FG Identifies Low Notification Of Child Tuberculosis As Key Challenge

The Federal Government has disclosed that a key challenge to the government’s control effort has been low notification of child TB cases mainly due to capacity gaps among healthcare workers in diagnosing Tuberculosis in childhood.

Although, it disclosed that it notified highest number of child TB cases of 12,977 in 2021 and the child TB proportion amongst the overall TB notification for the same year was 6% as the figure is far lower than the World Health Organization(WHO) benchmark of 12% and this implies a high proportion of missing child TB cases in Nigeria.

The Minister of Health, Dr Osagie Ehanire in his Keynote address at the Ministerial Press Briefing in Commemoration of 2022 World TB Day in Nigeria further disclosed that government’s Drug Resistant(DR-TB) response has equally not yielded the desired results.

Ehanire said, barely 2,975 (14%) of the estimated 21,000 DR-TB cases were notified in 2021and another disturbing trend is the low enrolment rate of diagnosed DR-TB patients on treatment.

“Only 2,197 (74%) of diagnosed DR-TB patients were enrolled on treatment in 2021. This is not encouraging as it is a far cry from our target of 100% enrolment for diagnosed DR-TB patients. These untreated DR-TB patients constitute a time bomb as they continuously spread DR-TB in our communities”.

Ehanire further pointed out that TB preventive treatment (TPT) is also another concerning aspect of our TB response and in 2021, Nigeria achieved only 7% of its target for TPT amongst under-5 and above-5 years’ contacts of bacteriologically confirmed TB patients.

The Minister however said, in responding to these challenges, the Government of Nigeria (GoN) has rejigged its TB response in line with the commitment made by His Excellency, President Muhammadu Buhari to END TB at the first-ever United Nations High-level Meeting (UNHLM) on TB in New York, United States in September, 2018.

“In line with the commitment, we developed and currently implementing a road map for translating the commitments into action.

“As earlier highlighted, these efforts are gradually yielding the desired results as we were able to achieve 48% of our UNHLM TB case finding target for 2021”.

“Let me inform you that despite the COVID-19 pandemic, Nigeria was commended for being among few countries with increased TB notification rather than a drop in 2020”.

“In furtherance to our National Strategic Health Development Plan II (NSHDP II) as well as the recently developed National Strategic Plan (2021 to 2025) for TB, our priorities moving forward are to ensure continuity of TB services through provision of integrated TB/COVID-19 services especially in the area of awareness creation, diagnosis and contact investigation; Scale up demand creation for TB services through strategic media engagement; Expand community TB interventions to all 36 States and the FCT, introduce new diagnostic tools, shorter TB Preventive Therapy (TPT) regimen and all oral medicines for treatment of DR-TB; Massively scale up TB service provision including TPT in both public and private facilities as well as in communities; integrate TB services into Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition (RMNCAH+N) services and Incorporate TB services as a package of care in the Basic Health Care Provision Fund (BHCPF), National and State Health Insurance Schemes.

“This years’ world TB day theme “Invest to END TB, Save Lives” and slogan “Give More, Do More, End TB Now!” is apt and fully aligns with our kick-out TB initiative.

“Key activities lined up for the week-long event includes amongst others the ministerial press briefing, community outreaches with the Well on Wheels truck and the first lady’s summit”.

The World Health Organization Country Representative, Dr Walter Kazadi Molumbo in his goodwill message said the theme for this years’ commemoration “Invest to End TB. Save lives” and the slogan ” Give more, Do more, to End TB now” conveys the urgent need for more resources to be invested to ramp up the fight against TB in line with commitments to end TB made by global leaders including His Excellency, the President of the Federal Republic of Nigeria, at the first-ever UN High Level Meeting on TB in 2018; which for Nigeria was to diagnose and treat 1,109,000 TB cases and place 2,183,890 clients on TB preventive Therapy (TPT) between 2018 and 2022.

Molumbo also maintained TB remains the top 10 causes of death worldwide and the leading cause of death from a single infectious agent with estimated 10 million people that had TB in 2020, with Nigeria and seven other countries accounting for two thirds of this global burden.

“We also know that Multi Drug Resistant TB (MDR-TB) and HIV co-infection is further complicating measures to address the burden of TB in countries”.

“Hence, the well-acknowledged success registered by the country in 2021 will need to be sustained.

Molumbo however thanked the Minister for facilitating the inclusion of TB interventions in state health insurance schemes towards this to increasing counterpart budgetary allocation for current Global Fund grant.

“The Hon Minister may therefore consider facilitating all states to include TB in their health insurance schemes as they become operational”.

“WHO will continue to support towards keeping TB control strategies up to date, strengthening partnerships, fostering innovation, finding missing cases and building capacity for all facets of TB control”.