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Fighting The Tuberculosis Scourge
TUBERCULOSIS, a disease once thought to be under control, remains one of the most significant health challenges in Nigeria. With over 467,000 cases recorded in 2023, Nigeria is now ranked as the sixth-highest TB-burdened country in the world and the first in Africa. This is a troubling statistic for a disease that is both preventable and curable.
The call by the wife of the President, Oluremi Tinubu, for united action to end TB resonates with all stakeholders. Governments at all levels, the private sector, civil society, and individuals must play their part in the fight against TB.
TB is caused by Mycobacterium tuberculosis, a bacterium that most commonly affects the lungs but can spread to other parts of the body. It is airborne, transmitted through droplets when an infected person coughs, sneezes or even speaks.
The symptoms are persistent coughing, fever, night sweats, weight loss, and fatigue. It thrives in conditions of poverty, overcrowding, and poor healthcare access, making low and middle-income countries particularly vulnerable.
Globally, TB claimed 1.6 million lives in 2023, with 10.8 million new cases reported. Alarmingly, 12 per cent of the global burden affects vulnerable populations, including children and adolescents.
Nigeria has a burden of 245,000 annual TB deaths.
The WHO Global Tuberculosis Report 2024 says TB remains a leading cause of death in Nigeria. The prevalence of drug-resistant TB and the overlap with HIV exacerbate the problem, presenting new challenges for treatment and containment.
The Nigerian government, over the years, has made some efforts to combat TB, including implementing the National Tuberculosis and Leprosy Control Programme. This programme has focused on early detection, treatment, and prevention.
International partnerships have played a significant role. Support from global organisations like the Stop TB Partnership and the WHO has facilitated awareness campaigns, provision of diagnostic tools, and supply of medications.
The private sector, too, has shown commitment, with a recent pledge of $25 million towards Nigeria's TB response. These efforts have yielded some progress: the country recorded a 24 per cent decline in TB incidence rates between 2015 and 2023.
However, the pace of progress is grossly insufficient. The high number of undiagnosed cases—estimated to be over 40 per cent of those affected—indicates a gap in access to healthcare, awareness, and community engagement. The lack of sustained domestic funding, poor integration of TB services into primary healthcare, and inadequate use of technology have hindered the fight against TB.
Several factors contribute to the persistence of tuberculosis in Nigeria. First, there is a significant lack of awareness about the disease. Many people do not know the symptoms of TB, how it is transmitted, or if it can be cured.
Second, the stigma associated with TB discourages individuals from seeking medical help. In many communities, TB is erroneously viewed as a disease of the poor or as a punishment for immoral behaviour.
Third, Nigeria's healthcare system is underfunded and overstretched. Diagnostic tools, such as GeneXpert machines used to detect TB and drug-resistant strains, are often unavailable or concentrated in urban centres, leaving rural populations underserved. The same applies to medications and trained healthcare workers.
To effectively tackle tuberculosis in Nigeria, a multi-pronged approach is required, involving government agencies, private sector actors, community leaders, and international partners. Public education must be a cornerstone of Nigeria's TB strategy.
Awareness campaigns should target rural and urban areas, using local languages and culturally relevant messaging.
Also, early diagnosis is critical to controlling TB. The government must invest in diagnostic tools and ensure they are widely available, particularly in underserved rural areas. Mobile testing units and community health outreach programmes can help bridge the gap in access.
With decisive leadership, adequate funding, and collective effort, the scourge of TB can be eradicated.
The time to act is now.
Transparency And Complex Dynamics In TB Modeling With ABMs
Photo Credit: Dr_Microbe
The following is a summary of "Agent-based modelling of Mycobacterium tuberculosis transmission: a systematic review," published in the December 2024 issue of Infectious Disease by Bui et al.
Traditional epidemiological models often oversimplify Mycobacterium tuberculosis (M.Tb) transmission, driving interest in advanced methods like agent-based modelling (ABM) to better capture the complexity of tuberculosis (TB) transmission dynamics.
Researchers conducted a retrospective study to analyze the use of ABMs in modeling the heterogeneity of M.Tb transmission and to identify the challenges and opportunities in the implementation.
They performed a systematic search following PRISMA guidelines across 4 databases (MEDLINE, EMBASE, Global Health, and Scopus), including peer-reviewed articles in English published up to December 2022, 2 investigators extracted data using a standardized tool. The review focused on studies that used ABM, individual-based, or microsimulation models of M.Tb transmission, excluding those centered on in-vitro or within-host dynamics. Data extraction focused on the methodological, epidemiological, and computational aspects of ABMs for TB transmission. No risk of bias assessment was done, as the review synthesized modeling studies without pooling epidemiological data.
The results showed 5,077 studies were initially identified, of which 26 met the inclusion criteria after exclusions. These studies varied in population settings, time horizons, and model complexity. While many included population heterogeneity and household structures, some lacked critical elements such as spatial structures or economic evaluations. Only 8 studies (31%) provided publicly accessible code, emphasizing the need for greater transparency in the area.
Investigators concluded that the ABMs offered a powerful tool for modeling complex disease dynamics like TB, addressing challenges like stochasticity, parameter tuning, and computational cost as an important tool for the reliable application.
Source: bmcinfectdis.Biomedcentral.Com/articles/10.1186/s12879-024-10245-y
Slum Residents' Relocation To Prevent TB Spread: Ministry
Jakarta (ANTARA) - Deputy Minister of Health Dante Saksono Harbuwono said that the relocation of residents living under Angke Toll Road in West Jakarta to flats is part of efforts to prevent the spread of diseases, including tuberculosis (TB).According to him, TB in slums, such as settlements beneath toll roads, is transmitted faster due to poor environmental sanitation.
"With relocation, they will have better sanitation and will be less susceptible to the possibility of contracting TB," he explained on Monday.
Harbuwono said that the government's quick-win program to eradicate TB involves environmental sanitation.
"Efforts to deal with TB involve several points, not only treatment and diagnosis, but also environmental sanitation issues," he added.
Therefore, his party supports the relocation program, especially to prevent the spread of infectious diseases such as TB.
He informed that so far, around 700 residents of the Angke Toll Road underpass have been relocated to flats in Jakarta.
"This sanitation job has been assisted by the Mayor of West Jakarta. The Mayor has moved around 700 people from the Angke Toll Bridge underpass to flats," he informed.
Related news: Government handles TB spread through name-, address-based surveillance
The West Jakarta city government has confirmed that 257 families, comprising 685 persons, living under Angke Toll Road have been relocated from the area.
Of the 257 families, 139 families with Jakarta resident identity cards have been relocated to Daan Mogot Flats, Rawabuaya Flats, Tegal Alur Flats, and PIK Pulogadung Flats.
Meanwhile, 98 families holding identity cards from other areas have been provided Rp1.5 million (US$90) per family as two months' rent.
Another 20 families without a Family Registration Number or identity card are in the process of registering their identity and relocating to flats.
The number of TB cases in Indonesia has reached 1.060 million, with the death toll from the disease reaching 130 thousand. Meanwhile, Jakarta has 30 thousand TB patients.
Harbuwono said that as per calculations, the death toll from TB is higher than the number of deaths due to COVID-19.
Related news: Indonesia pushes TB vaccine, aims for elimination by 2030
Translator: Redemptus Elyonai, Resinta SulistiyandariEditor: Yuni Arisandy SinagaCopyright © ANTARA 2024
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