Nigeria and tuberculosis

Nigeria wears many badges of dishonour but has just been reported to be in yet another black spot on tuberculosis (TB) index rate, occupying the fourth position in the world behind Indonesia, China and Russia and topping the list in Africa. This is even with the assertion by the minister of health, Isaac Adewole, that 80 per cent of TB cases in Nigeria remain undiagnosed. According to him, Nigeria is only able to diagnose roughly one out of six TB cases. This is indeed a very bad place to be and the country must do the utmost to exit immediately.

Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air, which can happen when someone with the untreated, active form of TB coughs, speaks, sneezes, spits, laughs or sings. So, one is more likely to get tuberculosis from someone he or she lives or works with. Although, anyone can be infected with TB, certain factors can increase the risk of the disease. These factors include weakened immune system, which makes the human body ineffective in mounting defence. This weak immunity can be occasioned by a disease condition such as HIV/AIDS. Thus experts say that since the 1980s, the number of TB cases has increased because of the spread of HIV, the virus that causes AIDS, as HIV infection suppresses the immune system. As a result, people with HIV are many times more likely to get TB.

Other predisposing factors include traveling or living in certain areas, especially countries that have high rates of TB and drug-resistant tuberculosis; poverty, substance abuse and tobacco use. Furthermore, where someone works or lives may also be a risk factor. For instance, a health worker having regular contact with TB patients without wearing a mask and doing frequent hand-washing may be at risk.

Similarly, people who live or work in a residential care facility such as prisons, immigration centres or nursing homes are all at higher risk of tuberculosis. This is because the risk of the disease is higher anywhere there is overcrowding and poor ventilation. In addition, living in a refugee camp such as the internally displaced persons (IDPs) camps or shelter characterised by poor nutrition and ill-health, overcrowding and unsanitary conditions, promotes high risk of tuberculosis infection.

TB symptoms can mimic many different diseases. Some of the signs and symptoms of TB are coughing that lasts three or more weeks; coughing out blood; chest pain, or pain with breathing or coughing; unintentional weight loss; fatigue; fever; night sweats; chills and loss of appetite.

It is a sad commentary on the nation’s health care system that Nigeria remains in a black spot on TB index rate. So, all must work together to change this narrative. Achieving this, requires intensifying awareness campaign to educate Nigerians on the realities of TB and let them know that it can be prevented, treated and cure if diagnosed early, and the services are free. Thus, there is need for improved working relationship between the media and the health sector as the media can help raise awareness and educate citizens on the prevention, diagnosis and treatment of TB.

In addition, government at all levels and religious leaders should embark on massive enlightenment programmes to sensitise the citizens on the prevention and treatment of TB and where they can access free treatment. Also, citizens should be enlightened on the nature of the disease and symptoms; and the need to quickly visit nearby medical centres for early diagnosis and treatment. Health-related non-governmental organisations should embark on massive sensitisation on the prevention and treatment of the disease. Individuals and parents should also take personal responsibility for their health and that of their children. Therefore, against the backdrop of the fact that TB is preventable in children through the administration of bacilleCalmette-Guerin (BGC) vaccine, parents should ensure that their children are immunised with BCG at birth. And it is free! For those, already infected, without treatment, TB can be fatal; therefore, it is a threat to their health. So, they should go for diagnosis and treatment, which are free too. With increased understanding of TB, public-health initiatives, and treatment, Nigeria should soon be out of the black spot on tuberculosis (TB) index rate.