By Abujah Rachael
According to World Health Organisation (WHO) tuberculosis (TB) is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. This ranks it above HIV/AIDS.
The cost of TB both in deaths and management is colossal, “Globally, there are estimated 10.6 million people with TB in 2021, with Nigeria and seven other countries accounting for two-thirds of the global total burden.
“A combined total of 1.6 million deaths were reported in the same year,” said Dr Enang Enang Oyama National Professional Officer-Tuberculosis Universal Health Coverage/Communicable & Non-Communicable (UCN) Cluster.
Oyama said in spite of the challenges, Nigeria has continued to make progress in its TB response efforts in the last five years with TB notifications increasing from 207,785 in 2021 to 285,561 in 2022 representing a 37 per cent increase.
“This indicates that the country in 2022 detected and notified about 60 per cent of the estimated 467,000 incidents of Tuberculosis cases but still missing about 171,439 cases,” he said.
He said that a large number of undetected TB cases constitute a pool of reservoirs that fuel ongoing transmission in the community, as one undetected TB case can infect between 12-15 people per year.
He said that the emergence of Multi-Drug Resistant Tuberculosis (MDR-TB) and the high number of HIV further complicate the burden of disease in the country.
Because of its infectious nature, people living with TB have to contend with stigma and discrimination from members of the society. Their plight is compounded by the cost of managing the condition.
Mr and Mrs Lawal Mudansiru peasant farmers, live at Wasa community, Federal Capital Territory. They tested positive to TB following a screening by the Institute of Human Virology Nigeria (IHVN) USAID GloVax program team and were placed on treatment. Consequently, their four children were placed on TB preventive therapy.
Mudansiru said he spent about N31, 700 on alternative traditional medicine and cough drugs to no effect up-until the IHVN USAID GloVax programmes team intervened.
He said unknown to them, his wife had been treating her symptoms as a normal cough for two months before she was screened and diagnosed with TB.
Another victim, Mrs Adama Dauda, a 28-year-old housewife with three children, reside at Ungwan Rugan in Ganjuwa Local Government Area of Bauchi. After complaining of coughing for over a month which defied local concoctions, her sputum sample was collected.
One week later, she tested positive. However, because of the cost of treating the disease, she had to live with the sever cough and associated chest pain for a long time until help came in the shape of an international donor.
“The USAID-supported KNCV vaccination team visited my village to vaccinate us and screen for Tuberculosis alongside COVID-19 vaccination, the team advised me to accept treatment and assured me of six-month free treatment”, she said.
“I was placed on treatment while my husband was placed on Tuberculosis preventive drugs.
“Nowadays, I feel healthy and better than before; my cough has stopped, and I no longer suffer chest pain,” she narrated.
Meanwhile when Mrs Amaka Odili, 47 years-old and a single mother of four, collapsed at home she was rushed to the Asiwaju Bola Ahmed Tinubu Primary Health Centre in Lagos state, where she was diagnosed with MDR-TB.
According to WHO first-line drugs used to treat the more common, drug-sensitive TB do not usually work on MDR-TB.
Before then, an ailing Odili had spent a fortune visiting various hospitals where unfortunately, TB test was not prescribed for her.
She said eventually the PHC arranged for her MDR-TB treatment, which included taking injectable drugs for six months.
The drugs came with physical and psychological pains for her as, according to her, she developed side effects, including numbness in the feet, hearing loss and kidney impairment.
Odili, HIV-positive and a cancer survivor, said she had almost given up hope as she was hospitalised for months. She said over a year since her treatment began, she now looks forward to full recovery.
Early detection is fundamental in the management of any disease, including TB.
Public health experts say one of the toughest challenges in the country’s fight against TB is lack of awareness as most Nigerians do not know TB symptoms hence, they only access tests when the disease had eaten deep into their systems.
The delayed test and treatment mean that the carriers ignorantly spread the disease even when there are early warning signs.
TB treatment can take years because many patients do not have the patience to see it through it as they abandon the treatment at the slightest sign of recovery.
Experts, therefore, advise that those on treatment should complete their regimen otherwise they risk unknowingly spreading it.
“People presumed to have TB often delay seeking care until advanced stages of the disease’’, said Dr Chukwuma Anyaike, National Coordinator, National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP).
According to him, unfortunately, those that seek care tend to do so at a patent and proprietary medicine vendors (PPMVs) or community pharmacies rather than at more suitable health facilities.
Anyaike said that TB-related stigma and discrimination also hinder health-seeking behaviour in TB victims.
“Overall awareness of TB is relatively high, but knowledge of transmission, symptoms and prevention is low.
“Much emphasis has also been placed on the service delivery side of TB with less attention to the drivers of behaviour change,” he said.
Observers say it will also take combined and sustained efforts to mitigate the spread of TB and boost its treatment in the country.
They say while government must ensure adequate funds for tackling the disease individuals, development partners and other stakeholders must play their part in supporting government efforts by creating awareness on prevention, early detection and treatment. (NANFeatures).
