Igoni, a native of
Omelema community in Abua/Odual Local Government Area of Rivers State has been coughing ceaselessly and decided to seek medical attention in one of the primary health facilities in the state. She had earlier submitted samples of her sputum to the facility’s laboratory, where it was confirmed that she had tuberculosis.
Even though she had started receiving treatment for the dreaded disease, she is worried about the future, she is also battling with how to manage the information, should she tell her husband? What about her head teacher at the primary school where she has secured a teaching job? How will people react? Although there are drugs to help her condition, is it possible that those around her could also have been infected by the virus?
Ibeka, a clinical nurse (one of the few men found in a female dominated profession) seems to be happy with his job and is quite under pressure in his health facility in Oyigbo. At home, his wife is not comfortable with his job especially the fact that he handles tuberculosis patients and often complains that he spends more time in the clinic than at home.
The above scenarios highlight the problems and challenges posed by tuberculosis. Though awareness is on the increase, people identified with the disease are often marginalised and isolated by the society.
Tuberculosis, an ancient disease caused by a bacterium called micro bacterium tuberculosis which affects the lungs of an infected individual generally presents with cough of two weeks and above, low grade fever as well as tiredness, body weakness and weight loss.
According to statistics from the state Primary Health Care Management Board department of disease control, a total of 2,592 T.B cases were detected and placed on anti-T.B. drugs in 2012 and a treatment success rate of 79.5% and cure rate of 72.5% was recorded. Also a total number of 674 cases were detected in the first quarter of 2013 with recorded treatment success rate of 86% and cure rate of 80%
Even though such marked success has been recorded in the treatment of the disease, the state government, with the support of the German Leprosy and Tuberculosis Relief Association (GLRA) has made free treatment of the disease available in over 112 D.O.T.S centres and one in-take centre in Emohua.
At a training session, organised for Local Government Area Tuberculosis/Leprosy supervisors and Primary Health care facility focal persons recently in Port Harcourt, Executive Secretary of the Board, Dr. Claribel I. Abam urged the TBL Local Government Desk Officers to be more committed to their duties so as to increase case detection rates of the disease in various communities from the present 17% to a set target of 50% before the end of 2014.
Dr. Abam said “more is expected of the health workers to reduce the statistics, we all know that the disease (TB) we are talking about here when there is multiple drug resistance, we are talking about death, not just death of the person carrying the disease but death of all the people around there”.
In addition to improvement of case detection rates, Dr. Abam gave assurances of the Board’s commitment to improve treatment success rate and total reduction of defaulter rates (those who stop treatment halfway) from the present 9% to 3% by the end of 2014.
Meanwhile, the Director, Disease Control Services at the Board, Dr. Roland Obed Whyte, believes that with proper health education of patients, families and communities as well as training and supervision of health care personnel at all levels of treatment, the burden of TB can be reduced in line with the Millennium Development Goals.
On his part, Dr. Whyte said “treatment is available in all primary health care centres, all general hospitals and even some private hospitals are partnering with us and the good side of it is that it is free, you don’t need to pay”.
He noted that a facility based survey carried out by his department, shows that HIV infection makes treatment outcome of TB worse and the prevalence of tuberculosis among HIV positive people in the state stands at 27%.
However, Dr. Whyte thinks that with training and retraining of health workers along with community volunteers, the low case detection would greatly improve.
Though, the war against tuberculosis seems to be making appreciable progress in the state, Mr. Messiah Mozan, the state focal person TB Network, an N.G.O. involved in the eradication of the disease in the country thinks that more could be done in the area of sensitization and awareness creation.
“We have in the last one year trained over 160 volunteers in eleven pilot L.G.A’s so that they can go into the communities, create awareness and sensitise the people on TB and they have been working in these areas but we need to scale up to the 23 LGA’s and the volunteers need to be encouraged and motivated with some financial reward, to be able to do the job very well” Mr. Mozan said.
As for Enume Joshua, the TBL supervisor for Ogu Bolo Local Government, she is grateful to the state government for the refresher training course for DOTS focal persons on how to handle TB cases in line with global best practices and encouraged other health workers who are not TB focal persons to be warm and receptive in managing TB patients and not stigmatise them stressing that the job is not only for the TBL focal person.
Owhonda is RSPHC MB’s Information Officer

Joy N. Owhonda