Nigeria’s TB burden

The recent disclosure by the World Health Organisation (WHO) that Nigeria occupies the 5th position among the 22 countries of the world with the highest tuberculosis burden calls for a drastic action to stem the ugly trend.

The ranking also becomes more worrisome in view of the fact that the country joins the rest of the global community in marking the annual World Tuberculosis Day.

The theme for this year’s commemoration which was marked yesterday is “It’s time”. The Day was intended to draw the attention of the international community to the danger of the disease with special focus on addressing the stigma, discrimination, marginalisation and overcoming barriers to accessing care.

The World Health Organisation (WHO) in conjunction with International Union Against Tuberculosis and Lung Disease (IUATLD) sponsored the first World Tuberculosis Day in 1982.

It was exactly 100 years after Dr. Robert Hermann Koch, the German physician and pioneering microbiologist, announced the discovery of mycobacterium tuberculosis, the organism that causes the disease, on March 24, 1882. Statistics from the WHO reveal that over 10m people are sickened by the disease annually with about 1.8m deaths recorded in 2015 alone, making it the top killer ailment worldwide. Tuberculosis is deeply rooted in populations where human rights and dignity are limited.

No one is immune to the disease but it thrives among people living in poverty, marginalised communities and other vulnerable populations. At the launch of the National Strategic Plan for Tuberculosis Control 2015 – 2020 and Dissemination of the First National TB Prevalence Survey Report, it was revealed that another alarming concern was the increasing cases of multi-drug resistant tuberculosis.

It has been observed that tuberculosis transmitted through the air put everyone at risk of being infected with the germs in an estimated nine million new tuberculosis cases globally.

The survey also revealed that Nigeria diagnosed and reported only 16 per cent of the estimated tuberculosis cases in 2013, stressing that with this very low TB detection rate, the country accounted for 15 per cent of cases that were either not diagnosed or notified within the period under review.

As at 2013 or thereabouts, the WHO classified Nigeria as the third highest tuberculosis burden country in the world and the first in the African region, harbouring over three million carriers of the disease. The current ranking can be seen as a huge improvement which government at all levels and healthcare givers should strive to improve upon. There is hardly any aspect of the nation’s health life that is free from one affliction or the other.

Notable among them are malaria, diabetes, hepatitis, cardiac diseases, eye and renal ailments. Another related factor is the HIV/AIDS, the disease that breaks down the immune system and exposes victims to opportunistic infections among which is tuberculosis. Then, of course, there are the tobacco-related illnesses that cause pulmonary disorders, leading to tuberculosis. For instance, between five and six million people die of tobaccorelated diseases yearly, while 600 deaths arise from secondary smoking, i.e. those who hang around smokers. Other factors that trigger off tuberculosis include poor hygiene, inability to detect the disease at its inchoate state, ignorance of the symptoms of the disease leading to its spread of the germs and infection of people around the sufferers.

It is, however, gratifying to note that the global efforts to combat the scourge have saved an estimated 54m lives since 2000 and reduced the TB mortality rate by 42 per cent.

 To contain the spread of this highly contagious disease, government must re-strategise to create more awareness among Nigerians especially those living in the rural communities. Many people afflicted by the disease resort to self-medication and may not even be aware of the free medical treatment that is available to them at the various Directly Observed Treatment Short (DOTS) centres across the country.

There is also the need to establish more DOTS destinations in urban and rural areas where tuberculosis cases can be easily diagnosed and treated without delay. Prevention, it is said, is better than cure.

More emphasis should, therefore, be placed on how to prevent people from contracting the disease as well as passing it from those infected to people close to them. Of all contagious diseases afflicting mankind, tuberculosis is about the most dangerous.

We call for more collaboration between the federal government and the relevant WHO agency in combating the scourge. In the same vein, we appeal to Nigerians to avoid practices that are inimical to their health. They should also be more sensitive to the symptoms associated with the disease with a view to accessing treatment at the right time

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