Tuberculosis (TB) is still one of the major threats to humankind, being the first known cause of death by an infectious disease worldwide. TB is a communicable chronic disease that every year affects 10 million people and kills almost two million people in the world.
The main factors fueling the disease are progressive urbanization and poverty-related socio-economic factors. Moreover, the lack of effective tools for TB diagnosis, prevention, and treatment have decisively contributed to the lack of an effective model to predict TB spread.
Tuberculosis is caused by a bacteria (Mycobacterium tuberculosis) that most often affect the lungs. It is, however, curable and preventable. The disease is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
Medical experts aver that people infected with TB bacteria have a 5–15 per cent lifetime risk of falling ill. Persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a higher risk of falling ill. When a person develops active TB disease, the symptoms (such as cough, fever, night sweats, or weight loss) may be mild for many months. This can lead to delays in seeking care, and results in transmission of the bacteria to others. People with active TB can infect 5–15 other people through close contact over the course of a year. Without proper treatment, 45 per cent of HIV-negative people with TB on average and nearly all HIV-positive people with TB will die WHO said.
Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk. People who are infected with HIV are 19 times more likely to develop active TB. The risk of active TB is also greater in persons suffering from other conditions that impair the immune system. On symptoms and diagnosis of TB, WHO identifies common symptoms of active lung TB to include cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats. Many countries still rely on a long-used method called sputum smear microscopy to diagnose TB.
Laboratory technicians look at sputum samples under a microscope to see if TB bacteria are present.
According to WHO, between 2000 and 2015, an estimated 49 million lives were saved through TB diagnosis and treatment. At least one-third of people living with HIV worldwide in 2015 were infected with TB bacteria. People living with HIV are 20 to 30 times more likely to develop active TB disease than people without HIV. HIV and TB form a lethal combination, each speeding the other’s progress. In 2015 about .4 million people died of HIV-associated TB. About 35 per cent of deaths among HIV-positive people were due to TB in 2015. In 2015 there were an estimated 1.2 million new cases of TB amongst people who were HIV-positive, 71 per cent of whom were living in Africa. WHO recommends a 12-component approach of collaborative TB-HIV activities, including actions for prevention and treatment of infection and disease to reduce deaths.
To address the risk for TB transmission to uninfected persons, the World body recommends implementation and scale-up of TB infection control measures, including managerial (leadership and commitment for establishing and implementing infection control policies at the health facility), administrative (prompt identification and separation of persons with presumptive TB, with timely diagnosis and treatment of TB patients), and environmental (optimization of building design and patient flow to reduce the concentration of TB droplet nuclei in the air and control directional flow of potentially infectious aerosols) measures and personal protective equipment (PPE) use, implemented in conjunction with other infection control measures, to reduce the risk for TB transmission in health care facilities.
A serious setback to the quest to eradicate tuberculosis is the stigmatization of those already infected by the disease. Stigmatization is a social determinant of health. Similarly, the public should be made aware that treatment for uberculosis is free and paid for by the government, therefore those who suspect that they may have TB should feel free to seek medical help immediately.
In Nigeria, the rapid urbanization along with unprecedented population growth is causing TB to be endemic. According to the WHO, Nigeria is one of the countries with a high burden of tuberculosis (TB) worldwide. In 2016, the prevalence of TB among HIV-negative people was 27 per cent in Nigeria. TB incidence rate (new and relapse cases) was 158 per 100,000 people, while the total number of TB mortality was 39,933 deaths in 2016.
This statistic, in our opinion, is alarming and calls for urgent measures on the part of health authorities to monitor and control the disease.