Nigeria adopts new strategy to end spread of TB

Humphery Chikezie, CNS Correspondent, Nigeria
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Nigeria is ranked third among the 22 high TB burden countries in the world. A survey conducted in 2014 by the National TB and Leprosy Control Programme revealed over 600,000 new cases of TB in Nigeria with just about 92,000 cases placed on treatment. This figure is worrisome, because according to health experts, one person with TB can transmit the disease to around 12 persons in a single year.

A deeper challenge is the rising cases of multi-drug resistant TB (MDR-TB) and extremely-drug resistant TB (XDR-TB), which require more intensive and longer treatment regimens. Health professionals have also pointed out that drug resistance can spread from one person to another, thereby compounding the burden of TB in communities.

Country Director of World Health Organisation (WHO), Dr. Rui Gama Vaz, said that the key to reducing the TB burden in Nigeria is early detection and treatment of any type of TB. At a webinar on ‘Is detecting drug resistance at the time of TB diagnosis important?’ global TB experts, including Dr Mario Raviglione of the WHO, and Dr Chadha of the International Union Against Tuberculosis and Lung Disease, raised similar concerns that beset the global TB problem.

Dr Sachdeva, lead author of a study done to assess the impact of ‘up-front’ molecular diagnostic Xpert MTB/RIF testing on detection of pulmonary TB and rifampicin-resistant MDR-TB cases in India, shared the study findings--

When implemented on a large scale in India the Xpert test increased case notification rates of all bacteriologically confirmed TB cases by 39% and increased rifampicin-resistant TB case detection by over fivefold compared to conventional drug sensitivity testing.

Nigeria too has recently adopted this new molecular technology of GeneXpert to facilitate not only faster detection of TB, but also diagnose resistance to rifampicin. Coordinator of the National Tuberculosis and Leprosy Control Programme, Dr. Gabriel Akang noted that the Gene Xpert is able to diagnose TB within two hours and thus helps enhance timely access to treatment for MDR-TB patients.

“Once you go for diagnosis, the patient will automatically be recorded and it is like using your handset to receive a text message. So it is a very robust tool to help us manage our patients effectively and to ensure that the patients get the best treatment that they deserve.” Stakeholders in TB control in Nigeria have pointed out that the key to ending the spread of the disease is to reach out to those in rural communities where the cases are rampant.

Dr Vaz said that, “There are key issues that are critical that we need to take into consideration. One of them is accessibility to health services. We need to bring the TB programme nearer to the communities for them to have easy access to diagnosis, treatment and care. We also need to make critical facilities available for treatment and care and to ensure that they have the necessary and good quality of care.”

Country director of FHI 360, Phyllis Jones-Changa said creating awareness on TB in communities is necessary to reducing the burden of the disease in Nigeria. “The main message that we have is that firstly you need to be aware of the disease and symptoms so that you can go in for testing, early detection and treatment. So if you are experiencing any symptoms of TB – persistent coughing for about two weeks, it is very important to go to your nearest health centre and they will be able to provide testing.”

Dr Akang informed that the current campaign in Nigeria involves community surveillance to detect and treat cases rather than waiting for patients to come to clinics. “Earlier we were just sitting in our clinics waiting for the patients to report, but now we have developed a new strategy to go to the community to look for these patients-- those missing patients who we are targeting. We are going to urban slums where one can see so many people sharing the same small rooms and some of them are coughing. So our main strategy is now to go to the community and look out for these patients and bring them for treatment.”

It has been globally accepted that early detection of TB, including MDR-TB, will help to end inappropriate treatment and stop transmission of the disease.

Humphery Chikezie, Citizen News Service - CNS
20 July 2015