Despite free test and treatment of Tuberculosis (TB) the world over, it is sad that 30 TB burden countries, including Nigeria accounted for 87 per cent of all estimated incident cases across the world in 2023. According to the World Health Organisation (WHO), 8 of the 30 countries, India (26 per cent), Indonesia (10 per cent), China (6.8 per cent), the Philippines (6.8 per cent), Pakistan (6.3 per cent), Nigeria (4.6 per cent), Bangladesh (3.5 per cent), and the Democratic Republic of Congo (3.1 per cent) accounted for more than two-thirds of global TB burden.
The global health agency revealed that approximately 8.2 million people were newly diagnosed with TB in 2023. This is reportedly the highest number recorded since WHO began global TB monitoring in 1995. It also represents a notable increase from 7.5 million reported in 2022, placing TB again as the leading infectious disease killer in 2023, surpassing COVID-19 disease.
The report shows that 55 per cent of people who developed TB were men, 33 per cent were women and 12 per cent were children and young adolescents. The Director-General of WHO, Dr. Tedros Adhanom Ghebreyesus, said “the fact that TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it and treat it.” WHO enjoins all countries to make good on the concrete commitments they have made to expand the use of those tools and end the TB.
In all, TB remains the world’s deadliest infectious killer. In 2022, 1.3 million people lost their lives to TB and 10.6 million people became ill with this preventive and curable disease. However, global efforts to combat TB have save an estimated 75 million lives since 2000. According to USAID/Nigeria TB most recent overview, in 2021, the estimated TB incidence in Nigeria was 467,000. Also an estimated 125,000 people died from the disease that year, while Nigeria notified 204,725 incident TB cases in 2021 and 75.55 per cent of notified bacteriologically confirmed individuals with TB were tested for rifampicine resistance.
Of the 2,975 individuals diagnosed with drug resistant (DR) TB, 2,197 or 74 per cent were put on treatment. The success notwithstanding, the disease is still spreading in spite of measures put in place by government and development partners to check it. For instance, a special childhood TB-case finding in May 2023 across the 36 states and the Federal Capital Territory showed that over 361,000 TB cases were reported in Nigeria in 2023 and nine per cent of these in children. Overall, this marked a 26 per cent increase in the number of cases compared with 2022.
While TB is a killer disease, the good news is that it is preventive and curable. Moreover, the test with treatment is free in all government health facilities across the country. However, many Nigerians don’t access treatment. They still believe that their enemy can inflict them with TB. The rising cases of TB are largely driven by superstition and ignorance in some Nigerian cultures. Some Nigerians believe TB comes from spiritual attacks. There is urgent need for more enlightenment programmes on TB, the causes, preventive measures and where people can have the test and access treatment.
According to medical experts, TB is a contagious infection that attacks the lungs. It can also spread to other parts of the body such as the brain and spine. It is caused by Mycobacterium tuberculosis. Early diagnosis of the disease helps in cure. That is why Nigerians should endeavour to know their TB status. The disease is not caused by enemies or evil spirits. Furthermore, the government provides free test and treatment for the disease in all government health facilities across the country.
We urge the federal and states health authorities to scale up the TB diagnostic network, including the needed human resources and an effective sample referral network. The government should expand TB services to all health facilities across the country. This includes screening of hospital patients which is informed by hot spot mapping. The government should also expand the engagement of the private sector in TB service delivery, including screening, diagnosis and treatment of childhood TB.
Let the government also provide person-centered TB treatment, adherence, care, back-to-treatment services, as well as social support services in the management of individuals with TB and DR-TB. There is a need to scale up the use of the improved oral DR-TB regimen. We call for a reduction of enrolment time and primary loss to follow-up of individuals with DR-TB as well as decentralizing DR-TB treatment and follow-up services. Above all, the government should strengthen contact investigation and TB preventive therapy across the country, including infection prevention in health facilities.