As the world marked the World Tuberculosis Day on March 24, 2017, the upsurge in the disease, which by estimates the world should be seeing its back, gives course for worry. Nevertheless, there is a strong move to end the spread of Tuberculosis, TB, by the World Health Organisation, WHO, which launched what it called “…new tuberculosis ethics guidance” as part of activities marking this year’s World Tuberculosis Day, WTD. The global health agency explained that the new ethics guidance aims to ensure that countries implementing the ‘End TB’ strategy adhere to sound ethical standards, to protect the rights of all those affected. The organisation also said that more than a third (4.3million) of people with TB are undiagnosed or unreported. While some receive no care at all, others access care of questionable quality. The disease, it added, claims 5,000 lives daily.
WHO has announced that the first ever global ministerial conference on “Ending TB” will be held in Moscow in November this year. Available information shows that over one-third of the world’s population is infected with TB, while over one million people become sick on account of the disease every year. In 2015, there were about 10.4 million new cases; with 5.9 million of the figure being men, 3.5 million are women and 1.0 million, children. The disease claimed 1.4 million deaths in 2015 and another 0.4 million deaths from the disease among people living with HIV. Globally, India, Indonesia, China, Nigeria, Pakistan and South Africa are among the 22 high TB burden countries.
In our country, tuberculosis is a major public health problem. It is estimated that 616 cases are reported for every 100,000 people. As should be expected, Nigeria ranks first in Africa and fourth among the 22 high TB burden countries in the world. No fewer than 460,000 cases of TB are recorded annually in the country. Health Minister, Prof. Isaac Adewole, said that 91,534 Nigerians are infected with TB every year, with many of the cases unreported. Despite this, he is optimistic that Nigeria will eliminate the disease by 2035. Sadly, the heaviest TB burden is carried by communities, which are already facing socio-economic challenges: migrants, refugees, prisoners, ethnic minorities, and others working and living in risk-prone settings.
Other victims are marginalised women, children and senior citizens. The Director-General of WHO, Dr. Margaret Chan, disclosed that TB strikes some of the world’s poorest people hardest. The agency, she said is determined to overcome the stigma, discrimination and other barriers that prevent so many of these people from obtaining the services they so badly need. The Director-General of National Agency for Control of AIDS, NACA, Dr. Sani Aliyu, said that TB and HIV pose serious challenges to the nation’s health sector. He further disclosed that 40 per cent of deaths in People Living With HIV, PLWHIV have been linked to TB, while an estimated 1.2 million PLWHIV have died of complications arising from TB.
Since TB and HIV control programmes are intrinsically linked and have many things in common, Aliyu suggested that a collaborative effort backed by a coherent and robust approach at national and sub-national levels by governments and partners will help tackle the deadly twin scourge and ensure a healthy TB and HIV-free generation.
There are 22 states in Nigeria with high incidence of the disease in the country. Imo State recorded about 1,143 TB cases in health facilities across the state as at December 31, 2016. The state government has established 27 Care Centres in the 27 local government areas of the state and urged the people to access treatment in those centres. In Lagos State, about 40 tuberculosis patients are presently receiving treatment and being monitored at Agege TB free care centre. Currently, Lagos State bears 8.4 per cent of the nation’s TB burden. The Federal Government has set up 318 TB centres in the country and there are plans to have at least one TB centre in each local government.
Since TB is curable and government has established centres where those with the condition can access treatment, we advise them to avail themselves of the opportunity. All the states with high TB burden should increase access to treatment centres as Imo State has done. TB patients should not be discriminated against or stigmatised. The disease is not caused by witchcraft. It is caused by a bacterial infection that can spread through the lymph nodes and bloodstream to other organs of the body. However, the good news is that the disease is curable and the treatment is free.
Thus, citizens with persistent cough should report to the nearest health facility for prompt and free treatment. People should avoid living in poorly-ventilated houses to reduce the risk of infection. Let all the three tiers of government work in concert to make Nigeria TB-free by 2035 as envisaged by the Federal Government. Like meningitis, more awareness should be created just as some of the changes in our personal environment like hygiene and ventilation must be taken seriously.