What to know about tuberculosis

TB is the world’s top infectious killer disease and remains a major public health problem in Nigeria. The country is classified among those with high burden for TB, TB/HIV and Multi-Resistant Tuberculosis (MDR-TB). Some symptoms of tuberculosis include cough lasting longer than two weeks in normal individuals, and any current cough in People Living with […]

TB is the world’s top infectious killer disease and remains a major public health problem in Nigeria. The country is classified among those with high burden for TB, TB/HIV and Multi-Resistant Tuberculosis (MDR-TB).

Some symptoms of tuberculosis include cough lasting longer than two weeks in normal individuals, and any current cough in People Living with HIV and AIDS, weight loss, night sweat and persistent fever. These symptoms may be masked by other illnesses and will defy other treatments.

National Coordinator of the National Tuberculosis and Leprosy Control Programme of the Federal ministry of Health Dr Adebola Lawanson said Nigeria has the highest TB burden in Africa and ranks 6th globally. Till date tuberculosis is estimated to kill 18 Nigerians every hour.

She said persistent cough for two or more weeks could be TB and any affected person should see a healthcare provider.

Dr Lawanson said diagnosis and treatment including tuberculosis drugs are available free of charge in all Directly Observed Treatment (DOTS) centres nationwide and that the disease is curable.

She said members of the public can call this toll free number of the National Tuberculosis and Leprosy Control Programme for directives (08002255282) or TB treatment centre nearest to them.

Dr Ezie Patrick C, a physician, said it was important to see a doctor once you have cough to discern what kind it is. He said it is not advisable to treat cough yourself, adding that though tuberculosis presents as cough, it is a unique cough and its tests and confirmatory test could not  be confirmed in laboratories without proper technology either gene expert test or AFB microscopy investigations.

He said tuberculosis, also known as TB, is spread by droplet infection, meaning that it is contracted when a person infected with TB coughs, or sneezes into the atmosphere.

“This action releases thousands of mycobacterium into the air, which are easily inhaled by unsuspecting individuals. Hence the spread is more effective in overcrowded areas and tight spaces, that is why outbreaks are fastest in prisons, buses, and overcrowded beaches among others,” he said.

The medical doctor said the damage caused by the bacteria is gradual and may take weeks to months to multiply and invade the lungs and even spread to the rest of the body.

“This spread is worse in individuals whose immunity is reduced for any reason such as HIV and AIDS, diabetes, individuals on steroids, pregnant women, and children, especially those under-five.

“TB can be found in the vertebra column commonly referred to as hunch back. It has also been found as swellings in the neck, in the ovaries, intestines, and disseminated around the body in forms we refer to as military tuberculosis. However the TB that affects the lungs is the commonest presentation of the disease,” he added.

Some of the challenges Nigeria faces concerning TB include poor knowledge about the disease amongst the populace, poor funding and undetected or missed TB cases among others.

It is important for government at all levels to improve funding for control of tuberculosis in the country.

Recently, experts in the health sector lamented that only 40% of the $278 million needed for TB control in Nigeria was available to all implementers of TB control activities last year.

The experts said 8% of the 40% funding was from domestic funding while 32% was from donors leaving a funding gap of 60%.

National Professional Officer on TB of the World Health Organisation (WHO), Nigeria office, Dr Ayodele Awe said, “The total number of funds needed for tuberculosis each year is $278 million. We only have 8 percent domestic funding. There is a huge gap of $157 million gap that is supposed to help us for advocacy and for increasing services coverage.”

Dr Awe, who is also the Acting Board Chairman Stop TB Partnership, said Nigeria was supposed to detect 429,000 cases of TB annually but that its highest case detection was 120,000 cases last year.

Country Director for KNCV Tuberculosis Foundation, and Chairman Planning Committee, Dr. Odume Bethrand, called on political leaders to invest more on TB control, saying it was a call to action to scale up research, funding, human rights and accountability to end TB in Nigeria.

Dr Patrick gave the following tips on preventing tuberculosis:

-Cough Etiquettes: The current cough etiquette advocates that handkerchiefs should not be used by coughing individuals. Tissues are recommended as they are used and discarded. The correct coughing etiquette is to cough into a tissue which is promptly discarded, or the inside surface of your arms This is because the bacteria that causes TB is very reactive to sunlight and is destroyed in a matter of minutes when exposed to sunlight.

-Immediate and prompt referral of anyone with chronic cough or cough lasting longer than two weeks.

-Ensuring that your houses are not overcrowded and that adequate sunlight and cross ventilation are allowed into the environment

-Ensuring vaccination of all children with Bacillus Calmette-Guerin (BCG) vaccine at birth. However, it is important to note that BCG does not prevent children from acquiring TB, it just prevents them from acquiring the malevolent forms of TB.

-Avoid self-medication; promptly see your physician for management of chronic cough.

-Avoid unnecessary use of steroids except when prescribed by a physician.

-Individuals with chronic illnesses such as diabetes, cancer and HIV should present to their physician on the occasion of any current cough