TB can be cured—Dr Efe

One-third of the world’s population is thought to be infected with Tuberculosis(TB). New infections occur in about 1 per cent of the population each year. In 2014, there were 9.6 million cases of active TB which resulted in 1.5 million deaths. More than 95 per cent of deaths occurred in developing countries. The number of new cases each year has decreased since 2000. About 80 per cent of people in many Asian and African countries test positive. In this interview with LARA ADEJORO, Dr Eseigbe Efe is a public health at the University of Benin Teaching Hospital (UBTH), Benin, says TB can be cured if patients adhere strictly to their medications.

What’s Tuberculosis?

TB is a disease condition that a lot of people are aware of. Its spread is worldwide, even though, we are beginning to see the decline in the rate of new cases but it’s common in the developing countries due to poverty, poor environmental hygiene, overcrowding. Primarily, it’s a disease caused by the bacterium mycobacterium tuberculosis (MTB). It spreads by droplets from infected people. A lot of people sneeze, cough and eat indiscriminately and these can put a lot of people at risk. A healthy person may not be affected any the bacterium because his body immune system can handle it appropriately. There was a time TB was almost down but because of the incidence of HIV which affects the immunity of people, then there was a resurgence. In many instance, we get to see a lot of people presenting with co-infection like TB/HIV and uncontrolled diabetes and these play a role in decreasing the immune system. There are other people like pregnant women, children, the elderly that tend to also have low immune system. Pathologically, it could be pulmonary (lung) or extra-pulmonary (it happens in the lungs or any other part of the body). TB of the lung is what we know as cough. There’s TB brain, abdomen, genital organ, bones, spines. A lot of people may have TB spine and think it’s arthritis and choose not to go for proper check-up. A lot of people are aware of pulmonary TB but not many are aware of the extra-pulmonary TB. About 10 per cent of latent infections progress to active disease which, if left untreated, kills about half of those infected. Some of the symptoms patients present with, especially the pulmonary TB is cough. The symptom they produce may contain blood, so anybody coughing for a duration of two weeks and above should go to the hospital for check-up. The symptoms also include fever, night sweat, weightloss, loss of appetite, fatigue.

You just said, there is a decrease in TB incidence in the country, what are the factors aiding this?

With the use of the Directly Observed Treatment Short-Course (DOTS) is to prevent non-compliance of the drug because one of the things that can lead to increased prevalence of TB is when patients don’t comply with their drugs and they become drug resistant and keep spreading the infection to contacts. DOTS helps to ensure that patients take their drugs as prescribed and they are given cards, so wherever the patient goes, he can present the card in any health facility and they’ll be able to see how long the patient has taken the medications appropriately.

How is TB diagnosis carried out?

For the diagnosis, they can check the sputum in the laboratory and if it’s positive, then it’s most likely to be TB. The Mantoux tuberculin skin test is often used to screen people at high risk for TB. Those who have been previously immunized may have a false-positive test result. In this particular test, an antibody is injected into the skin and in about 72 hours, the swelling of that part of the body will be measured and if it gets to a particular length, then you’ll know that the person has been exposed to TB.
One of the reasons for drug resistance is that a lot of people don’t comply with their medications. Though, the drug is free and readily available but most people still don’t comply.  TB can be cured if the patient adhere strictly to taking his medications. Usually, most patients with TB co-infection and they also get treatment for both HIV and TB.

What are the challenges doctors face while treating TB patients?

The challenge is that many of the patients don’t present early. Besides,  outside this country, you can’t purchase any anti-biotic without a prescription but in this country, you can get any drug anywhere even on the street. The federal government and the state government are trying but they still need to invest in TB research and drug. There is need for political will