Health
Nigeria Ranks High in TB Infection Despite Free Testing, FG Laments
By Laide Akinboade, Abuja
The Federal Government has expressed dismay with the country’s position in the recent World Health Organization’s Tuberculosis ranking.
“It is unfortunate that despite the availability of free testing and medication, Nigeria still ranked highest among countries in the world with TB especially among children,” Health Minister Osagie Ehanire, told a press conference organized on Friday, to commemorate the 2023 world TB day.
In the WHO’s global TB report, Nigeria ranks as the 6th country in the world and the first in Africa with the highest number of people infected with TB. It is also included among the 8 countries that have two-thirds of global TB cases.
According to Osagie who was represented by the State Minister of Health Ekumankama Joseph, Nigeria’s position on the ranking was a result of various negative factors:
“There are 467,000 TB cases in Nigeria in 2021. In 2022 there was an estimated 479,000 TB cases in Nigeria out of which 285, 562 were notified. In 2022, there is an estimated 3,932 Drug Resistance Tuberculosis cases were diagnosed and 3,185 (81%) were enrolled on second-line treatment,” he said.
The Minister further said the problems were compounded by the citizens’ ignorance of the TB virus. “Only one out of every four Nigerians has adequate knowledge about TB.”
However, the minister said the country recorded some improvement in the area of Human Immunodeficiency Virus (HIV) testing among TB patients as 97% of Nigeria’s TB patients have documented HIV results, which was far higher than the global and African region averages of 76% and 89% respectively.
“The federal government is committed to ensuring the end of TB in Nigeria. All the interventions of the Federal Government are yielding positive results. We have been able to expand the TB facilities from 2, 038 in 2014 to over 20, 000,” he said.
The Minister also called on Nigerians to take an active role in ending the transmission of Tuberculosis in the country. “If you or anyone you know is coughing for more than two weeks ensure that you get tested,” he advised.
Also Speaking, the WHO’s Country Representative (WR) Dr. Walter Mulombo, represented by Dr. Laxmikant Chavan WHO’s Technical Officer said that Nigeria at the United Nations High-Level Meeting (UNHLM) on TB in 2018 made a commitment to diagnose and treat 1,109,000 TB cases and place 2,183,890 clients on TB preventive Therapy (TPT) from 2018 to 2022.
“But after the end of 2022, Nigeria is yet to achieve this commitment as available reports show that the country is trailing behind in all the set targets,” he said.
He noted that TB control budgets in Nigeria continue to be drastically underfunded.
“About 69% of the TB budget in 2021 was unfunded, this is a major threat to the country’s efforts in achieving the set targets. Too many people are pushed into poverty when they contract TB due to lost income, transport costs, and other expenses. 71% of the TB patients in Nigeria and their households are affected by catastrophic cost due to TB.”
Dr. Walter reiterated WHO’s continued support to Nigeria in developing and implementing guidelines, plans, frameworks, and strategic documents to end the TB epidemic in Nigeria.
“In addition, we will facilitate research to provide evidence-based interventions and innovations for finding the missing TB cases and enhancing the country’s efforts in reaching the set targets. We will continue to work with the programme to build the capacity of senior and middle-level managers across the states on the needed knowledge and skills for improving quality of care and data analysis towards formulating evidence-based policies for enhancing programme performance at all levels. In addition, we will continue to support monitoring of the programme at all levels, in real-time, to identify challenges and advise on strategies to address the challenges,” he said.
Also, the Deputy Director, Office of HIV/ AIDS and TB USAID Nigeria, Omosalewa Oyelaran said since 2003, Nigeria remains in the top 10 countries affected by TB, with one of the lowest detection rates globally.
She said to combat this debilitating disease; USAID collaborates with the Government of Nigeria and other national and international partners to support the National Tuberculosis Program. Since 2003, USAID has contributed more than $250 million to TB control efforts in Nigeria.
In 2022 alone, USAID programs helped screen over 15 million individuals for TB. USAID’s support also includes the provision of TB screening, diagnostic, treatment, and preventive services in 18 states through community and facility-based interventions.
“In partnership with the Government of Nigeria, USAID’s ‘TB Accelerator’ model invested in local civil society organizations (CSOs) to increase access to quality TB prevention, diagnosis, and treatment, including multi-drug resistant TB.
“These local CSOs collaborate with the national and state TB programs to deploy, and scale, state-of-the-art equipment and tools to improve the detection of TB. USAID also facilitates multi-sectoral public-private partnerships to increase public awareness and advocate for domestic resources to address the TB epidemic in Nigeria. As a result, Nigeria realized a significant increase in TB case finding and treatment coverage over the past three years.
“Despite the additional challenges posed by the COVID-19 pandemic, we have achieved significant results working together in partnership with GON and Global Fund.
