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EDITORIAL

Nigeria And Tuberculosis Burden

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World Health Organisation (WHO)

Nigeria is one of the countries included among the 30 high burden countries for Tuberculosis (TB). Actually, the country is adjudged the seventh most endemic in the world and the second in Africa.  The World Health Organisation (WHO), in its estimates of the incidence of the disease, avers that TB in Nigeria is 322 per 100 000 population with only 15 per cent of the total burden of the disease in the country being notified in 2015.

The world body also declared that Tuberculosis (TB) became a global emergency in 1993 and it remains one of the world’s major causes of illness and death. It is an air-borne infectious disease caused by bacteria, which primarily affects the lungs. It is both preventable and curable and one- third of the world’s population, two billion people, carry the bacteria. More than nine million of these become sick each year with active TB that can be spread to others. Latent TB disease cannot be spread. TB disproportionately affects people in resource-poor settings, particularly in Africa and Asia. The disease poses significant challenges to developing economies as it primarily affects people during their most productive years. International health authorities estimate that more than 90 per cent of new TB cases and deaths occur in developing countries.

In Nigeria, WHO estimates that 210,000 new cases of all forms of TB occurred in the country in 2010, equivalent to 133/100,000 population. There were an estimated 320,000 prevalent cases of TB in 2010, equivalent to 199/100,000 cases. There were 90,447 TB cases notified in 2010 with 41, 416 (58 per cent) cases as new smear positives, and a case detection rate of 40 per cent. On the positive side, 83 per cent of the cases notified in 2009 were successfully treated. However, the main goal of Nigeria’s TB programme is to halve the TB prevalence and death rates by 2015. 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.

It is on record that the TB burden is compounded by a high prevalence of HIV in the country which stands at about 4.1 per cent in general population. The disease is regarded as an opportunistic disease in cases of HIV. This has resulted in an increase of TB patients from 2.2 per cent in 1991 to 19.1 per cent in 2001 and 25 per cent in 2010. Experts believe that the TB situation in the country is HIV-driven. For instance, the proportion of TB patients tested for HIV was 79 per cent in 2010, with a 25 per cent TB- HIV co-infection rate. The age groups commonly affected by TB are the most productive age groups, with the 25 – 34 age group accounting for 33.6 per cent (15,303) of the smear positive cases registered in 2010.

Notable organizations around the world are in the vanguard of efforts to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global tuberculosis epidemic which happens to be the unprecedented world’s most infectious deadly killer with about 4500 lives lost per day.

It is encouraging to note that significant progress has been made in the fight against Tuberculosis, but it continues to be a life-threatening disease that is worsened by many challenges responsible for its prevalence. Diagnosis, treatment and cure, for Tuberculosis continue to be a matter of global concern, especially in the emergence of Multi-Drug-Resistant TB (MDR TB) which poses a major health security threat and jeopardizes long running global efforts to curb the deadly disease. Unfortunately, in Nigeria, TB has assumed a challenging development problem because one of the major factors fuelling its prevalence is poverty.

Sadly, in our opinion, the country has about 152m Nigerians living below poverty line. WHO reports that about two million people die from TB yearly and 10.4 million new cases of TB were reported in 2016, with seven countries accounting for 64 per cent of the burden comprising of India, Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. One factor unites many of these people affected by TB, they are the poor and the disadvantaged who live in impoverished communities with remote access to healthcare. The good news is that TB among PLHIV is preventable and curable; TB drugs are available, free and provided for in many health care centres.





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