Experts has said that tuberculosis (TB) remains a major cause of morbidity and mortality in Nigeria at epidemic proportions, and Nigeria is classified as a high TB, TB/HIV and multi-drug resistant TB (MDR-TB) burden country.
This was disclosed recently in Lagos at a TB/HIV project close-out ceremony tagged: ‘Improved TB/HIV Prevention and Care-Building Models for the Future Project,’ organised by KNCV Turberculosis Foundation with its co-implementers, Pharm Access Foundation (PAF), in collaboration with the Federal Ministry of Health.
According to the KNCV project coordinator, Dr. Victor Adepoju, Nigeria has the highest number of estimated TB cases in Africa and the fourth highest in the world, with 11 per cent of these cases estimated to be among children.
He said: “In 2017, Nigeria notified a total of 104, 904 TB cases, which are only 26 per cent of the estimated 407,000 cases for the country, meaning 74 per cent or 302, 096 TB cases were undetected in 2017. TB is an airborne disease; it is everywhere; urban, rural settings and can affect anyone – man, woman, rich, poor, old and young. However, immunosuppression, living in slums, densely populated areas, with limited access to health services and inhabited by persons of low socio-economic status, are some risk factors for TB.
“In line with the National Population Commission, Lagos population is estimated to be 21 million, with varied private sector and several urban slums. Lagos carries 8.4 per cent of the TB burden and its responsible for 9,727 (9.27 per cent) of the total 104,904 cases notified country wide in 2017.
“It is estimated that between 2,557 and 4,072 Private Health Facilities (PHFs) are registered in Lagos with only 103 of the total private facilities engaged with the Lagos State TB and Leprosy Control Program (LSTBLCP) to notify TB cases into the surveillance system in 2015. Challenges in engaging the private sector in the provision of TB services include stigma and misconception, lack of business case, poor knowledge of TB transmission and poor awareness among many others.”
Explaining further, he said, the DGIS funded project is a five-year project (2014-2019) financed by the Dutch Ministry of Foreign Affairs and is built on the main intervention area to improve TB and TB/HIV case finding and treatment success by strengthening engagement of the private sector in Lagos.
“The model focuses on employing dual but integrated tools; the International Standards for TB Treatment and Care (ISTC) and SafeCare, to assess and improve the quality of TB/HIV services in the private health sector in Lagos. The aim of the interventions is to demonstrate that the private sector could provide affordable, safe, and high-quality TB/HIV care, thus strengthening the impact of the national and State TB programme when actively engaged and supported by the public sector.”
He noted, however, that the project utilises the combined KNCV and Pharm Access Foundation expertise to translate the model into building sustainable health systems, exploring health financing options and business models, to improve access to quality TB/HIV services in the private sector.
“The tools and methodology are used to assure quality at the lowest level of implementation i.e. the health facilities, patent medicine vendors, community pharmacies and other informal outlets.”