Till today, Tuberculosis (TB) remains an alarming Public Health challenge in Nigeria, with recent data highlighting both progress and persistent gaps in case detection and management. The World Health Organization (WHO) has designated Nigeria as a nation with high burdens of drug-resistant variations (DR-TB), TB/HIV, and TB. Yet, underreporting of cases continues to increase the high risk of transmission. TB services are also not completely integrated into standard pediatric health treatments like immunization and nutrition. According to estimates, 15 people can contract Tuberculosis annually from a single missed case.
The gap in case detection is mostly among children, due to some health workers at facility and community level not sufficiently skilled to detect childhood Tuberculosis, as well as a lack of awareness among families and communities. An estimated 361,000 cases were reported in 2023, a 26% rise over 2022, according to preliminary data. Interestingly, children accounted for 9% of these cases, showcasing the disease’s influence on people of all ages. This increase in case notifications is indicative of the continuous work to enhance reporting and detection systems across the country.
Nigeria aims to achieve the End TB Targets by 2025.
With 282,184 cases reported, 2022 likewise experienced a high case count. In 2021, the country recorded 204,725 reported cases of tuberculosis, which accounted for around 44% of the 467,000 incident cases that year. This showed that more than half of the cases were unreported or untreated, highlighting significant difficulties in the healthcare system’s ability to properly detect and treat patients. According to the Global Fund, Nigeria has made some noteworthy progress toward achieving the End TB Targets, which call for a 50% decrease in the prevalence of cases and a 75% reduction in mortality by 2025.
As per the revised National Strategic Plan for TB (2021–2025), strengthening information management systems is crucial for providing care. The Management Science for Health (MSH) in Nigeria has invested in a manager Case Notification system with technical support and funding from USAID and the Global Fund. This system collects real-time data, which is then extracted and imported into the country’s DHIS2 site. It was also reported that the Nigerian government, the Global Fund, and health partners have signed eight new grants worth US$933 million.
Several innovative tactics have been put into practice.
This additional fund was targeted to support national health systems and pandemic preparedness while aiding in the fight against tuberculosis from 2024 to 2026. International collaborations and initiatives have greatly aided progress in reducing TB in the country. Nigeria’s National Tuberculosis, Buruli Ulcer and Leprosy Control Programme, together with its partners, including WHO, has been putting several innovative tactics into practice, such as a TB drive across the 36 states and Federal Capital Territory, to intensify case detection across the country. In May 2023, a unique week of testing was held to identify cases among children.
According to Dr. Sheu Gele, the manager of the Kebbi State TB program, the effort demonstrated the significance of case-finding in the community, particularly among youngsters, and signifies the start of ongoing active surveillance for TB in accordance with WHO guidelines. He continues by saying that extensive mobilization and raising awareness among health and community professionals, especially pediatricians and community-health workers, has been successful. WHO has supported the national program’s adoption of evidence-based case-finding tactics, such as health workers training.
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In 2023 and the first three months of 2024, WHO educated 242 health workers to enhance the identification, reporting, and treatment of cases in five states, with support from The Global Fund to Fight AIDS, TB, and Malaria. Additionally, WHO also trained 60 supervisors from 27 local government units in Borno State for 10 days in January 2024 at the governor’s request. It has implemented the testing use of a “treatment decision” algorithm and aided in the implementation of the six-month treatment regimen for drug-resistant tuberculosis. This aims to standardize clinical evaluation and decision-making in order to improve the detection of tuberculosis cases in children.