Over the years, the gap in tuberculosis case identification has been a major challenge in the country.
Nigeria is listed among the 30 high-burden countries for tuberculosis and as of 2020, the estimated incidence of TB was 452,000 cases; out of which, 138,591 were diagnosed and notified.
Based on this, experts and stakeholders have called for better measures to control and eradicate the disease and are urging the Federal Government to invest more in acquiring the GeneXpert machines, which are vital tools in the fight against TB.
They made the call as Nigeria joined the global community to mark the 2024 World Tuberculosis Day. Pulmonologists specifically called for increased investments to achieve the goal of eradicating tuberculosis by 2030. They noted that the FG could invest in ending TB by increasing funding for TB control programmes.
PUNCH Healthwise reports that the 2024 World TB Day is celebrated on March 24, with the theme, ‘‘Yes! We can end TB!’
The World Health Organisation described TB as a communicable disease that affects the lungs and is caused by a bacterium called Mycobacterium tuberculosis, which spreads through the air when an infected person coughs, sneezes, spits, or laughs boisterously.
WHO noted that TB remains one of the world’s top infectious killer diseases with more than 10 million annual cases and one million deaths recorded.
According to the global health organisation, Nigeria has the highest burden of TB in Africa and ranks sixth among the 30 countries globally with the highest burden of the disease.
The WHO targets to end TB by 2030 by reducing its incidence by 80 per cent and deaths by 90 per cent.
Recently, the National Programme Officer for TB for the WHO, Amos Omoniyi, said there were 97,000 TB-related deaths in Nigeria, amounting to 23 per cent of 2.4 million deaths in the African region.
He also noted that despite Nigeria accounting for the high burden of a disease that is preventable and treatable, it still has a 70 per cent funding gap in programmes meant to curb its spread.
Speaking exclusively with PUNCH Healthwise in commemoration of World TB Day, the experts lamented that stigmatisation, lack of GeneXpert machines, poverty, and other factors contribute to the country’s persistently high TB prevalence.
A Consultant Pulmonologist, Dr Modupe Ogunshina stressed that though a variety of factors contribute to the nation’s rising TB burden, poverty is a key driver in its spread.
She said, “I think factors responsible for the high rates are multifactorial. So we first of all talk about the knowledge of the people on TB itself. There are still some people who are not following the advice that if you cough for two weeks, visit the hospital.
“Poverty is a driving force and has continued to be a driving force. And you know that in the last few years, Nigeria’s economy has been very challenging and we believe that with God, we will have a better solution.
“The spread of TB and the increase we have is multifactorial; they are interconnected. You can’t take one single thing and say this is the only reason, there are so many of them.”
The Pulmonologist, however, maintained that there is a need for collaboration in addressing the social and economic factors that contribute to the spread of TB.
She added, “To end TB will take a multi-dimensional approach. One of the key things is the barrier to diagnosis, which is the gold standard for diagnosis of TB, the GeneXpert machine. I think maybe it’s more like a rate-limiting factor.
“There is a need to have more Genexpert machines across the country. Yes, I know we also have the challenges of light and all. But what we use to diagnose is key and that is the GeneXpert machine.”
“I know that the government is trying to have dispatch riders that carry samples to where they can be tested but the more machines we have, the more tests that can be carried out, and that means the results turn around timing will be much shorter. This will also make the commencement of patients’ treatment faster.
“So, one key thing is to increase the number of GeneXpert machines we have. I believe there are capable hands that can manage and operate the machines if they are available. But the thing is, by the time you provide the GeneXpert machine, don’t forget that it’s a cold-sensitive machine and needs constant electricity. There’s a need to get a constant cold environment, otherwise, the machine will spoil the results, and so many other things.
“So, diagnosing TB can be much easier, faster, if you have more GeneXpert machines, and available in more locations. Yes, there are other things that the government does because they are found. We have to diagnose using the X-ray and all. But let’s even have more machines first. Then we can go a step further by providing other artilleries for diagnosing TB,” she stated.
On the government’s effort in terms of treatment, the physician said, “I believe the government is trying. Drugs are available. Once patients are diagnosed, which is what the programme is all about, they access drugs in the nearest place to their homes. This is so that they will not say transportation made them not to I come.
“So, the treatment and drugs are available. We only need to ensure we get patients diagnosed. Well, nothing is perfect. There might just be some lapses. At least that is fair.”
On his part, a pulmonologist at the Olabisi Onabanjo University Teaching Hospital, Dr Tope Oni, said there is a need for the FG to improve diagnosis and treatment of TB infection.
He noted that new technologies and strategies are needed to achieve the 2030 goal, adding that Nigeria must step up efforts to provide quality TB care for all.
Oni called for increased investment and action to end TB, urging the government at all levels to invest in GeneXpert machines.
The pulmonologist noted that the machines are a vital tool in the fight against TB.
He said, “These machines can quickly and accurately diagnose TB, including MDR-TB. They are also portable and can be used in remote areas where other diagnostic tools are not available.
“One of the biggest challenges in eliminating TB is the emergence of drug-resistant strains of the bacteria. Over the past decade, there has been a rapid increase in the number of cases of multidrug-resistant TB (MDR-TB). These strains are more difficult to treat and have a higher mortality rate than non-resistant forms of the disease.
“New drugs are needed to fight multidrug-resistant TB, as well as improved diagnostic tools to detect it.”
Similarly, the Head, Grant Management, Global Fund, Mark Eddington said the country must maintain the advancements made in research and development, such as additional treatment and preventive regimens, vaccinations, and improved instruments for diagnosing TB.
While lamenting that TB treatment is underfunded in Nigeria, Eddington said the government need to increase its investment to be able to eradicate the disease by 2030.
“We would like the government to maintain and increase its investment in TB.
“We would like to see significant investment in TB. Tuberculosis is dramatically underfunded in Nigeria.
“Nigeria used to detect about 100,000 cases of TB a year. That has increased three times and so Nigeria is now finding about 90 per cent of such cases, which is an estimate.
“The trouble is to treat these cases, we need significantly more investment than is currently in the system. So what we would like to see from the FG is to step up investments in health, maintain the gains, and continue to make real progress,” he said.
