How To Combat Rising Cases Of Tuberculosis In Nigeria – Health Expert
A Pulmonologist specialising in lung and other respiratory conditions, Dr Kingsley Osagie has stated that Nigeria needs to involve more voices in the fight against Tuberculosis.
Dr. Osagie, Chief Consultant and pulmonologist at the National Hospital Abuja pointed out that the country needs strong voices and influential persons to support the cause of eradicating the rising cases of the disease.
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The consultant told THE WHISTLER in an exclusive interview that tuberculosis remains a significant top public health concern globally, which is also taken as a public health challenge in Nigeria.
Tuberculosis, popularly called TB, according to WebMD is a contagious infection caused by a type of bacteria called Mycobacterium tuberculosis. It usually attacks the lungs and can also spread to other parts of the body, like the brain and spine.
It is said the bacteria spread through the air and can be contracted through tiny droplets of an infected person.
“Tuberculosis thrives among people with HIV/AIDS and others with weakened immune systems.
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“People with latent TB show no sign, however, active TB shows symptoms, which include cough that lasts more than 3 weeks, chest pain, coughing up blood, fatigue, night sweats, chills, fever, loss of appetite and weight loss.”
High Tuberculosis Profile
According to him, the contagious disease accounts for around 9 million identified cases each year.
He stated that there are 22 high-burden TB countries, with Nigeria oscillating between fifth and sixth place.
He stated that Nigeria occupies the number one TB position in Africa, “though it sometimes shares this with South Africa,” and that, while the World Health Organization (WHO) has continued to advocate the fight against tuberculosis (TB), Nigeria still has a large number of TB missing cases.
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How To Track Missing TB
He stated that in order to track missing TB cases, there is a need for increased budgetary provision, local industry involvement, and getting TB Champions — Those with money and influence in society.
“We need a strong TB voice in Nigeria,” he stated, noting that the previous First Lady of the Federal Republic of Nigeria made efforts in that direction.
According to Dr Osagie, the Federal Government needs to prioritise owning the Tuberculosis Programme; the Global Fund— an active organ of WHO that provides major funds used in running the TB programme globally.
He noted that more diagnostic Centres need to be created with adequate community-based officers engaged in the act of locating these missing cases from the communities.
He said while TB drugs are free, there is a need to ensure that they are accessible to TB patients through increased monitoring and evaluation, and that loss to follow-up TB cases remains a challenge; thus, “we need operational research to determine why,” including having an adequate TB linkage system to harvest the missing cases.
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Government Should Invest In Technology
He stressed the importance of the government investing in technology by purchasing more GeneXpert machines for TB diagnosis.
Furthermore, Osagie stated that the HIV management programme should be optimised by incorporating INH prophylaxis into the HIV/TB program, given that HIV is a major contributor to the increase in TB cases.
Isonicotinic Acid Hydrazide(INH) prophylaxis also known as Isoniazid prophylaxis therapy is a significant public health intervention to prevent the progression of latent tuberculosis to active tuberculosis disease among people living with HIV, he explained.
Equipped To Address “High Pill Burden”
Dr Osagie said there are primary and secondary Drug Resistant Tuberculosis (DR-TB) that pose a concern in Nigeria as well as insufficient diagnostic instruments such as the geneXpert machine, Line Probe Assay (to detect drug resistance tuberculosis ), and treatment facilities, pointing out that, “we are treating some in the community now.”
He also addressed the “high pill burden” in the country, stating that TB patients may need to take approximately 15 to 16 tablets of TB doses daily, highlighting the long treatment term of roughly 20 to 22 months or 9 to 11 months for short treatment.
He added that the emergence of PreXDR (Pre-Extensively Drug-Resistance) and XDR (Extensively Drug Resistance ) Tuberculosis, drug side effects, and stringent follow-up procedures among others is also a burden to bear.
“We must be equipped to detect these cases and when we find them we must be ready to offer standard treatment using Directly Observed Therapy.
“We must be ready to deal with issues of loss to follow up, encourage patients and their treatment supporters to follow recommended guidelines in the management of Tuberculosis,” he recommended.
Increase TB Advocacy
He called for increased TB advocacy noting that the awareness rate in Nigeria is very low, adding that, “The Government can certainly do more.
“The Government can increase awareness by doing Advocacy;
“Adequate communication with the aim of informing the people on the burden of TB means of identifying presumptive cases, diagnosis, availability and accessibility of treatment options, that treatment is free.
“Government should translate messages into local languages, put up jingles on Radio/TV, erect billboards, employ and empower more community-based persons to disseminate this information, fish out those with cough and encourage them to go for testing and treatment, emphasising that “they are free.
