How Nigeria can improve on tuberculosis treatment
Nigeria has the seventh highest diseases burden among the 22 countries with the worst cases, according to World Health Organisation and tops Africa’s ranking. Tuberculosis is the ninth leading cause of death worldwide estimated at 10.4 million infections and 1.8 million deaths annually. In Nigeria the estimated incidence of TB is 322 per 100 000 population.
Despite significant progress over the last decades, TB continues to be the top infectious killer worldwide, claiming over 4,500 lives a day. The emergence of multidrug-resistant TB (MDR-TB) poses a major health security threat and could risk gains made in the fight against TB.
Experts say more can be done to raise awareness about the effects of TB and adopting the World Health Organisation recommendations for treating multidrug-resistant tuberculosis would help the country improve outcomes of treatments.
MDR-TB is a major driver of antimicrobial resistance worldwide and threatens hard-earned gains made in the global TB response over the past twenty years. Diagnosis and treatment of MDR-TB remain a major challenge, with only one in four affected people currently being detected and even fewer being treated successfully.
According to Peters Etete, president, Nigerian Thoracic Society, TB is a medical disease has a lot of socio economic confounders; it affects the economically productive age group in the community, thereby affecting productivity.
“More worrisome is the fact that about one in three people with TB are never diagnosed and in Nigeria the proportion of missed cases is as high as 50 per cent. This means they will not be treated and they will continue to transmit the disease in the community,”
“Nigerian has made some significant strides towards TB control, but we know we can do better and faster to achieve the End TB Goal,” said Etete.
Tuberculosis is a curable disease. TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.
Meanwhile major improvement in treatment outcomes and quality of life of patients with multidrug-resistant tuberculosis (MDR-TB) are expected, following key changes in MDR-TB treatment was announced on 17 August 2018 by the World Health Organisation (WHO).
According to the agency, the first important change is a new priority ranking of the available medicines for MDR-TB treatment, based on a careful balance between expected benefits and harms. Treatment success for MDR-TB is currently low in many countries. This could be increased by improving access to the highest-ranked medicines for all patients with MDR-TB.
The second important change is a fully oral regimen as one of the preferred options for MDR-TB treatment, with injectable agents proposed to be replaced by more potent alternatives such as bed aquiline (the first-ever medicine to be developed specifically for the treatment of MDR-TB). Injectable agents cause pain and distress to patients, with many experiencing serious adverse effects that often lead to treatment being interrupted.
“The treatment landscape for patients with MDR-TB will be dramatically transformed for the better with the announcement today,” said Soumya Swaminathan, WHO Deputy Director-General for Programmes.
Swaminathan added that “Building on the available new data, and with the involvement of a large number of stakeholders, WHO has moved forward in rapidly reviewing the evidence and communicating the key changes needed to improve the chances of survival of MDRTB patients worldwide. Political momentum now needs to urgently accelerate, if the global crisis of MDR-TB is to be contained.”
Analysts say there is a need to devote more funds to Nigerians TB centres and also political, social commitment for further progress towards eliminating the disease as a public health burden.