World Tuberculosis Day 2016
Thursday 24th March is World Tuberculosis Day. World TB Day each year is designed to build public awareness that tuberculosis today remains an epidemic in many countries in the world, with an estimated 9.6 million new cases in 2014. TB has been eliminated in Europe and the Americas. In contrast, TB is still raging like wild fire in India, China, Indonesia and Nigeria causing death and disability to our people.
The theme of the 2016 World TB Day Commemoration in Nigeria is ‘’Find TB, Treat TB and Working together to Eliminate TB’’ while the slogan is ‘Unite to End TB’.
The many faces of TB
Tuberculosis affects people in many different ways and comes in many guises. Many people think that TB only affects the lungs and causes the sufferer to cough while losing a lot weight. This is perhaps the commonest way TB presents. But, many other sufferers do not have cough as it affects their bones leading to destruction of the spine and deformity. Many of the patients with hunchbacks may have suffered from TB of the bone.
Tuberculosis also affects children. TB in a child is of special significance and a real public health hazard. It shows that the child has been recently exposed to TB and calls for serious screening of the contacts of the child. In children, TB can be very devastating. TB can easily spread throughout the body and lead to life threatening illnesses such as TB meningitis.
How can TB be spread?
TB bacteria are spread from person to person through the air. The TB bacteria are put into the air when a person with TB disease of the lungs coughs, sneezes, speaks, sings or spits indiscriminately. People with TB disease of the lungs can spread bacteria to others with whom they spend time every day. People nearby may breathe in these bacteria and become infected. In effect, someone with a chronic cough due to TB can spread the infection to close contacts like children and family members if adequate infection control is not practised.
Not everyone infected with TB bacteria becomes sick. Some people have the infection but are not sick and do not have any symptoms, so they cannot spread the disease to others. The germ is in their body but is not active. However, they need to be discovered and treated to prevent them from developing the active disease. This is because the person’s resistance to infections is very high.
It is for the same reason that children are given the BCG immunization at birth to boost their protection against the TB germ. However, if there is a reduction in the resistance to infection in one’s body (reduced immunity), which usually occurs when someone has HIV, is on certain medications like steroids for prolonged period of time or cancer therapy that reduces immunity or chronic malnutrition, the inactive infection can become a disease and the TB bacteria will multiply in the body.
Sick with TB
If TB bacteria become active in the body and multiply, the person will get sick with TB disease. These people are sick suffering from the active disease. This means that the disease is multiplying and destroying tissue in their body and they can spread the disease. Children who catch TB get pretty sick.
Diagnosis of TB
TB can be easily diagnosed with a simple laboratory test using a sputum sample. The laboratory diagnosis rests mainly with the identification of the tubercle bacilli in a clinical specimen (sputum, other bodily fluids such CSF) by using available laboratory methods: microscopy, culture and GeneXpert MTB/RI. The test GeneXpert MTB/RI and others have the potential to revolutionize the diagnosis of TB. Other methods such as a good history of contact with a sufferer, a chest x-ray and a skin test are also important.
The TB Control setup in Nigeria
The good news is that the diagnosis and treatment of tuberculosis are provided free of charge by the Federal Government through the National Tuberculosis and Leprosy Control Program (NTLCP) with the support of partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, USAID, WHO, Clinton Health Access Initiative as well as private sector organisations like Agbami-Co-Ventures.
Collaboration
The NTLCP is collaborating with the Association of General and Private Medical Practitioners of Nigeria (AGPMPN) in spreading the message to all nooks and corners of Nigeria. The collaboration will enhance the number of diagnostic, treatment and research centres in Nigeria. Private hospitals exist in every part of the country and can enhance a functional referral system plugged into the national pathways for diagnosis, treatment and control of TB.
We need private hospitals to domicile the diagnostic kits and drugs for easy access by Nigerians. This also allows monitoring, evaluation and research by the team thus spreading the catchment net widely. This is also in the spirit of public private partnership in health care as majority of Nigerians patronise private hospitals and clinics.
The big guns
Dr Lovett Lawson, Chairman, Stop TB partnership in Nigeria, Dr Gabriel Akang, Dr Josephine Okechukwu and Dr Emmanuel Meribole, all of NTLCP are billed to attend the 38th Annual General Meeting and Scientific Conference of the AGPMPN coming up in April to enlighten the public, the press and healthcare practitioners on TB. The conference starts on the 14th of April at the International Conference Centre in Abuja.
The issue of drug resistant TB and its treatment will be one major focus.