“We commend the Government of Nigeria’s efforts to sustain the accelerated service delivery that resulted in yearly case notification increases of 160 percent between 2019 and 2022.
“However, much remains to be done if Nigeria is to meet its TB control target of ending the TB epidemic by 2035. We must continue to work together to reach all TB patients and their contacts in Nigeria.
“However, the greatest challenge is the funding gap, which is estimated to be 70 percent of the resources needed to effectively control TB. Therefore, I call on you to mobilize domestic resources to meet this funding gap through budgetary allocations, the inclusion of TB services in health insurance schemes, and enhanced private sector engagement”, she said.
The Ag. Board Chair, Stop TB Partnership Nigeria, Dr. Queen Ogbuji in her goodwill message said out of the annual estimate of 479,000 TB cases in Nigeria, only 285,561 were notified.
According to her, it’s good progress in the right direction, considering the fact that Nigeria was able to increase its notification even when the world was grappling with COVID-19 and many countries of the world had low case notification and more TB deaths.
The increase has been consistent since then and Nigeria needs to be applauded for this. However, a lot needs to be done to close the gap. While we commemorate, let it remain top in our minds the picture that Nigeria ranks first in Africa and sixth in the world accounting for about 4.6% of the global TB burden
“TB disease is often more severe in children with higher mortality among those less than 5 years old. The notification of children with active TB disease has remained abysmally low at only 6% of the annual notification.
“As the country continues to make progress to find the missing TB cases and put them on treatment, many resources are needed to accomplish this, unfortunately, of the $373 million needed for TB control in Nigeria in 2020, only 31% was available and 24% of this came from the donors, only 7% was from domestic source”, she added.
Health
Expert Advocates For Elimination of Mother-to-Child Transmission of HIV Through HIV Self Testing.
From Attah Ede, Makurdi
Eliminating mother-to-child transmission of HIV in Nigeria is an achievable goal, but it requires innovative approaches that can address the unique barriers faced by women in underserved communities.
An expert on health related matters, Dr Godwin Emmanuel stated while interacting with newsmen as part of activities commemorating the just concluded World Aids Day in Makurdi, the Benue State capital.
Dr.
Emmanuel who is the Managing Partner/Impact Officer of MOZUK Future Solutions Limited, stated that the World AIDS Day have come and gone, yet Nigeria government must not fail to examine some of the gaps that must be urgently bridged as a nation.He explained that each year, thousands of children are born with HIV, largely due to inadequate access to testing and treatment during pregnancy, disclosing that the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that Nigeria contributes about 22% of global paediatric HIV cases which indicates the urgent need for innovative approaches to curb MTCT.
“This brings me to a recent study in Lagos and Kano which demonstrated how HIV self-testing kits offer a practical, effective, and scalable solution to our MTCT challenges.
“The study interrogates an initiative seeking to integrate HIV Self-Test (HIVST) kits into TBA services as part of a broader strategy to eliminate MTCT.
“The intervention targeted underserved communities where healthcare access is limited, leveraging the trust and accessibility of TBAs to distribute self-testing kits and provide essential counselling”.
According to him, the study, led by Dr. Toriola Adebayo of Lagos State University Teaching Hospital and Dr. Usman Bashir of Aminu Kano Teaching Hospital, articulated the role of local expertise in advancing healthcare solutions tailored to community needs.
“In this intervention, 182 TBA clinics across three local government areas (LGAs) in Lagos and Kano States were equipped with HIVST kits. TBAs received extensive training on the administration of the tests, pre- and post-test counselling, and linkage to care for those who tested positive.
“Among the 1,982 pregnant women enrolled in the study, pre-intervention testing rates were markedly low, with just 60% in Lagos and 38% in Kano having ever been tested for HIV. After the introduction of HIVST, testing uptake surged, with all participants voluntarily using the kits during antenatal visits.
“The results were promising:
HIV Positivity Rate: An overall positivity rate of 0.8% was recorded, with slightly higher rates in Lagos (1.1%) compared to Kano (0.8%).
“First-Time Testers: Remarkably, 80% of those who tested positive were undergoing HIV testing for the first time.
Linkage to Care: All HIV-positive individuals were successfully linked to ART services, demonstrating the effectiveness of the TBA-led model in bridging gaps in healthcare access.
“The success of this initiative exemplifies how HIVST can become a cornerstone of affirmative action against paediatric HIV infections, which was also a critical focus of World AIDS Day observances.
“As evidenced by the success of the Lagos and Kano initiative, when confidentiality, stigma reduction, and leveraging trusted community figures like TBAs are prioritised, HIVST has the potential to transform PMTCT efforts across Nigeria.
“This is even more so with sustained investment, community buy-in, and political will. This can move us closer to a future where no child is born with HIV and every mother has the opportunity to live a healthy, fulfilling life”, Dr. Emmanuel alluded.
