THE TUBERCULOSIS SCOURGE

• The authorities should do more to contain the epidemic

The United States Centre for Disease Control said recently that no fewer than 18 people die in our country every hour as a result of Tuberculosis. This makes Nigeria the first in Africa and the sixth globally to suffer such affliction. Indeed, late last year, Dr. Wondimagegnehu Alemu, World Health Organisation (WHO) Country Representative for Nigeria revealed that on a daily basis, no fewer than 420 fatalities are recorded in our country as a result of the highly preventable and curable disease.

What this suggests is that we are on the brink of a major health crisis. There is therefore the urgent need for more commitment from all stakeholders to tackle the TB burden.

This is a major public health issue that needs to be addressed especially when it is fuelled by large undetected and missed cases. According to Alemu, out of every 400,000 cases in Nigeria, only 100,000 are detected while the remaining 300,000 are missed. To compound the problem, tuberculosis in Nigeria has been made worse by the issues of drug resistant TB and the HIV/AIDS epidemic. Alemu said the highly infectious disease is most often transferred from undetected cases because those that have been detected have the potential to be successfully treated while a missed case has a potential to infect 15 other persons per year. This is frightening especially when it is considered that the 300,000 reportedly undetected cases could infect as many as 4.5 million people annually.

Given the foregoing, we must underline the need to intensify efforts to find all missed cases of tuberculosis in Nigeria for proper management. Until we are able to find and treat missed TB cases, the prevalence of the disease and the death rate will continue to be high. Again, there is the National Tuberculosis and Leprosy Control Programme (NTLCP) which was established in 1989 but officially launched in February 1991, with a mandate to coordinate tuberculosis and leprosy control activities in the country. From Alemu’s perspective, while millions of Nigerians could access healthcare in private hospitals, only 14 per cent of these health institutions in Nigeria actually collaborate with the NTLCP to tackle the disease.

The real mandate of the NTLCP is to help significantly reduce the public burden of the two diseases. The NTLCP is also part of the Federal Ministry of Health which controls most of the funding for work on the disease in Nigeria. But clearly, the figures and facts show the NTLCP is challenged to undertake its responsibilities and we will like to see it strengthened beyond what exists at the moment.

Again, the health authorities in Nigeria must do well to conclude work on the National Strategic Plan for Tuberculosis Control which aims to provide Universal Access to Prevention, Diagnosis and Treatment by 2020 in line with its commitments to the WHO. Of course there are challenges of inadequate funding and technical capacity, but that is where collective participation of both the public and private sectors comes into play.

Religious and traditional institutions should be educated to further enlighten people on the need to report potential cases of tuberculosis for treatment. Active house-to-house case searching should also be initiated to educate the public and detect potential cases, while people living with HIV, children and urban slum dwellers, prisoners, migrants from conflict-ravaged communities; internally displaced people and facility based health care workers should be monitored intensely to ensure they are fit and free from the disease.

Unless proactive measures are collectively taken, we may continue to have high death rates from tuberculosis.