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Tuberculosis: Physicians suggest measures to prevent spread, reduce burden

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Some public physicians on Thursday suggested strategic measures to prevent spread and reduce the burden of tuberculosis (TB) in Nigeria.

They said the burden of TB was heightened by various factors.

The factors included unclean environment; unhealthy living; lack of screening; open defecation; malnutrition; overcrowding; and uncompleted treatment.

Tuberculosis is caused by bacterium (Mycobacterium tuberculosis) that often affects the lungs.

It is spread from person to person through the air. When people with TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

Statistics from the World Health Organisation show that Nigeria ranks first in Africa and sixth among 30 countries globally with the highest burden of the disease.

Nigeria also ranks first in Africa with the number of undetected cases.

A public health physician, Dr Chidiebere Thaddeus, blamed the high incidence of tuberculosis, which was common among rural and city slum dwellers in Nigeria, on the current economic hardship in the country.

Thaddeus identified malnutrition as a factor that had reduced TB patient’s chances of surviving treatment.

According to him, the economic hardship and inflation in the country made it difficult for a lot of people to afford a balanced diet or feed adequately.

He said that unhealthy living environments and open defecation were practices still common in Nigeria, that greatly contributed to the burden of tuberculosis.

He said, “Nigeria is ranked the highest country with open defecation and Lagos is the highest city in Africa with open defecation.

“This implied that a lot of people in the country still randomly urinate and defecate without minding the health implications of such acts.

“Unhealthy environment due to pollution and open defecation/urination increases the chances of contracting diseases like TB.”

He advised that every act that could result in environmental pollution and an unhealthy environment should be discouraged as part of an effort to curb the burden of TB.

Also, a Medical Laboratory Scientist, Mr Olumide Fadipe, expressed worry over the position of Nigeria as the sixth and first in rank among countries with high TB cases in the world and Africa respectively.

Fadipe, the Chairman, Association of Medical Laboratory Scientists of Nigeria (AMLSN), Lagos State Chapter, said that finding hidden cases remained the major challenge with Tuberculosis control in the country.

According to him, there is a need to focus more on TB screening and treatment as more Nigerians have less access to good meals which can boost their immunity against the infection.

“Nigeria remains one of the 30 countries globally with the highest burden of the disease. Nigeria also ranks first in Africa in the number of undetected cases.

“Since we are dealing with a highly infectious but treatable disease, we have to focus on detecting these cases and then caring for the affected ones to prevent the spread.

“Detection of new cases and placing them on care should be the major focus point,” he said.

A general physician, Dr Ayodele Ademola, also advised that people should devise other means of exchanging pleasantries and appreciation, rather than hugging.

Ademola, also the Medical Director, StrongTower Hospital and Advanced Fertility Centre, said that overcrowding and close contact were major means of contracting the TB infection.

“TB can easily be transmitted through close contact with an infected person. Maintaining social distancing is key in preventing its spread. You can show love or appreciation without embracing.

“Another core challenge is patients who break their treatment plan and stop taking their drugs, which gives room for multi-drug resistant tuberculosis. This makes the bacteria become resistant to treatment and drugs become ineffective,” he said.

Ademola emphasised the need for more advocacy on tuberculosis particularly at the grassroot to educate the masses about the disease.

“Tuberculosis is one of the most violent infectious diseases; it still needs to be tackled, and a major way to curtail it is through advocacy.

“Therefore, communities need to know how the disease spreads and how it can be prevented and controlled.

“This is important now because the economic situation denies people good food, which has brought malnutrition and has made the antibodies of tuberculosis patients almost impotent,” he said.

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WHO to begin vaccination against Human Papilloma Virus May 27 in Kogi

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The World Health Organisation (WHO), says it plans to commence vaccination against Human Papilloma Virus (HPV) on May 27 in Kogi.

The state’s Team Lead of WHO, Dr Muktar Toyosi, said this when he led his team on an advocacy visit to the State Council of the Nigeria Union of Journalists (NUJ) on Wednesday in Lokoja.

