World TB Day 2024: Nigeria’s tuberculosis scourge persists

TUBERCULOSIS, a lung disease that afflicts millions of people worldwide, is dangerously on the march in Nigeria. A new report by the National Tuberculosis and Leprosy Control Programme noted that Nigeria alone accounted for 23 percent of deaths resulting from TB in Africa. This burden is huge.

The report states that undetected TB carriers in the country are capable of infecting between 12 per cent and 15 percent of the country’s population annually. This is disturbing, primarily as other diseases like Lassa fever, malaria and meningitis are ravaging Africa’s most populous country.

In 2022, 1.3 million died of tuberculosis, per the World Health Organisation, which has set aside March 24 (today) annually to raise awareness about the disease. The WHO says, “The theme of World TB Day 2024 – ‘Yes! We can end TB!’ – conveys a message of hope that getting back-on-track to turn the tide against the TB epidemic is possible through high level leadership, increased investments, and faster uptake of new WHO recommendations.”

The National Coordinator of NTBLCP, Laraban Shehu, at the 2024 Pre-World TB Day news conference in Abuja, the country’s capital, revealed that Nigerians are dying daily from the disease.

Shehu, who regrets that Nigeria has a huge funding gap as 17 percent of its TB budget is not funded, states that the country requires $300 million to bridge the gap. For Nigeria, this is a massive sum in an era of naira depreciation.

“The meaning of this is that in Nigeria, every five minutes, one person dies of TB,” Shehu said. “So, this is the disease killing people more than the number of people that died of COVID. And the regrettable thing is that this is a disease that is curable and can be prevented.” This is alarming.

In an updated list released in June 2021, Nigeria remained among the 30 countries named by the WHOas “high burden countries for TB” along with several countries (Sierra Leone carries the heaviest burden) and Brazil. The list is for the 2021-2025 period. Nigeria is also among the list of countries burdened with HIV-resistant TB. However, Cambodia, the Russian Federation and Zimbabwe “transitioned out” of the worst-burdened list in 2021.

A contagious lung disease, TB is caused by a bacterium, Mycobacterium tuberculosis, which can attack any part of the human body such as the spine, the brain, or the kidney. The infection creates either of two conditions: the TB disease, ora latent TB Infection that luckily, may not result in sickness.

But the TB disease, if untreated or not treated properly, can be fatal, warns the US Centers for Disease Control and Prevention.

It remains a major public health problem globally and is one of the leading causes of death worldwide. An estimated 9.9 million people developed TB in 2020, with Nigeria having the highest number of TB cases in Africa and accounting for 4.6 per cent of the Global TB burden (WHO Global TB report 2021) alongside a high triple burden of TB, Drug Resistant-TB, and HIV-associated TB.

The European Respiratory Reviewposits that thetotal eradication of the disease is far off “due to the lack of a completely effective vaccine and large reservoir of people infected with latent tuberculosis.”

The symptoms of the disease include persistent cough, chest pain, tiredness, night sweats, fever, and appetite and weight loss.

The TB Disease is often more severe in children less than 15 years, with higher mortality amongst those less than five years. The notification of children with active disease and latent TB has remained abysmally low, accounting for just 6.0 per cent (out of the country’s total of 450,000) of all forms of notified TB cases in 2021, according to KNCV Nigeria, a non-profit non-governmental organisation focused on the eradication of the disease in Nigeria.

For now, Nigeria is ranked the sixth country with the highest number of TB cases globally. The country, in 2021, contributed 4.4 percent to the total TB cases globally.

Data from the WHO show that two-thirds of the global TB cases are found in eight countries. These countries are India (28 percent), Indonesia (9.2 percent), China (7.4 percent), the Philippines (7.0 percent), Pakistan (5.8 percent), Nigeria (4.4 percent), Bangladesh (3.6 percent), and the Democratic Republic of the Congo (2.9 percent).

Earlier this year, the Coordinating Minister of Health and Social Welfare, Muhammed Pate, noted that in 2023, the country reported over 300,000 new cases of TB, marking the first time in history that such a number will be recorded.

Thankfully, TB is both preventable and curable. National and sub-national initiatives should therefore be stepped up to locate all infected persons through increased testing and place them on treatment.

Public awareness programmes should feature collaboration among the three tiers of government, NGOs, international aid agencies, faith-based organisations, communities and educational institutions.

The Federal Ministry of Health in its 2019 Annual TB Report bemoaned the low treatment coverage of 27 per cent nationwide and the huge number of missing TB cases. It should partner with its 36 state counterparts to reverse this trend.

There should be increased funding, training of health workers and outreach activities. As persons living with HIV are more susceptible due to weakened immunity, special attention should be paid to them.

Children should be regularly tested. States and local governments should revive the primary heath care centres.

Government at the three tiers should key into multilateral programmes aimed at subduing the TB scourge, attracting financial, material, and technical support. They should create awareness programmes and sustain such through the traditional and social media platforms on the dangers and care for TB.

There should be special programmes to curtail the spread of the disease in the prisons and detention facilities. Animals designated for sale should be vetted to determine whether they are not infected with latent TB.

Furthermore, the government should support local manufacturing of TB drugs in Nigeria to reduce dependence on importation and the proliferation of fake medicines. Through concerted efforts, the TB advance must be halted.