GLOBAL TUBERCULOSIS SCOURGE: THE NIGERIA PANORAMA

BY: Aghedo Ojore Godday (AMIIM, HRMA)

Nigeria joins the rest of the world every March 24^th, to commemorate the World Tuberculosis (TB) Day. It is important for everyone too to take cognizance of this day and ensure a renewed commitment to protecting one’s family and indeed neighbours from the devastating health, social and economic consequences of this highly infectious disease. Over 95% of TB related morbidity and mortality occur in low-income and middle-income countries especially in Africa. This means a lot to us in the public health sector.

Despite being curable, World Health Organization (WHO), states that TB kills 18 Nigerians every hour and 4,500 people globally per day. 407,000 HIV negative persons and 63,000 HIV positive persons in Nigeria are estimated to have TB every year. While mortality in TB/HIV co-infected persons stands at 39,000 annually, TB related death in HIV negative persons is projected at 115,000 persons annually.

For the records, Nigeria is now ranked 6th globally and 1st in Africa among the 30 high burden countries and sadly among the 14 high burden countries for TB infection prevalence, TB/HIV co-infection and Multi-Drug Resistant (MDR) TB cases (Global TB Report, 2017).

CHALLENGES…

Major challenges faced in the fight against TB in Nigeria include but not limited to:

1.      Low TB case finding both in adult and children.

2.      Poor knowledge about TB.

3.      Poor health seeking behaviour of Nigerians, and

4.      Low TB treatment coverage.

5.      Escalating number of MDR-TB cases

Away from the aforementioned challenges, another threat is that, about one-third of the world’s population has latent TB (according to WHO). Latent TB means, people have already been infected by “mycobacterium tuberculosis” without morbidity and capability of transmitting the disease. However, latent TB carriers do have a 10% lifetime risk of TB morbidity or developing active TB, while persons with compromised immune systems have a much higher risk of falling ill. Compromised immune system is common with people living with HIV (PLHIV), patients of various viral infections, diabetic persons, people who use tobacco or suffer malnutrition.

THE WAY FORWARD…

1.    In addressing the setbacks around case finding, the World Health Organization (WHO) has engaged 12,000 persons to report cases suspected to be TB in about 12 high burden states in Nigeria. While this is an effective and laudable step, that number is not enough; therefore we can volunteer to report TB suspected cases to relevant health professionals in our community health facilities offering TB services. According to Dr Emperor Ubochioma, an estimated 418,000 new TB cases occurred in Nigeria in 2018 but the country was notified of only 106,533 (25 per cent). This leaves us with a gap of over 311,000 (75 percent).

2.    In addressing challenge number four above, Dr Adebola Lawanson and National Coordinator of the National Tuberculosis, Burulli Ulcer and Leprosy Control Programme (NTBLCP), had said through Dr. Emperor Ubochioma, “The Federal Ministry of Health with support from partners is rapidly expanding TB diagnostics and treatment services to more sites across the country.” This is critical because the undetected TB cases constitute a puddle for incessant transmission of the disease in Nigeria. I must commend the FMoH and NTBLCP for the much incentive given to MDR-TB patients, in ensuring adherence to TB treatment.

3.    Ongoing and unalloyed sensitization of the public about TB will enhance case finding and demystify TB treatment myths, which have prevented TB infected persons from seeking professional care and treatment in the past. TB is a bacteria disease, it is curable and it is not a sign of witchcraft. People must know this truth and that is where the media comes in. Medical journalists, researchers and health educators must rise up to this challenge and wear TB a human face like we have done to HIV. “Prevention” they say, “is better than cure.” Preventive measures such as isoniazid preventive therapy (IPT), intensified case finding (ICF), nutrition intervention services, infection control in health facilities and even ART initiation have documented records of effectiveness.  ART significantly but not entirely reduces the risk of TB disease in PLHIV. Some common signs and symptoms of TB are: fever, persistent cough (especially for about two weeks), night sweating and sometimes, lymphnoadenoparthy.

4.     Poor health seeking bahaviour is an endemic problem in Africa, especially among the masculine gender. Female are twice more proactive about their health than the males, but it high time we changed this ugly thread. Regular routine medical checkups can be lifesaving and highly economical. It is always best to seek professional medical advice rather than resorting to self-medication when we feel unwell. In my book: Healthy Life Compass (Aghedo, 2017), I dealt exhaustively with the health consequences of self-medication. While the government is making unpretentious efforts to expand the coverage of health services in Nigeria, Nigerians must make themselves available to access such services.

5.    Right policy formulation – Nigerian government should come up with favourable policies that will enhance smooth intervention of both corporate and private performers towards curbing the TB scourge.

CONCLUSION

Health is Wealth! Health is Priceless!! Health is Life!!! Taking issues of your health seriously is beneficial, because a compromised health can amount to a crumbled life and destiny. TB is curable, yet it is claiming scores of life every single day. This is a cause to worry. While we acknowledge the previous and ongoing efforts of individuals, relevant agencies of the government and global partners/donors on TB programmes in Nigeria and Africa at large, it is obvious we still have much to be done in achieving the 90-90-90 target by 2020 and ending TB by 2030. Just 11 days ago, precisely on March 14^th, 2019, the President announced the latest national HIV prevalence to be 1.4%, a laudable decline from 3.1% in 2015. We must commend the FMoH, NACA, NCDC, other stakeholders and global partners for the success of the Nigeria AIDS Indicator and Impact Survey (NAIIS) – one of the largest HIV/AIDS surveys in the world. Of course, I am glad to be part of that project. So, if we could bring down HIV to this point, then I believe we can eliminate TB in record time. This is a herculean task before us but it is not impossible. The end of TB was made visible when Dr Robert Koch found its cause in 1882, March 24^th. The 2019 World TB Day theme is: “IT IS TIME!” Indeed, it is time for action… It is time to End TB in Nigeria and Africa in general. It is time for the young, old, men, women and all stakeholders concerned to join hands together in making Nigeria a TB-free country. YES, IT IS TIME! Keep the promise, find TB and treat TB!

