Nigeria Takes Drug Resistant TB Control Drive to Communities



The Federal Government of Nigeria aims to tackle Drug Resistant Tuberculosis with more funding for the procurement of more diagnostic tools and engaging the community

By Marcus Fatunmole

The Nigerian Government is proposing to spend $206, 612 to procure and install 25 GeneXpert machines for the detection of drug-resistant tuberculosis. This will be the first time that the Government will be buying such machines since all the existing 391 machines were provided by donors according to the government’s official record.

Also, the government is looking at new ways of closing the TB control gap in Nigeria by engaging Civil Society Organizations (CS0s) to deepen community involvement.

This is in view of the fact that most cases of TB in Nigeria occur at the community level.

At the virtual Civil Society Accountability Forum 2020 TB Pre-Conference meeting held recently, with the theme: “Integrating Community System Strengthening for Effective, HIV, TB, Malaria and COVID-19 response,”Acting Board Chair of Stop TB Partnership, Dr Ayodele Awe said a survey conducted in 2012 showed that 75 percent of cases of tuberculosis, occurred in communities.

He said community level is the operational level for TB and related ailments. “Community level is the level of integration of diseases,” he said, adding that civil society play important role in national development, particularly at the community level; hence the decision to hunt for the disease in communities.

Though the CSOs showed strong commitment to pursue the agenda, findings by have shown that there may be some hurdles to cross to interrupt the disease.

Apart from the fact that the nation’s health sector currently suffers from dearth of needed infrastructures, poorly-motivated and inadequate human resources, requisite technologies and other kits to identify TB are largely in short supply. This is even as the nation ranks among eight leading countries worldwide with highest cases of the condition.

The Lancet had published an article in January 2020, highlighting some of the challenges the country faces in its war against TB.

“Nigeria has the highest tuberculosis burden in Africa and one of the world’s widest gaps between estimated and reported cases according to the recently released Global TB Report 2019. A comparison of the reports for 2018 and 2019 showed the disease burden is increasing in Nigeria in sharp contrast with the improving global outlook.

“Tuberculosis incidence rose in Nigeria from 418000 cases in 2017 to 429000 cases in 2018, and deaths also rose from 155 000 to 157 000 within the same period, with tuberculosis treatment coverage stagnant at 24%. While there has been a reduction in the number of laboratory-confirmed cases of drug-resistant tuberculosis, with incidence falling from 2300 cases in 2017 to 2275 cases in 2018, the estimated cases rose from 5400 in 2017 to 21 000 in 2018. Progress has, however, been made in the percentage of HIV-positive individuals on tuberculosis preventive treatment, which increased from 39% in 2017 to 62% in 2019.

In his presentation, National Community TB Taskforce, Dr. Chijioke Osakwe, said CSOs would leverage their presence in communities by interacting further with community members to arrest the disease and related challenges.

Speaking on the impacts of coronavirus pandemic on TB and control of other diseases, he noted that lockdown and fear of COVID-19 in the country reduced hospital attendance by almost 50%, while some facilities closed down as a result of infection of health workers with COVID-19.

He said despite the negative impacts of COVID-19 on management of TB  in the country, volunteers across communities supported programme implementation by delivering drugs to patients, conducting house to house search for TB cases and ensuring patients adhere strictly  to treatment.

Another expert, Dr Amos Omoniyi, said the country had made significant achievements in finding and managing TB in communities. “If you look at some of the cases that we had in 2019, between 25 and 27 percent of them are through community referrals. Community contributions to case finding are on the increase,” he stated.

He explained community participation had grown over the years, adding that the growth should be built upon.

A TB survivor, Mrs Adebola Adams, called for engagement of TB survivors in the fight against the condition.

She said TB survivors fall under different groups namely skilled, unskilled, lettered, unlettered, professionals, artisans, people who are socially inclined, people with religious affiliations.

“The first things I think we can is that TB survivors have to be empowered in some ways basically with basic things of life, including clothing and shelter. Once TB survivors have basic things that they need, it will not be difficult to actively engage them in the community or other programme that will help push out TB from our country,” Mrs Adams said.




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