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Checking spread of tuberculosis



TUBERCULOSIS (TB) is an infectious disease. It is the second biggest killer disease  in the world. Reports have it that tuberculosis could be traced back to 18th and 19th centuries, when a tuberculosis epidemic rampaged Europe and North America, before the German microbiologist, Robert Koch discovered the microbial causes of tuberculosis in 1882.
Following Koch’s discovery, the development of vaccines and effective drug treatment led to the belief that TB was almost wiped out. The United Nations at one point predicted that tuberculosis would be eliminated worldwide by the year 2025.
Unfortunately, it was not so. In the mid-1980s, TB cases began to rise worldwide, so much, that in 1993, the World Health Organization (WHO) declared TB as a “global emergency;” the first time that a disease had been labeled as such.
Often times, people pay little or no attention to the issue surrounding tuberculosis. In 2015, it was reported that millions of people died from the disease, with 10.4 million falling ill. That’s alarming, one would say.
Another report by the World Health Organization (WHO), estimated that nine million people a year get sick with TB, with three million of these “missed” by health systems.
Another  issue of concern is the WHO ‘s report that tuberculosis is among the top three causes of death for women aged 15 to 44.This calls for serious sensitization about the disease.
A medical practitioner, Dr John Onyiora, said that tuberculosis is an airborne pathogen. That means that the bacteria that cause TB can spread through the air from person to person. It affects the lungs and can spread to other organs around the body.
He listed symptoms of tuberculosis as cough, night sweats, fever, and weight loss and so on. These symptoms, he said, may be mild for many months, and people with TB can infect up to 10-15 other people through close contact within a year.
According to him, there are two kinds of tuberculosis infection: Latent TB and Active TB .In latent TB, the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active. While in Active TB, the bacteria do cause symptoms and can be transmitted to others.
Throwing more light to it, Dr Onyiora said that about one-third of the world’s population was believed to have latent TB. He explained that there is a 10 percent chance of latent TB becoming active. He pointed out that the risk is higher in people living with HIV or malnutrition or people who smoke.
Another medical personnel in Enugu, Dr Edwin Okeke, said that TB affected all age groups and all parts of the world. However, the disease mostly affects young adults and people living in developing countries.
According to him, Nigeria is faced with the challenge of tackling the spread of tuberculosis. It was reported that not less than 18 Nigerians die of tuberculosis every hour, totaling 432 deaths daily.
The World Health Organization ranks Nigeria as having the second highest incidence rate in Africa and 7th among the 30 high TB burden countries in the world.
WHO’s report said  “every hour, 47 Nigerians develop active TB, seven of who are children”, even as Nigeria is ranked among the 14 high burden countries for TB.
Acting Coordinator, Non -Communicable Diseases Cluster, WHO, Dr Linda Ozor, at the 1st National Summit on Public Private Mix (PPM) for TB Control, held in Lagos, this year, while quoting the 2017 Global TB Report, said Nigeria was among the 10 countries that accounted for 64 percent of the global gap in “missing TB cases”.
Ozor, who represented the WHO Country Representative, Dr Wondimagegnehu Alemu,  said it was essential to engage the private corporate organizations and private health institutions to commit to take TB control as one of their corporate social responsibilities.
In her words:, “More worrisome is the fact that every hour, 18 Nigerians die of TB, a disease that is preventable and curable. This is not simply statistics, behind these figures they are humans. The disease in Nigeria is further fuelled by the large number of undetected TB cases (missing cases), which serve as pool of reservoir for the continuous transmission of the disease. Each undetected TB case has potential of infecting 10-15 persons.
Ozor said that Nigeria increased its tuberculosis detection rate from 17 percent to 24 percent (41 percent increase) and declared 2017, year for accelerated TB case finding. She however disclosed that outstanding challenges were being addressed collectively by stakeholders to get a breakthrough in the fight to end tuberculosis.
She went further to say that, among the challenges are how to find the remaining 300,000 cases which are still missed by the health sector. Of the total 400,000 cases, only 100,000 were reported. In Lagos State, of the three expected cases, two are missed.”
Expanding quality TB diagnostic coverage nationwide, both optimisation of the existing gene Xpert diagnostic machine (390 and increasing awareness of the general public) were also among the challenges faced in Nigeria.
The spread of tuberculosis in Nigeria is worrisome. In the South East zone, the cases are there and there is a health centre that manages the disease .Lagos State was said to have the highest estimated burden of TB cases in the country.
Commissioner for Health in the State,  Dr. Jide Idris, said the development was by virtue of the state’s large population density and metropolitan nature of Lagos.
He said that at the moment, there are 926 TB treatment centres, covering all 57 local government areas and development centres, 108 TB microscopy and 30 GeneXpert sites with at least one machine in each of the 20 local government areas.
As expected, one would say the federal government should rise up to its responsibility.. Well, recently, the  Minister of Health, Prof Isaac Adewale, at a symposium on tuberculosis, themed: ‘Raising Future Leaders To End TB in Nigeria,” held  in Bingham University Karu, Nassarawa State, stressed the need for concerted efforts towards the reduction of the burden of tuberculosis disease in Nigeria.
Represented by the permanent secretary, Federal Ministry of Health, Clement Uwaifo, Adewale said that  Nigeria was one of the countries on the list of 30 high burden TB, TB/HIV and MDR-TB countries as compiled by the World Health Organisation (WHO).
He added that the Federal Ministry of Health, as part of its efforts to coordinate and control TB in Nigeria, established the National TB and Leprosy Control Programme in 1989. He noted that the TB control strategies in Nigeria since the inception of TB have been in consonance with all the WHO recommended strategies
According to him, “the new WHO End TB strategy for the control of the disease was adapted by the country in 2016 with the goal of ending TB epidemic in Nigeria. Presently, research discoveries has made available a WHO approved rapid TB diagnostic tool with higher specificity and sensitivity”.
Well, the federal government and stakeholders should give ears to the advice of the Dean, Faculty of Health Sciences, Bingham University, Karu, Prof. Lovett Lawson, if the fight against the spread of tuberculosis in Nigeria must be won.
Professor Lawson,  in a  symposium on tuberculosis, advised  stakeholders to create more awareness about tuberculosis by increasing funding for TB activities, ensure access to TB treatment and support people that are on treatment for TB, among many others.
He said, “No doubt we continue to make tremendous progress in the fight against TB as a nation, with significant improvement in early diagnosis and treatment especially with the adoption and increasing use of GeneXpert machines in most centres and availability of drugs for those infected all over the country, there still remains a huge burden of TB in Nigeria. Of the global deaths, Nigeria is far worse affected than any other country in Africa”. A call for concern  and a challenge  for all stakeholders.”

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