- More diagnostic machines an advantage
Following the positive impact made by the deployment in 2021 of 39 machines for the diagnosis of tuberculosis (TB) in Nigeria, an additional 333 Truenat diagnostic machines have been provided across the country this year in a bid to scale up detection as a necessary condition for effective treatment of the disease. It is an infectious disease caused by bacteria that often affects the lungs. It spreads through the air when people with TB cough, sneeze or spit. It is preventable and curable.
Funded by the Global Fund, an international financing and partnership organisation established to support the fight against AIDS, Tuberculosis and Malaria, the provision of the diagnostic machines is implemented through the National Tuberculosis Programme (NTP) and endorsed by the World Health Organisation (WHO).
There is every reason for optimism that the substantial increase in the number of these machines will considerably enhance the capacity for detection and treatment of tuberculosis in Nigeria, especially as more areas previously underserved or completely excluded from access to these services can now be reached.
Giving an insight into the immense benefits of the machines, the Head of Laboratory Services at the Tuberculosis and Leprosy Control Programme (NTBLCP), Rita Akpakpan, said: “With Truenat, we can identify TB cases with as few as 30 bacilli per milliliter, compared to 10,000 required for detection by microscopes. This precision will significantly reduce the number of undiagnosed patients, thereby curbing the spread of TB in communities.”
She also noted that “Beyond TB detection, Truenat machines can also identify drug-resistant TB cases, enabling tailored treatment for patients who do not respond to conventional TB drugs. This dual functionality is critical for improving treatment outcomes and reducing the burden of drug-resistant TB.” Also noteworthy is that the machines can be used to diagnose other diseases such as COVID-19, hepatitis and HIV with positive implications for the healthcare system generally.
However, those who administer these programmes have the responsibility to ensure that the machines are maximally utilised and efficiently maintained at the various health facilities to which they are deployed.
The importance of this initiative in the effort to upscale healthcare delivery in Nigeria cannot be overemphasised as the country is reported to have the sixth largest TB burden globally with an estimated 4.3 percent of new cases being multi-drug resistant. According to one study, there are approximately 590,000 new cases of the disease reported annually in Nigeria and of these about 140,000 are also HIV positive.
Indeed, tuberculosis is said to be responsible for more than 10 percent of all deaths in the country. While Nigeria has the second largest TB burden in Africa, it is ironic that the country as at 2018 had one of the lowest case detection rates in the world with an estimated 24 percent of incident cases being detected. This is far lower than the WHO STOP TB objective of 84 percent detection rate. The substantial expansion in the number of diagnostic machines will surely help to redress this deficiency.
Read Also: Estimated billing system: FG to distribute two million prepaid meters by Q1 2025
Treatment period for the disease is often lengthy, running into several months, and most vulnerable victims cannot afford the considerable cost. Given the country’s high population, low detection rates and poor primary healthcare capacity, the resultant delay in treating a tuberculosis patient, according to experts, can potentially result in the transfer of the infection. The consequent increase in the number of affected persons worsens the burden both on the healthcare system and on the economy as a whole. This is why increasing the capacity for early detection and treatment is so critical.
Intensifying efforts to reduce poverty levels and raise the level of economic well-being for most Nigerians is imperative to effectively fight tuberculosis, especially as undernutrition is identified as one of the contributory factors to TB prevalence. Multivarious strategies against diabetes, HIV infection, alcohol use disorders and smoking, which also predispose to tuberculosis, are vital.
The training of sufficient numbers of healthcare workers in the use of the diagnostic machines is equally essential if the initiative is to be sustainable. According to the NTBLCP, training of healthcare workers on their use has already commenced in the Federal Capital Territory (FCT) and Nasarawa State with additional training centres planned for Lagos, Ogun and other parts of the country. However, training two staff members per facility, as planned, is in our view insufficient.