He further revealed that HIV self-testing kits offer a simple, private, and effective means of determining one’s HIV status, adding that the kits allow individuals to test themselves using a saliva sample or a small drop of blood, with results available in minutes.
Highlighting the importance, the health, said the convenience and confidentiality of this method are particularly appealing to those who might avoid traditional testing due to stigma or fear of disclosure.
He stated that the fear of being judged or ostracised often prevents pregnant women from seeking HIV testing, stressing that HIVST kits allow individuals to test in the comfort of their homes or a private setting, without fear of disclosure. This is particularly crucial for pregnant women, who may face compounded stigma if diagnosed with HIV.
“Increased Testing Uptake as demonstrated shown the intervention in Lagos and Kano demonstrates that when provided with confidential and convenient testing options, more women are willing to know their HIV status. Early diagnosis is key to initiating ART, which can reduce the risk of MTCT to less than 1%.
Prof. Mojisola Adeyeye, the Director-General, National Agency for Food and Drug Administration and Control (NAFDAC), says she supports herbal medicine production in the country.
She said this on a Forum in Abuja.
She, however, explained that for NAFDAC to accommodate herbal medicine as part of its regulated products, such herbal preparation must go through clinical trials.
She disclosed that the major challenge to herbal medicine practitioners is how to secure resources to finance clinical trial for their products, which she said cost a lot of money because it is a major aspect in medicine.
She added that “I believe in natural medicine, I was brought up with it, like the Agbo that we were taking and it was working.
“Herbal medicine or natural medicine work, before I came back home from the United States, I started a research on natural medicine for the cure of sickle cell, my niece who is a sickler got on it and her episodes decreased by 70 to 80 per cent.”
She explained that the agency gives approval for natural medicines once proven it is not toxic, and they have been used and tested before.
“We approve them for two years and then they can renew if they do clinical trial because it is something we are not used to in Nigeria.
“China supports many of these herbal practitioners.”
The director-general also spoke about using fruits and vegetables as medicine to cure some illnesses, adding that some of these fruits contain antioxidants that prevent cancer. (NAN)
The Nigeria Centre for Disease Control and Prevention (NCDC) has allayed public fears over the detection of the SARS-CoV-2 XEC subvariant globally.
The Director-General of the centre, Dr Jide Idris, did this in a public advisory issued on Saturday night in Abuja, made available to newsmen.
Idris reassured Nigerians that the variant, though identified in 29 countries, has not been detected in Nigeria.
He said that the XEC subvariant, a descendant of the Omicron JN.
1 lineage, was currently classified as a Variant Under Monitoring (VUM).According to him, this means that it is being closely observed for potential concerns but does not yet pose significant risk.
“The XEC sub-variant has been reported in Europe, Asia, North America, and Africa, with Botswana being the only African country to record cases so far.
“While the sub-variant exhibits higher transmissibility, there is no evidence of increased disease severity,” he said.
The NCDC boss said that Nigeria had been monitoring the JN.1 variant, classified as a Variant of Interest (VOI), which has been present in the country since January.
He assured Nigerians that the National COVID-19 Technical Working Group was conducting continuous surveillance and data analysis.
Additionally, he said that a dynamic risk assessment was being organised to strengthen the country’s preparedness and response capabilities.
He urged health facilities nationwide to ramp up COVID-19 testing and forward positive samples to accredited laboratories for genomic sequencing.
He encouraged the public to maintain vigilance and adhere to basic health protocols, including handwashing, mask usage in crowded spaces, and ensuring proper ventilation indoors.
He advised vulnerable groups, such as the elderly and those with underlying health conditions, to remain cautious.
“COVID-19 remains a significant risk, particularly for the elderly, individuals undergoing cancer treatment, organ transplant recipients, and those with suppressed immune systems.
“We urge Nigerians to get vaccinated and receive booster doses as recommended,” he said.
The director-general also called on state governments to enhance public health infrastructure, provide resources for improved surveillance and diagnostics, and promote public health education.
He reaffirmed the agency’s commitment to providing Nigerians with accurate and timely information on the evolving COVID-19 situation globally.
He urged citizens to avoid misinformation and rely on verified updates from its platforms.
“For assistance, the public is encouraged to contact the NCDC via its toll-free number 6232 or, WhatsApp: 07087110839, Twitter: @NCDCGov and Facebook: @NCDCgov,” he said.
Report says that the XEC variant of COVID-19 is a recombinant strain, meaning it results from the combination of genetic material from two or more existing variants of the SARS-CoV-2 virus.
Recombinant variants can emerge when different strains infect the same individual and exchange genetic material during replication.
This process may lead to new variants with unique properties, such as increased transmissibility, virulence, or resistance to immunity.
While thousands of mutations have been tracked globally, only a few variants are monitored for public health significance.
Nigeria’s NCDC and global health organizations like the WHO continue genomic surveillance to monitor and respond to emerging variants.(NAN)
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