About a year ago, Mallam Mainasara Mohammad, a resident of Makera, a locality in Kebbi State, Nigeria, grew increasingly concerned about his nine-year-old son, Yusuf. The child had been coughing for weeks, having difficulty sleeping, and was unable to attend school.
After hearing on the radio about the government offering free tests for people coughing for more than two weeks, Mohammad took Yusuf to the health center. Following a chest x-ray and a sputum test using the specialized GeneXpert system for rapid tuberculosis (TB) diagnosis and antibiotic sensitivity testing, Yusuf was diagnosed with drug-resistant TB.
Yusuf immediately began treatment with a combination of TB medicines for six months. Additionally, Yusuf’s family members were screened for TB and given a course of anti-TB medications to prevent the spread of the disease. The medication was provided free of charge to the family.
Mohammed recalls, “We would go to the hospital every week to collect the TB treatment. This allowed the health workers to monitor Yusuf’s progress. I am relieved that my son is now better and back in school.”
Nigeria has the highest TB burden in Africa, with 268 people dying from the disease in the country every day. However, TB cases are underreported, increasing the risk of transmission. It is estimated that one missed case can infect 15 people with TB in a year.
The gap in case detection is most pronounced among children due to insufficient training of health workers at the facility and community levels to detect childhood TB, as well as a lack of awareness among families and communities. TB services are not fully integrated into routine children’s health services such as nutrition and immunization programs.
To enhance TB case detection in the country, Nigeria’s National Tuberculosis, Buruli Ulcer, and Leprosy Control Programme, along with partners like the World Health Organization (WHO), have been implementing various innovative strategies. This includes a TB drive across all 36 states and the Federal Capital Territory, as well as a special childhood TB case-finding testing week held in May 2023.
According to preliminary data, over 361,000 TB cases were reported in Nigeria in 2023, with 9% of these cases occurring in children. This marked a 26% increase in the number of cases compared to 2022.
“The TB drive highlighted the importance of case-finding in the community, particularly among children, and signals the beginning of ongoing active TB surveillance in line with WHO standards,” says Dr. Sheu Gele, the TB programme manager in Kebbi State.
Community sensitization efforts target high TB burden communities, guided by data and a hotspot mapping tool. Community health workers work with local organizations to engage community leaders, conduct meetings, and mobilize efforts to find active TB cases.
WHO has supported the national TB program by implementing evidence-based strategies for case-finding, including training health workers. With funding from The Global Fund to Fight AIDS, Tuberculosis, and Malaria, WHO trained 242 health workers in 2023 and the first quarter of 2024 to improve TB case detection, reporting, and treatment in five states. Additionally, in January 2024, WHO conducted a 10-day training for 60 TB supervisors in Borno State at the request of the state’s governor.
WHO has also helped roll out a six-month treatment regimen for drug-resistant TB and is piloting a “treatment decision” algorithm to standardize clinical assessments and enhance TB case detection in children.
Dr. Walter Kazadi Mulombo, WHO Representative in Nigeria, emphasizes WHO’s commitment to working with the Government of Nigeria and partners to eliminate TB. TB is preventable and treatable, and by quickly detecting and treating cases, the goal of eradicating TB from Nigeria can be achieved.
Distributed by APO Group on behalf of WHO Regional Office for Africa.