NIGERIAN Teaching Hospitals are not properly equipped to handle cases of Multidrug-Resistant Tuberculosis (MDR-TB), and as a result, the disease is fast becoming an epidemic in Nigeria, says President of the Nigerian Thoracic Society, Prof. Gregory Erhabor.
Erhabor, who is also a Consultant Chest Physician at the Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, Osun State, said TB mortality rate has remained high due to HIV/TB co-infection and inability of the hospitals to properly diagnose the MDR-TB.
Erhabor said Nigeria ranks fifth among 22 countries with the highest TB burden globally due to lack of government spending. “With over 8.8 million cases of TB detected recently, the ailment accounted for an estimated 1.4 million deaths in the world and is the second leading cause of death from infectious diseases in the world, after HIV/AIDS.”
According to the National TB Reference Laboratory, Microbiology Division, Nigerian Institute of Medical Research (NIMR), diagnosis of Tuberculosis (TB) amongst HIV patients is a great challenge due to the low density of Acid Fast Bacilli (AFB) in their sputum.
Also, in a study conducted to determine the sensitivity of direct smear microscopy (DSM) for TB diagnosis in HIV endemic setting, using culture as a gold standard, 549 TB suspects were screened and a new system was introduced but the country’s Teaching Hospitals lack newly adopted facilities.
He noted that TB accounts for 2.5 per cent of the global burden of diseases, while Africa accounts for 82 per cent of TB cases among people living with HIV. “In the past 15 years, the number of new TB cases has doubled in Nigeria, and the number of HIV infections is also high.”
Erhabor mentioned that one-third of the 38.6 million HIV-positive people in the world is also infected with TB and at increased risk of developing the active and contagious form of TB. He said the disease has remained the world’s top infectious killers and cause of deaths within the economic reproductive age groups (15-54yrs).
He stressed that about 95 per cent of TB deaths occur in low and middle-income countries due to poverty and lack of government interest in disease and as a result, Tuberculosis is important to respiratory medicine because of its grave effects on the affected individuals as well as its impact on the nation’s economy.
“The major problem of TB in Nigeria is that the government has refused to play active role in the struggle, especially in the area of funding. The mileage we got in TB management is as a result of donor agencies through free drugs, diagnosis and others for infected persons. Government needs to invest in the fight against the scourge,” Erhabor said.
He added that the body is working with its American counterpart, National TB Programme, and a few other agencies to end the scourge in the country, despite challenges faced.