Toyosi said that the vaccination was meant for girl child of between the age nine and 14.

He said the ongoing sensitisation was to keep the people informed, and educate them on the vaccination of their children to protect them against cervical cancer in future.

”Kogi falls within the second phase of the programme. We are soliciting for the cooperation of the media in educating the people of the state on the HPV vaccination.

“There need for girls child across the state to take the vaccination to safeguard their future.

“Although the vaccine was initially scarce and difficult to get, the good news now is that it has been made available by the government,” Toyosi said.

Also speaking, the State Technical Assistant for WHO, Dr Ahmed Attah, said that the HPV mostly affect women, adding that the vaccination remained a preventive measure against the disease.

Attah, a former state Chairman of the Nigeria Medical Association (NMA) and a former Chief Medical Director (CMD), Kogi Specialist Hospital (KSSH) Lokoja, urged parents and guardians to avail their children of the vaccination to justify government’s investment.

In his response, the Kogi NUJ Chairman, Mr Seidu Ademu, described the health sector as very critical, stressing that the vaccination was a right step in the right direction.

Ademu promised a robust partnership with WHO to enable the team to achieve its set goals.
He stressed the need to inform, educate and sensitise the general public on the need to embrace the vaccine by ensuring that girls within the age range were vaccinated.

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NCDs will be leading cause of mortality in Africa by 2030 – WHO

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The World Health Organisation (WHO) says Non-communicable Diseases (NCDs) will become the leading cause of mortality in Africa by 2030 if urgent measures are not executed by member states.

Dr Matshidiso Moeti, WHO Regional Director for Africa, joining virtually, made the assertion on Tuesday at the opening of the first International Conference on PEN-Plus in Africa (ICPPA 2024) in Dar es Salaam, Tanzania.

The ICPPA 2024, holding from April 23 to April 25, is aimed at addressing severe NCDs in Africa.

It is being hosted by the WHO Regional Office for Africa, Helmsley Charitable Trust, and the United Republic of Tanzania. Moeti urged member states to embrace strategies that would help to address the issue.

“We are faced with non-communicable diseases and data from low and middle income countries show that 26 per cent of total health spending was due to NCDs, second only to infectious and parasitic diseases.

“Meaning it is urgent to give these often overlooked diseases priority attention as Africa is severely affected and more than in any other place in the world.

“The surge in the burden of NCDs on our continent over the past two decades, is driven by increasing incidences of risk factors, such as unhealthy diets, reduced physical activity, obesity, and air pollution.

“NCDs are set to overtake communicable, maternal, neonatal and nutritional diseases combined as a leading cause of mortality in Africa by 2030.

“And here, the NCDs are called silent epidemics. Unfortunately, this rapid devolution, with a higher mortality rate has not been recognised in the region, because we’re not investing adequately in detecting and lowering the burden of these diseases,” Moeti said.

Moeti noted that severe NCDs like type one diabetes, rheumatic heart disease, and sickle cell disease more frequently affect children and young adults in the majority of Africans population.

She advised that Africa must show increased commitment in addressing NCDs with adequate and sustained resources.

She also said there was the need to strengthen accountability and assess the impact of interventions by enhancing surveillance and monitoring.

According to Moeti, this can be achieved using reliable and timely data at national and sub national levels to drive policy and action as we move forward.

Ms Elke Wisch, UNICEF Representative to Republic of Tanzania, said that collaboration was at the heart of collective response to tackling NCDs.

“Today’s gathering underscores the urgency and importance of addressing NCDs comprehensively and collaboratively.

“The WHO package of essential non communicable  interventions for PEN, for primary healthcare and low resources settings, and the recently launched regional strategy on PEN-Plus provides a strategic framework  for tackling NCDs at their roots,” she said.

Also speaking, Ummy Mwalimu, Minister of Health, Tanzania, said that non communicable diseases NCDs, have become a formidable threat to the health and wellbeing of “our people.”

