It’s time to prevent TB with good nutrition, regular checks
The World Health Organisation (WHO) said an estimated 115, 000 HIV positive people die yearly from tuberculosis in Nigeria, while an estimated 39,000 HIV negative people also die from the disease.
Consultant Respiratory Physician at the College of Medicine Lagos State University Teaching Hospital, Dr. Olayinka Olufunke Adeyeye, said World Tuberculosis Day is set aside to commemorate the time Robert Kochs discovered the germ responsible for tuberculosis. The disease is usually as a result of infection from the germ called mycobacterium tuberculosis.
She said: ‘This germ enters the body, when a person with the active form of the disease coughs, sneezes, spits or have manoeuvres that enable them generate secretions from their throat into the atmosphere. At this time, the germs are shed into the air and individuals can inhale them into the lungs from where the infection gains entrance into the body and can spread to other parts.
“Anyone can be infected with tuberculosis. The disease is quite common in Nigeria. The infection can be in two forms, which include active disease and latent disease. And it is those with the active disease that spread the infection to others. The disease can also affect the lungs tissue alone, which is called pulmonary TB, or affect other parts of the body, known as extrapulmonary TB.
“Nigeria is among the 14 high burden countries for TB, TB/HIV and multi-drug resistant TB. It ranks seventh among 30 high burden countries and second in Africa. The problem of TB has been made worse by the epidemic of HIV infection, and the issues of multidrug resistance.
“It is important that children be immunised at birth with bacillus calmette-guerin (BCG) vaccine. It is also important that cases of TB are diagnosed early and treatment commenced to reduce transmission of disease in households and communities. It is the responsibility of everyone to encourage early treatment seeking behaviour in individuals with persistent cough that lasts more than two weeks, associated with weight loss, excessive sweating, particularly at night or cough associated with bloody expectoration.
“People with HIV infections are particularly at risk and so, people should know their HIV status. There are treatments to be given to such individuals to protect them from developing the disease. Poor housing, homelessness and social deprivations are also catalysts for TB transmission, though it is not a disease of only the poor.”
She noted that treatment for TB is free and available in the direct observed therapy (DOTs) at clinics that are available in virtually all public primary, secondary and tertiary care facilities in Lagos.
“The test to diagnose TB is now very quickly done,” she said. “And it will also detect if the TB will respond to the usual drugs or is the resistant type. This is very important because treatments differ.
“Ordinarily, TB treatment is for six months, with some combination of antimicrobial drugs that will kill the germs and eradicate them, if taken properly without missing doses. The drugs are taken under supervision of a healthcare provider. This is important because erratic drug usage and default from treatment is a major reason for development of resistance.
“When resistance develops, the treatment is more expensive and takes a longer time, with more side effects from medication. When HIV is present, both diseases will need to be treated.”
Adeyeye explained that tuberculosis is a wasting disease, and the drug treatment is essential to getting well.
She said: “Any additional disease like HIV infection and diabetes, among others, if present, need to be treated and the dietary concern addressed. Generally, good nutrition, fruits and vegetables and high protein are important with supplementation and vitamin B6.
“No age is immune to TB, as it affects both the young and old. It affects both sexes almost equally, but after 14 years, it seems to occur more in males. If very severe, it spreads very fast with high fatality.
“My advice would focus on the theme for this year’s World TB Day, which says, ‘It’s Time.’ It is time to increase conversation and advocacy on tuberculosis for early diagnosis and treatment. It is time for everyone to join hands with government and development partners to increase diagnosis, support treatment, and eliminate stigma associated with TB.”
Adeyeye explained that signs and symptoms of TB include cough lasting more than two weeks, cough associated with bloody expectoration, recurrent fever, night sweat and significant weight loss. TB diagnosis and treatment is free.
So, patients should try to get tested and treated. Tuberculosis remains an epidemic in many parts of the world, causing the deaths of nearly one and half million people each year, mostly in developing countries.
Dr. Olusola Adeyelu, a Senior Registrar in the Department of Internal Medicine at the Lagos University Teaching Hospital, said there are sometimes no signs or symptoms. But weight loss, night sweats, swells, water in the chest and chest pains are the early symptoms of tuberculosis.
He said: “If someone is infected with tuberculosis, the patient should visit community health officers, health centres and hospitals with properly trained personnel, community extension workers, and lab scientists and medical doctors, microbiologist for at least six months or beyond, depending on level of improvement or cure.
“Tuberculosis could be prevented, if only government and other donor agencies would provide good housing, nutrition, finance, compulsory and free original medication, train personnel for a follow up of patients, and rehabilitation of present and past patients.
“Tuberculosis care must not follow the HIV way. Some people are living on HIV, while some are living with it. The people living on it are getting richer, while the people living with it are dying. TB treatment must be seen as an enforceable human right in all ramifications, diagnosis, treatment and rehabilitation with a chest physician having a say at all stages, diagnosis and management. A curable disease like Tuberculosis must be cured.”
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