Nigeria Adopts Client-centred Strategies, Reaches Out To Vulnerable Population To Control Tuberculosis And COVID-19

On a recent weekday, when 25-year-old John Odido left his home at Gishiri Village, Abuja, to his barbing shop in the same community, he had no plan to conduct any medical test or get his first dose of the COVID-19 vaccine. 

Like most young people in the community, Mr Odido had been procrastinating, believing there was no urgency to receive the vaccination due to the decline in reported COVID-19 infection cases in Nigeria.

However, with convincing information from the mobilization team of the National Tuberculosis and Leprosy Control Programme (NTBLCP) during the National Tuberculosis (TB) Testing Week community outreach, with the theme: “Check Am O”, Mr Odido had a change of heart.

The outreach was organized by NTBLCP in collaboration with the World Health Organization (WHO) and partners to increase TB case notification in the country while leveraging the services to detect Tuberculosis (TB), Human Immunodeficiency Virus (HIV/AIDs) and COVID-19 cases and provide the COVID-19 vaccine to the people. The campaigns were conducted during the period of 1-5 August in many of the states across the federation.

Mr Odido joined the queue of people waiting to conduct TB, HIV and COVID-19 tests and returned to receive his results after two hours. The results of all his tests came out negative. Thereafter, he received his first jab of the COVID-19 vaccine.

“I received the COVID-19 vaccine because I know COVID-19 is still around. It is convenient to receive it here as it has saved me from making the trip to our health centre, which is far from my house. I went to convince my friends to take the tests and receive COVID-19, but some are declining, and because of them, I know I have to continue observing all the infection prevention and control measures,” he said.

The selection of the Gishiri settlement as the outreach post was based on a data review of the burden of TB, and the population density of the area which revealed that some diagnosed TB patients come from this community within the metropolis of the Federal Capital Territory.

For Victoria David, a 40-year-old housewife and mother of six, the TB testing brought to her vicinity motivated her to come out for testing as it also saved her from making a trip to the health care centre.

Mrs David said she had been having bouts of cough and decided to check it out.

“I had treated for TB about two years ago. But I started coughing again early this year, and immediately I heard they were conducting TB test, I decided to take advantage of the opportunity,” she said

Meanwhile,  Grace  Daniel, a 23-year-old student and trader, also took advantage of the outreach to receive her second COVID-19 jab.

She was also lending her voice to convince her family members, friends, and other youths about the need to take the COVID-19 vaccination without further delay.

Ms Daniel said she had received the first shot last year but did not complete it because she had to travel to school.

“I kept procrastinating on receiving the second dose, but now that they are here, I have received it,” she said.

Optimizing opportunities

TB and COVID-19 are both infectious diseases that attack primarily the lungs and have similar symptoms such as cough, fever and difficulty in breathing. TB, however, has a longer incubation period with slower onset of disease.

Both diseases have high fatality rates globally, with TB being the highest cause of death from a single infectious disease prior to the COVID-19 pandemic, and Nigeria ranks sixth among the 30 high-burden countries in the world and first in Africa.

Meanwhile, the COVID-19 virus has infected 262 664 people with 3147 deaths in Nigeria from the onset of the pandemic.

To mitigate the spread of both diseases in the country, the National Coordinator, National

Tuberculosis, Buruli Ulcer and Leprosy Control Program (NTBLCP), Dr Chukwuemeka Anyike, said integrating the services would strengthen the health system to detect and respond to the diseases while putting the patient at the centre of health care service delivery.

We are taking advantage of the TB testing week currently underway to find as many missing TB cases as possible in the country. We are also using the opportunity to test for COVID-19 and HIV and provide the COVID-19 vaccination.

“Essentially, the campaign is leveraging the meagre available resources to achieve the global push for integrated health services, and we hope that at the end of the year, we will record a higher TB case notification than last year,” he said.

In 2021, Nigeria notified 207,785 TB cases, 50% higher compared to 138,591 cases notified in 2020.

Vital partnership

Commending the government for the initiative, the village head, Chief Bala Akusu Nbwaha, said he was impressed with the turnout of the people in the community.

“We sensitize the people about the importance of checking for TB and COVID-19 as well as receiving the COVID-19 vaccine. My cabinet members and I, have received the COVID-19 vaccination and that is why we are encouraging others to do so, he said.

During the campaign in the community, 127 people were screened for TB and 19 tested for COVID-19. Of which 44 presumptive TB were identified. For further confirmation, sputum samples were collected from 43 persons and 4 were positive. Meanwhile, 64 people received the COVID-19 vaccination. Of which 57 received the first shot.

Given that eliminating TB and achieving herd immunity against COVID-19 are top government priorities in Nigeria, Dr Enang Oyama, WHO technical officer, said WHO and its partners have continued to support the Government of Nigeria to leverage the COVID-19 response to drive a joint TB/COVID-19 bidirectional screening and vaccination campaign to improve TB case finding.

He said with the similarities between both diseases an innovative approach was adopted to achieve maximum optimization of funds and human resources.

Dr Oyama emphasized that active TB case finding is vital in combatting the scourge of the disease as over 300 000 cases are estimated to be missed annually.

“Furthermore, WHO will continue to support the government at all levels to ensure that the Covid-19 response programme takes advantage of the extensive structures and human resource capacity available in the TB control programme to improve the diagnosis and management of cases at the community level,” he said.

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