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© Aghedo Ojore Godday (AMIIN, HRMA)

NIGERIA GENERAL ELECTIONS: THE PROGNOSIS AND DIAGNOSIS, -BY: Godday Ojore Aghedo

A nation founded on falsehood cannot stand the test of time, so it is with an individual or political cabinet enthroned by stolen mandates. Many people are befuddled and bewildered by the spate of ignoble events that have dragged Nigeria as an entity into the mud of national defacement, value degradation and global object of mockery. Thus, they have continued to query in soliloquy, what is happening to us? How did we get here? Where are we going to? Only to be answered by dead silence. But I have a revelation for you: AFTER OSUN TEMPLATE WAS BUSTED, EDO TEMPLATE WAS USED. The Osun State Template was version 2018 (OST_V.2018) but failed, while the Edo State Template which was version 2016 (EST_V.2016) still spawned results for the mischievous developer and programmer.

Nigeria missed it when the Amended Electoral Bill was not endorsed into law by the president, and the senate was too divisive to exercise their constitutional veto power. We have once again washed our dirtiness in the comity of nations and International Election Observers (IEO). Oh yes, I have my sentiments and candidates of preference because I am a concerned Nigerian and I have right to choose who leads me. But that is not the basis of this write up, it is about Nigeria as a nation and the electoral processes. I am more concerned about the PROCESS than the PRODUCT. This is because, once the PROCESSES are faulty or compromised, the PRODUCTS can never satiate the cravings of the consumers. Having read the lame arguments of some myopic or better put, blind Nigerians whose perspectives are borne out of religious and political party fanaticism, I concluded that we still have a long way to goal in our quest for peaceful, united, strong and progressive nation.

Under our watch, our democracy was not only raped but whisked away to an unknown destination. The ransom for its restoration may be overbearing - I pray we would have learnt our lessons and be equal to the task by then. I also pray that before 2023, a messiah will rise from the wilderness to fix these lapses, amidst predictable strong oppositions though. We finally lost our voices when we started clapping for impunity, vindictive castigations, setting aside of the Rule of Law for party supremacy or so called national interest, dictatorial tendencies, regionalism or regional prejudice, marginalization under the façade of meritorious selection, and cluelessness because of the alleged rottenness of “the past 16 years.”

Let me shock you:

1.       Over-voting is not when the number of casted votes exceed the number of accredited voters. It is when the number of casted votes exceed the number of registered voters in that polling unit (PU). The Nigeria constitution and courts recognize only the later as a malpractice. For instance, if in PU – 5, there are 1300 registered voters, and on election day only 450 voters turned up for accreditation and voting, but result announced was 950 votes, THERE IS NO OVER VOTING HERE BECAUSE 950 DOES NOT EXCEED 1300, even though it exceeds 450 accredited voters. That is a weakness of the Nigeria constitution and some politicians are exploiting it to their advantage.

2.       CARD-READER is not tenable in court for justifying or debunking any electoral malpractice because it is not yet recognized in the constitution; even though INEC adopted it and selectively cancelled votes in polling units where it was not used.

3.       We no longer have an independent, upright and apolitical judiciary. Forget it; judiciary is no longer the hope of “ALL common men” but “selected common men.” They are now loyalists of the presidency and powerful politicians. If you lose any election, don’t border going to court except you are a friend of the employer because verdicts don’t come from judges anymore, but from their employers. However, there is no harm in trying, and I still believe in miracles. Under the current circumstances, ONLY DIVINE INFLUENCE can restore any stolen mandates.

Therefore, I congratulate all the winners and losers at the just concluded general election. And for those with our stolen mandates, remember that your days are numbered and God still rules in the affairs of men (Daniel 4:17).

But as for you my friend, it is a new year, accept the reality and move on. Plan your life, work hard, pray and trust God and you will succeed in this same Nigeria – with or without a responsible government. Do not be a burden on the government, take up the challenge and chart a glorious path for your future. I know you have a great destiny, which is what you should be pursuing. DON’T GIVE UP ON YOURSELF, NOT EVEN ON NIGERIA!

Friends, welcome to the NEXT LEVEL. For me, it is a NEXT LEVEL of glory, success, breakthrough, joyful sounds, celebrations, favour, Holy Ghost anointing and demonstration of power, righteousness and sanctification, relevance in God’s vineyard,  a NEXT LEVEL of unprecedented achievement in my career, a NEXT LEVEL of international and intercontinental open doors, a NEXT LEVEL of financial abundance and prosperity, a NEXT LEVEL of admirable & ground-breaking exploits both in the secular and sacred worlds, physical and spiritual realms, a NEXT LEVEL in purpose actualization, and a NEXT LEVEL in my walk with God.

I speak to Nigeria today, you are delivered from demonic manipulations, you people shall not be foolish, you will experience a NEXT LEVEL of economic growth, unity, technological advancement, agricultural explosion, oil boom, peace, GDP growth, infrastructural development, massive job creation, a NEXT LEVEL of sincere war against corruption and insecurity, it shall be an indisputable POSITIVE NEXT LEVEL for Nigeria and Nigerians, so help us God.

From this month forward:

-Nigerians will march forward,

-Nigeria will march forward,

-Nigeria will work again

-There is hope for Nigeria.

My name is Godday O. Aghedo - a concerned Nigerian, a space-age & futuristic thinker, and an objective analyst. I remain apolitical!

©Godday O. Aghedo, March, 2019