By Chioma Obinna

With Nigeria ranking amongst 22 top countries with high burden of Tuberculosis globally, experts have raised concerns over substantial gap between the effective management of TB at health facility levels in the country.

The gap, according to health experts complicates the growing public health problem of Multi Drug-Resistant Tuberculosis (MDR-TB) with over 7,000 cases MDRTB reported in Nigeria annually.

MDR-TB is tuberculosis that no longer responds to at least two of the major first line drugs for treatment. Despite the strides made nationally and globally over TB/MDRTB control, the gap currently existing in these facilities has escalated prevalence of MDRTB.

The experts who raised the concern during a training workshop in Lagos, cited that in Nigeria, Lagos State contributes up to 10 percent of the national burden of TB, thus ranking among states with highest incidence of TB.

The experts who are at the forefront of curbing TB both at the national and global level opined that there is need for the country to intensify efforts towards tackling the menace.

Medical Director, St Kizito Clinic, Dr. Alda Gemmani, explained that MDRTB has become a public health concern following its high prevalence which is now higher than WHO estimate.

According to WHO, recent prevalence survey in Nigeria showed that TB burden is the third highest among 22 countries with high burden.

“More than 7,000 cases were reported with MDR-TB in Up to 17 percent of TB burden are MDR-TB patients among newly infected and retreated patients.

On challenges, she identified stigma,   adding that until recently unavailable and inaccessible tests to identify MDR-TB now the gene Xpert machine is being used but yet to be universally accessible in the country.

Other challenges, Gemmani listed include’ “Few MDR-TB treatment centres leading to long waiting period for confirmed cases of MDR-TB across the country. Long duration of treatment with greater possibility of developing extreme resistant TB (X-DR), which is more difficult to treat with less than 50 percent success rates especially among HIV infected persons and absence of child friendly treatment regimes for MDR-TB.”

To control the spread, she said people should adhere to cough etiquette. “Check every cough that has persisted for two weeks with your DOTS.

“We set up a TB/DOTS centre in 2005, nine years ago. Since its inception we have made over 8,000 visits aimed to screen, diagnose and monitor Tuberculosis. More than 1,200 patients have been successfully treated. Corporate donors such as Chevron, which donated us the X-Ray machine, and helped us to build the TB DOTs Centre, have been crucial in sustaining our efforts.

In waging war against TB, she also, noted that community participation is imperative in strengthening the health system framework. “More education, funding, technical support and research on TB management at all levels of health care are crucial. These will contribute greatly in reducing the burden of TB and HIV as expressed in the millennium development goals.”