She urged for collective efforts to address these threats.

“They are silently affecting the lives of our citizens, our communities, undermining the progress we strive to achieve as a nation.

“The impact of these diseases extends beyond individual suffering.

“It affects our communities, our economy, and ultimately the future of our nations in our continent.

“Yet, in the face of these challenges, we are not discouraged together. We have chosen to confront these non-communicable diseases.’’

She urged for lifestyle change as positive way to combatting the negative outcomes of NCDs.

James Reid, Programme Officer for the Helmsley Charitable Trust’s Type 1 Diabetes (T1D) Programme, said he was happy at the level of interest and momentum in engagements to address NCDs, especially Type 2 diabetes.

He, however, identified finance as one of the biggest challenge and hindrance. He said that while political leaders and stakeholders identify the challenges that NCDs pose, the strategies to prevent them, especially NCD care, were limited.

“Leadership for driving of PEN-Plus is very important to make sure that ministry of health leaders and all others involved, really understand how to change the dynamics as well as adopt solutions to suit specific localities,” she said.

WHO’s PEN-Plus (Package of Essential NCD-Plus), is a regional integrated care delivery strategy to address severe non-communicable diseases at first-level referral health facilities.

At the 2022 WHO Regional Committee Meeting for the African Region, the 47 Member States of the AFRO region voted to adopt the PEN-Plus strategy.

It is focused on alleviating the burden among the poorest children and young adults. This is by increasing the accessibility and quality of chronic care services for severe NCDs including Type 1 diabetes, rheumatic heart disease, and sickle cell disease.

 ICPPA 2024 provides opportunity to shore up international support for scaling up PEN-Plus in the African Region. Also, the conference serves as a platform to raise awareness of severe NCDs, share lessons from countries implementing PEN-Plus and identify opportunities to strengthen NCD management.

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UNICEF emphasises importance of polio vaccination to caregivers

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The United Nations Children’s Fund (UNICEF) has encouraged caregivers in Katsina, Kano and Jigawa States to present their eligible children for the next round of polio vaccination exercise.

Mr Michael Banda, the Officer-in-charge of UNICEF Kano Field Office, made the call in Kano at a media dialogue on the polio campaign on Friday.

The media dialogue was organised by UNICEF in collaboration with the Kano State Primary Healthcare Development Agency, with participants from the above-mentioned states.

The News Agency of Nigeria (NAN) reports that the four-day polio vaccination exercise is scheduled to commence on April 20, across the three states.

According to the UNICEF Officer-in-charge of the Kano field office, the importance of the exercise cannot be overemphasised.

“As the data show, in Kano, Jigawa and Katsina, we have over 556,750 children who have not received one single dose of vaccination they should have received.

“These are referred to as zero-dose children. Such children inexorably are vulnerable to vaccine-preventable diseases, including poliomyelitis.

“This is unacceptable and must be tackled frontally. Not only is polio vaccination crucial, but all routine vaccinations are also critical to children’s survival.

“We must all work together to strengthen routine immunisation services and ensure that all children under five receive all vaccines, including the polio vaccine,” Banda said.

He added that, if all children got vaccinated and receive the vaccines they needed to receive, they would no longer be at risk of contracting polio, with attendant debilitating consequences.

He said that, rather they would have received the immunity which would protect them against vaccine-preventable diseases.

Banda emphasised that immunisation had been proven to be the most cost-effective protection against vaccine-preventable diseases.

“Let’s all work together, government, development partners, religious and traditional leaders, communities, NGOs, CSOs and the media, to ensure that every Nigerian child under five is vaccinated.

“This will protect them from not just polio, but all other vaccine-preventable diseases,” he appealed.

According to the UNICEF official, managing misinformation and vaccine hesitancy for Polio and overall vaccination is very crucial in Nigeria to stop the outbreak.

He stressed that the role of the media, including social media, was important in this aspect.

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