Tuberculosis (TB) has remained a major public health problem, responsible for the leading cause of hospital admissions across public and private health institution in Nigeria. With TB remaining a leading cause of death in adults, especially among the productive age group, Nigeria ranks 10th among the 22 High Burden Countries (HBCs), contributing 80 percent of the estimated 8.7 million new TB cases recorded in 2012 globally.
While about 97,799 TB cases were notified in the country in 2012, according to Onyebuchi Chukwu, minister of Health, health experts have called for investment towards discovery of anti-TB vaccine with $45,748,310 is required to improve access to available quality TB services and information in the country, Nigeria Stop TB Partnership Strategic Plan 2013 – 2015 report shows.
In an interview with BusinessDay, Osahon Enabulele, president, Nigerian Medical Association (NMA), said with Nigeria captioned in World Health Organisation (WHO) 2012 global TB report as a nation with high TB and Multi-Drug Resistant TB (MDR-TB) burden, Lagos, Kano, Oyo and Benue states had the highest prevalence in descending order whereas Ekiti and Bayelsa states had the least cases of TB.
Enabulele identified poor availability of microscopy (smear), drug susceptibility centre and presence of only one national reference laboratory at the National Tuberculosis and Leprosy Control Programme (NTLCP) Headquarters in Kaduna, as drawbacks to TB eradication as evident in WHO 2012 global TB report.
The NMA President noted that non-availability of second-line drug susceptibility testing centre, which is quite crucial in management of MDR-TB with high rate of tuberculosis in HIV infected persons up to 26 percent, has led to a rise in TB cases in the country.
“Funding of TB control activities is another area of poor performance with only 71 percent budget implementation; only 28 percent came from domestic sources and 48 percent from Global Fund, an international funding partner of the US Government, an observation considered as ominous.
“Confirming those fears, 2013 budget shows that whereas there is a marginal increase of 2 percent in domestic funding, contribution from the Global Fund has depreciated to 42 percent, a sign for Nigeria to start looking inwards for other funding options for the fight against TB,” Enabulele explained.
Currently, MDR-TB and Extensive Drug Resistant TB (XDR-TB) are major threats to TB control efforts in the country. With primary focus at the moment in the country focused on Directly Observed Treatment Short course (DOTS) coverage, there is elevated risk of MDR-TB if success treatment rates are not sustained at very proportions and most laboratories lack of capacity to monitor drug resistance, Nigeria Stop TB Partnership Strategic Plan 2013 – 2015 report shows.
“MDR-TB is resistance in vitro to Rifampicin and Isoniazid whereas XDR-TB is resistance to a fluoroquinolone plus one or more of the injectable agents. This implies that the standard six/eight months treatment with first-line anti-TB drugs is no longer effective for people with MDR-TB and XDR-TB. Instead they are treated with drugs that are less efficacious, more toxic and much more costly over a timeframe of up to two years.
Source: BusinessDay