We need to create more awareness about TB in Nigeria

We need to create more awareness about TB in Nigeria

WITH over 480 000 people

affected with multidrug-resistant tuberculosis, MDR-TB, in 2013 globally, Nigerian researchers have identified awareness creation on the prevention, management and treatment of Tuberculosis, TB, in communities remains as panacea to reducing the burden of the disease in Nigeria.

Meanwhile, the World Health organisation, WHO, has called on countries of the world to intensify efforts aimed at ending TB burden in the world.

Statistics from the WHO show that an estimated 9 million new cases of TB occur globally, out of which three million cases are missed, either not diagnosed, not treated or diagnosed but not registered by the National TB programmes, NTPs.

Researchers at the Nigerian Institute of Medical Researcher, NIMR, who spoke in Lagos are worried that Nigeria remains among 11 high TB burden countries that contribute 15 percent of the three million missed cases of TB, globally.

Decrying that it is unacceptable that Nigeria ranks 3rd among the 11 countries, they said despite control efforts by the Federal Government, Nigeria does not  meet any of the Millennium Development Goals, MDG, 3 targets in reducing TB incidence, prevalence and mortality rates.

The Director- General, NIMR, Prof. Emmanuel Ujah, said the death toll from the disease is still unacceptably high and efforts to combat it must be accelerated if the global targets, set within the context of the MDGs, are to be met.

Ujah  who enumerated the ongoing strategies in conducting research on TB said 2015 marks a transition from MDGs to post – 2015 development frame, adding that within the context, the WHO has developed a post – 2015 global TB strategy called “the End TB Strategy”.

The goal of the strategy is to end the global TB epidemic by 2035 with targets of 95 percent reduction in TB deaths and 90 percent reduction in TB incidence. The strategy also targets a zero catastrophic costs for TB affected families by 2020.

He emphasised the need to intensify efforts towards reaching those that have been infected but do not have the information on where to access the diagnosis and treatment.

Ujah argues for need to also intensify outreach efforts to at – risk communities and slums, screening of HIV infected individuals for TB, capacity building through training and research, adequate laboratory support system, treatment and funding.

In his contribution, Head, NIMR Research Group, Prof. Oni Idigbe said if diagnosed and managed effectively, TB is curable.   “We have all the weapons to diagnose and manage the disease but by 2015, TB remains a big challenge.  It was documented that 37 million people were cured of TB within 2010 and 2013 because they were effectively diagnosed and efficiently cured using the right congregation of drugs. Why are we having new cases of TB?

On the three million detected people that are lost due to lack of care, he lamented that one case of TB has the potential of infecting 12 people every year. “You can now imagine how many people these three million people would have infected every year. That is why WHO in the past three years had insisted that we locate these three million people to make sure we get them treated  and cured  and that is the only way we can get to zero TB world.”

''The burden of TB in Nigeria was further made worse by challenges of HIV co-infection, drug-resistant TB and TB among children.  'We are even going beyond multi drug resistance TB cases as we are now having cases of Extremely Drug Resistant TB in Nigeria,

''Even with all the efforts of the  Federal Government in  providing substantial human and financial resources to control TB in Nigeria, many people still do not make themselves available for treatment.

''This shows that we still need to reach out to those people in the rural communities where TB cases seem to be rampant and educate them to curb the spread of the disease, '' he said.

Challenges: “We are also having challenges because; we are not enforcing adequate legislation to control TB drugs. Ideally for all the National programmes across the world you get your drugs from the global drug facility which is a division in stop TB partnership and then for the second line drugs, it's absolutely controlled by what you call the green light committee of the stop TB partnership but hope is not lost, all these TB drugs we are talking about were developed about 40 years ago but I tell you that there are two new TB drugs that have just come into the pipeline. There is the one we call the Bedaquiline  and then the celadadmin, all of these drugs when they come in they have the potential of changing the epidemiology of TB, because these drugs can cure both susceptible and resistant TB, but our fear is that let us not mismanage these drugs.”

In his lecture tagged; “Efforts on Tuberculosis Control”, Clinical Sciences Division, NIMR, Dr Dan Onwujekwe noted that DOTS is still an assured strategy for TB control and that innovative non –DOTS modifications achieved high acceptance treatment success rate in NIMR as one stop shop facility for HIV/TB management.

He noted that health workers managing TB/HIV should assess and factor in individual patient constraints in devising innovative ways of improving TB treatment outcomes.

“We can reach, treat and cure TB through innovation approaches to improve treatment completion, working in collaboration with community – based organisations,” he added

Meanwhile, the WHO is calling for “global solidarity and action” to support a new 20-year strategy, which aims to end the global tuberculosis epidemic.

The world health body decried that an estimated 1.5 million people still die of tuberculosis each year.  The disease frequently has devastating economic consequences for affected families, reducing their annual income by an average of 50 percent, and aggravating existing inequalities.

“This is a matter of social justice, fundamental to our goal of universal health coverage. Each and every man, woman or child with TB should have equal, unhindered access to the innovative tools and services they need for rapid diagnosis, treatment and care,” says Dr Margaret Chan, WHO Director-General.

SPEAKING, DR MARGARET CHAN, WHO DIRECTOR-GENERAL SAID 2015 IS SEEN AS A CRITICAL YEAR FOR ACTION TO ADAPT AND ROLL OUT THE STRATEGY IN DIVERSE COUNTRY SETTINGS. ACHIEVING SUCCESS FOR THE STRATEGY WILL REQUIRE THE TB COMMUNITY AROUND THE WORLD TO WORK TOGETHER TO LEVERAGE ALLIANCES AND RESOURCES.

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