-Caveat Lector-

Poverty Blamed for Rising TB Cases in Nigeria


Africa News Service
23-MAR-99

LAGOS, Nigeria (PANA, 03/23/99) - Peter Ajayi is a middle-aged emaciated man,
who lives on alms begging in Lagos. He attracts attention to himself with a
cardboard he wears round his neck. It bears the folowing words: "I am a TB
(tuberculosis) patient. Please help me with money so that I can purchase my
prescribed drugs."

It is doubtful if he gets any help from people. This is probably because he
begs at bus stops, where most of the people hardly have enough for themselves.


Another reason could be that it is unwise to get too close to a tuberculosis
patient for fear of contracting the dreaded air- borne disease.

But Ajayi is just one of the over 100,000 people who suffer from TB in
Nigeria, according to the federal ministry of health.

As Nigerian joins the rest of humanity in marking the World TB Day Wednesday,
health officials here say the disease is fast becoming a serious problem in
the country of more than 104 million people.

In a recent study, the Nigerian Institute of Medical Research (NIMR) found
that besides the number of TB cases rising, the disease was "now the leading
killer of people infected with the AIDS virus."

Oni Idigbe, a researcher with NIMR, attributed the increase to the prevailing
poor economic conditions in Nigeria, which he says has resulted in the
majority of the populace not having enough or even the right type of food to
eat. Consequently, he continued, "many have become malnourished."

Other factors blamed for the high incidence of the cases in the country are
poor hygiene and overcrowding.

According to Idigbe, the majority of the TB patients in Nigeria were aged
between 20 and 49.

A former health minister, Ikechukwu Madubuike said that TB was already a major
public health problem, even if only an insignificant fraction of the sufferers
come forward to receive treatment "owing to the social stigma associated with
the disease."

But the federal health ministry has launched a campaign to encourage TB
sufferers not to shy away from treatment. The message being sent out is that
the disease can be cured provided treatment is started early, taken regularly
and sustained for the correct length of time.

Above all, the ministry stresses that the treatment is free at all TB clinics
in the country.

These clinics use "DOTS" (Directly Observed Treatment Short course) considered
the most effective strategy available for controlling TB.

Recommended by the World Health Organisation, DOTS does not only involve
direct observation of treatment, but also requires microscopy services,
reliable drug supply and monitoring systems as well as politiical commitment.

In the last three years, over 60,000 patients have been treated under DOTS in
Nigeria, according to official figures.

Records from the National Tuberculosis and Leprosy Control Programme show that
some foreign agencies have been assisting the ministry in control efforts
because of the huge cost of running clinics for the two diseases.

These include the German Leprosy Relief Assciation which is active in 14 of
Nigeria's Southern States including Abia, Anambra, Akwa Ibom, Bayelsa, Cross
River, Delta, Ebonyi, Edo, Enugu, Ekiti, Imo, Rivers, Ogun and Ondo.

Other assisting agencies are the Damien Foundation of Belgium, currently
working in Oyo and Osun States, west of the country, while the Netherlands
Leprosy Relief is helping in containing TB in Bauchi, Gombe and Kaduna in the
North.

As a result of the assistance from these foreign agencies, the health ministry
has been able to establish TB treatment facilities in about 300 of the 776
local government areas in the country.

Some 100 mocroscopy centres for carrying out TB tests as well as 350 treatment
centres have also been set up across the country.

But experts say the cooperation of all concerned, including the health
authorities, the patients themselves, the assisting agencies, as well as the
public at large and poverty alleviation mechnisms remains a vital element in
the treatment and control of TB.

By Chike Okocha, PANA Correspondent



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