Tuberculosis making an unwelcome comeback

It was a long, gloomy weekend at the Yaba Mainland Hospital, formerly called Infectious Disease Hospital, two weeks ago. Sunday Okeowo sat on a pavement outside the ward with his head buried in his palms. He is one of the four people who lost their relatives to tuberculosis in just one weekend.

He occasionally gnashed his teeth as he awaited the body of his beloved 24-year-old daughter which was wheeled out from the ward into the hearse. "Another dead body again?" asks a hospital attendant, who passed by the ward's entrance. "God will save us from this kind of disease," she lamented.

The bereaved man would rather not talk, but according to eye witnesses at the hospital, four bodies were wheeled out from Friday through Monday. They were said to have died of tuberculosis.

Tuberculosis, a bacterial infection that affects the lungs, is 100 percent curable and treatment is even free in many parts of the country. The reality does not reflect this however. According to a joint report by World Health Organization (WHO), World Bank and UNAIDS, 889,666 Nigerians are infected with the disease and it kills 117,141 people annually.

Ignorance

Dan Onwujekwe, a Microbiologist specialising in TB treatment at the Nigerian Institute of Medical Research (NIMR), says a lot of people are dying of the disease due to ignorance.

"What is killing people is ignorance not the bacteria," he said.

Dr. Onwujekwe added that many people who come to receive treatment at NIMR come in half dead, because they patronize all sorts of spiritual or herbal homes."

"Many of them would have gone to several churches and spiritual homes, but the message is simple, TB is curable and the treatment is free. All you need is to go to the nearest DOTS (Directly Observed Treatment Shortcourse) centre, but our people are so ignorant; they stay in their homes and keep spreading the disease and when they are almost dead, they blame it on a witch."

Superstitions

Chuka Benjamin, who brought his 47-year-old aunt to NIMR says that when she began to cough blood, they took her to church thinking it was a spiritual attack.

"They told us it is an enemy attack. Before that, she was always coughing and sweating a lot at night. Then she started growing lean; it was one of our neighbours who told us to go to a private hospital," he said.

Mr. Benjamin, who lives in Lagos, said that after a test, the private hospital referred them to a General Hospital, which in turn refereed them to NIMR. "We have spent a lot. We didn't know that it is free here," he added. "But I thank God that now she is feeling better."

Addressing TB in communities

"Addressing TB at the grassroot is a major problem Nigeria has today," according to Oni Idigbe, the chairman of the National Tuberculosis and Leprosy Control Program.

The World Health Organization ranks Nigeria fourth amongst the 22 countries that bear the high burden of TB and recommends that these countries should detect at least 75 percent of active TB cases and treat at least 85 percent."

"For now we are not meeting this target. Case detection for TB in Nigeria is far below what the WHO recommended in 1991. We are still at 30 percent detection rate. But by now Nigeria should be reaching above 60 percent detection rate."

He points that a major challenge of addressing TB is the community.

"We need strong advocacy at the grassroot; teaching community members how they can detect at least one case of TB; through signs and symptoms such as coughing consistently for three weeks, night sweats, unexplained weight loss."

"If everyone is able to detect one case of active TB, it will save 10-15 more people because one person with an active case, can infect 10-15 more people when he coughs or sneezes. If this is not detected and treated, the infection progresses geometrically," he added.