By Esther Atani, The Sight News
Tuberculosis, or “consumption” as it was called in 460 BC, is a communicable air-borne disease caused by a bacteria called Mycobacterium tuberculosis. The WHO estimates that there is 8-10 million new cases worldwide every year and this affects a third of the world’s population. Tuberculosis (TB) is caused by bacteria that spread from person to person by means of minute liquids through air, by the already infected person while engaging in activities like coughing, speaking, sneezing, spitting, singing or laughing.
Genetic studies suggest that tuberculosis has been present for at least 15,000 years. Evidence of tuberculosis in humans dates back to 2400-3400 B.C where mummies have been shown to have evidence of disease in their spines. It was called “consumption” because of the drastic weight loss in severely affected patients and the way the infection appeared to “consume” the patient.
According to the 2017 Global TB Report, Nigeria is among the 14 high burden countries for TB, TB/HIV and Multi Drug Resistant TB. The country is ranked 6th among the 30 high TB burden countries and first in Africa with Lagos having the highest TB burden in Nigeria due to overpopulation. The problem of TB in Nigeria has been made worse by the issues of drug resistant TB and the HIV/AIDS epidemic.
HIV and TB
Since the 1980s, the number of cases of tuberculosis has increased dramatically with more than 2 million people dying worldwide because of the spread of HIV, the virus that causes AIDS. Infection with HIV suppresses the immune system, making it difficult for the body to control TB bacteria. As a result, people with HIV are many times more likely to get TB and to progress from latent to active disease than are people who aren’t HIV positive.
Tbfacts.org estimates that 407,0003 people in Nigeria have TB each year. This is the estimated number of HIV negative people. In addition there are an estimated 63,000 HIV positive people who get TB each year. An estimated 115,000 HIV negative people die from TB in Nigeria each year and an estimated 39,000 HIV positive people also die.
Multi Drug-Resistant TB (MDR-TB)
Another reason tuberculosis remains a major killer is the increase in drug-resistant strains of the bacterium. Since the first antibiotics were used to fight tuberculosis more than 60 years ago, some TB germs have developed the ability to survive despite medications, and that ability gets passed on to mutations of TB germs.
Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets. This usually happens when a patient infected with tuberculosis does not complete the course of treatment. The surviving bacteria become resistant to that particular drug and frequently other antibiotics as well. Some TB bacteria have developed resistance to the most commonly used treatments, such as isoniazid and Rifampin.
Controlling The Spread of TB
Tuberculosis (TB) cases can be prevented or minimized when the following measures are strictly adhered or observed:
- Avoid any contact with tiny droplets of saliva or mucus that is expelled from TB patients.
- Reducing intake of alcohol, avoiding substance use and cigarette smoking.
- Avoid use of any cloth or handkerchief used by TB patients.
- Eat a healthy and a balanced diet.
- Have a Bacillus Calmette–Guérin (BCG) vaccine to prevent TB.
- If you live with an active TB patient encourage the person to follow treatment instructions.
Treatment and Testing: When a person is diagnosed with TB disease, a contact investigation is done to find and test people (like family members) who may have been exposed to TB. People diagnosed with TB disease or latent TB Infection are then treated.
Tuberculosis disease can be treated by taking several drugs for a long duration of about six months and above. Some drugs used to treat TB are Isoniazid, Rifampin; Ethambutol; Pyrazinamide with other new drugs needed and sought out because of the complexity and toxicity of the current TB drug regimes. And TB can be prevented, treated and cured if the diagnosis is done on time, as services are free in the treatment of TB in any of the government approved centers in Nigeria.
New technologies like whole genome sequencing and geneXpert machines help in the control of TB by aiding public health professionals to see patterns of TB transmission. This tool can help focus public health efforts to find and treat persons with TB disease and latent TB infection.
Awareness:
Due to constant awareness in general and private hospitals, clinics and health centres, and also with the introduction of free medical check-ups, follow-ups, and medications, there has been a positive decline over the recent years.
Despite this progress, additional efforts are still needed to ensure that Nigeria is not left behind in the current global strategy to end TB disease. With very little being done to involve corporate, financial, and oil and gas organizations to fund TB research, the country needs 76% more funding (over 300 million dollars) for TB control compared to the current funding level if we are to end TB by the year 2030.
Reducing TB disease burden in the country will require a multi-pronged approach that includes increased funding, health system strengthening and improved TB surveillance, as well as preventive efforts for alcohol use, smoking and diabetes.
Esther Atani is the Health Correspondent for The Sight News and can be reached via email on ataniesther@gmail.com
