Lagos-Ogun cross-border TB new target for control

A new intervention is expected to catch undetected cases of tuberculosis migration between Lagos state and neighbouring border communities of Ogun state. The Challenge TB programme, funded by the United State Agency for International Development and run by KNCV, is concerned about cross-border migration of TB between both states. It has chosen Ogun—and Nasarawa—to be […]

A new intervention is expected to catch undetected cases of tuberculosis migration between Lagos state and neighbouring border communities of Ogun state.

The Challenge TB programme, funded by the United State Agency for International Development and run by KNCV, is concerned about cross-border migration of TB between both states.

It has chosen Ogun—and Nasarawa—to be included in the 12 states with the highest TB burden where it works.

Many patients living in Ogun and working in Lagos migrate between both states in the midst of their treatment and fail to complete cure, or are among undetected cases of the disease.

“Working in Lagos without factoring in Ogun is just taking care of half the problem,” said Dr Festus Soyinka, Ogun state tuberculosis, leprosy and buruli ulcer control officer.

“It is a mobile population. With an arrangement that covers the two states, there could be a cross-border intervention between Lagos and neighbouring Ogun mobile communities. A lot of them have become slums which are also areas of importance in terms of TB control.”

“Where they reside is not where they work. We have seen the effect of this on treatment and completion rate and cure rate. And where we are not curing our patients that we are detecting, because they are treated halfway or we lost them to follow-up, it also gives grounds for development of resistant TB strains, which is one of the biggest problems the programme is battling with now.”

Ogun is also looking to create awareness about TB that matches awareness about HIV/AIDS and malaria, including a mobile van to go into under-served communities without organised health systems that can actively search for TB.

Many cross-border migration of TB are unaccounted for. KNCV started a baseline assessment of TB prevalence in Ogun last week ahead of the start of its programme funded by a five-year USAID grant.

It has marked five local government areas that fall touch the Lagos border.

“The basic thing is for us to find TB cases and treat them,” said Dr Nkem Chukwueme, senior regional programme manager for KNCV Lagos region.

Around the world, 22 countries account for 80% of TB cases.

Nigeria is first in Africa and fourth globally, with 12 states—where KNCV currently works—accounting for nearly half of all TB cases. But only 15% of possible TB cases are detected.

“That means for every six cases in a community, only one is identified, so where are the other five cases?” said Chukwueme.

“We decided there were additional states to be incorporated.”

Ogun state has welcomed its inclusion in the 14 states where international funding will help active search and treatment of TB cases.

“We need a strategic plan,” Ogun health commissioner, Dr Babatunde Ipaye, said in talks with KNCV officials at the start of the baseline assessment in Abeokuta.

“But I also plead with you, once you develop your strategic plan, please assist in first-year operational plans, so it becomes implementable from the get-go.

“It is usually better for the people who conceive the idea, who have seen it work, to actually help develop a first-year goal.”