TB Control in Nigeria

Abstract

As of 2007, the WHO reported that Nigeria had a tuberculosis (TB) incidence of 311 per 100,000 people. Among the 22 High Burden Countries around the world, Nigeria was ranked fourth highest on the list. Public healthcare spending only accounted for 3.5 % of the total government expenditure. Nigeria has received outside funding from The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), the USAID Tuberculosis Control Assistance Program (TBCAP), and the Canadian International Development Agency (CIDA) program. Nigeria established the National TB & Leprosy Control Program (NTBLCP) in 1989, which started the Directly Observed Therapy Short Course (DOTS) program in 1993. A USAID/CIDA grant helped to increase the DOTS and microscopy centers significantly in 2005. Complicating the TB issue is that currently 27 % of TB patients are co-infected with HIV. The much higher number of DOTS centers compared to ART sites has resulted in a low rate of TB patients receiving ART treatment. Multidrug-resistant TB strains have emerged in Nigeria, with rates among retreatment patients of approximately 15 % in 2010. The STOP TB strategy strongly urges Nigeria to increase public funding for TB from all tiers of government, improve DOTS coverage in healthcare facilities, improve TB services at HIV clinics and HIV screening at TB clinics, and strengthen national laboratories by improving equipment and training.