The weighty burden of tuberculosis in Nigeria
Fadeke Ademosun (not real name) is a 45 year-old widow with two children based in Abeokuta; Ogun state recollects her journey of pain struggling to survive tuberculosis.
Last year, I began to cough and started losing weight for no reason. Within six months I lost a lot of weight and I was vomiting, I thought I had the Acquired Immune Deficiency Syndrome (AIDS).
I never knew anything about the symptoms of tuberculosis; I thought the cough was normal because I work as a cleaner in a school where I sweep most often, thinking it was the dust I inhaled that might has caused the coughing. But I still did not know that I had contracted the disease.
The doctor told me that I have to carry out a chest X- ray which diagnosed me of TB; it showed it had been dormant in me for almost one year.
I do not know how I got the disease; tuberculosis is a serious disease and should be taken seriously. It has pulled me through pains, this is besides the drugs and the anxiety that I would die soon.
Ademosun advised that doctors should make people more aware of the disease and its symptoms. It is treatable with early diagnoses.
Tuberculosis (TB) is contagious and airborne. It spreads 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.
TB is one of the top 10 causes of death worldwide. It is also the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV.
The most common symptoms include: Cough lasting for more than two weeks, and sometimes with blood-streaked sputum, shortness of breath, loss of appetite and weight loss, fever and sweating, extreme fatigue.
Nigeria is among 14 countries with the highest burden for TB, TB/HIV and multi-drug resistant (MDR)-TB. It ranked 7th among the 30 high TB burden countries and 2nd in Africa. Every hour 47 Nigerians develop active TB, seven (7) of whom are children, according to the 2017 global TB report.
Funding gap, high tuberculosis burden and rising incidence of multi drug resistance are among factors hindering Nigeria’s fight against TB, leading to 420 Nigerian deaths daily.
Currently, there is no effective vaccine to prevent TB and about 104,904 cases were notified in 2017 out of the estimated 420, 000 huge TB cases in Nigeria.
“Every day, 420 Nigerians die from Tuberculosis, an estimated 300,000 cases remain undetected with each of the undetected cases having the potential of infecting between 10 and 15 others. TB is not far from anyone,” said Adebola Lawanson, National Tuberculosis and Leprosy Control (NTBLC).
Similarly, Lovett Lawson, board chair, Stop TB partnership Nigeria added that TB is curable if it is diagnosed early enough. Despite the significant challenges to the country’s public health institute, it can be controlled.
“Tuberculosis control in Nigeria is grossly underfunded, receiving less than 30 per cent of the required funding, there is an enormous gap between the TB control and the amount needed to achieve the mission to universal access to service delivery” Lawson said.
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.
Nigeria, India, Indonesia, China, Philippines, Pakistan and South Africa accounted for 64 per cent of the new cases of tuberculosis, the report reveals.
Despite progress made in the last two decades, the incidence of TB is not declining fast enough to end the disease as envisaged under the Sustainable Development Goals 2.
Nigeria has over 1,700 points for diagnosis and more than 5,000 points for treatment of the disease but only about 20 per cent of Nigeria’s TB burden gets detected.
In 2014, Nigeria developed a national strategic plan for TB control which it planned to run between 2015 – 2020 to provide citizens with universal access to high-quality, patient-centred prevention, diagnosis and treatment services for TB, TB/HIV and drug-resistant and TB by 2020. But the programme has recorded only uncertain success.
According to the Stop TB Partnership, “although TB is curable and preventable all people developing TB, including drug-resistant TB, needs to be diagnosed and treated, and those at highest risk of developing TB (contacts of patients, people living with HIV) need to receive preventive therapy.
Currently, only about 60 per cent of TB and about 25 per cent of drug-resistant TB are notified as receiving treatment; the remaining are the millions of people who are ‘missing’ from care. Coverage levels are lower for children, and preventive therapy coverage is minimal.”
To address the burden in the country, President Muhammadu Buhari stated that the National Action Plan on TB Eradication 2015-2020, is being pursued with renewed vigour, and structured on five priorities: detection of TB in adults and children; improving treatment in specific geographic areas that are under-performing; integrating TB and HIV services; building capacity for diagnosing and treating drug resistant TB; and creating strong and sustainable systems to support these achievements
ANTHONIA OBOKOH