important to call on other states  governments to key into the WoK initiative. This is the only way to reach residents of hard to reach areas with TB screening services.

The federal government should also look at ways of escalating the initiative by encouraging and supporting the states and local governments to procure the WoK to be distributed to all nooks and crannies of the country.

It is also encouraging to note that USAID team with KNCV Nigeria Management have had an in-depth discussion on gaps along DRTB (Drug resistant TB) pathway and strategies for improving DRTB case finding and case holding in Nigeria.

This is important because experts have since raised the concern that if care is not taken, resistant TB will soon become an epidemic in Nigeria.

Also, heart-warming is receipt of a donation of MiniXray with Qure.ai from MiniXray Team, Illinois USA by the KNCV Management.  The equipment which is portable digital xray with artificial intelligence will be deployed for targeted community TB case finding.

It is important to stress that for Nigeria to halt the spread of TB and improve TB case finding in the country, every available equipment and strategy must be deployed so as to avert the looming TB epidemic.

Corporate bodies, well-meaning Nigerians and philanthropists can also intervene by procuring the WoK for distribution in all parts of the country.

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