Findings from a new research across West Africa have shown increasing levels of Multi drug-Resistant Tuberculosis (MTB), sounding an alarm of a possible epidemic, particularly in Lagos and Ibadan, the region’s most populous and largest cities respectively where the prevalence rate is astronomically high.
The findings which were published yesterday in the BMC journal of medicine, found a high proportion of isolates that were resistant to one or more first-line drugs accounted for 39 percent across the West African sites.
In 2014, 9.6 million people around the world became sick with TB disease and there were 1.5 million TB related deaths worldwide, noted the Centers for disease Control and Prevention.
“I know that it is on the increase,” says Michelle Dania, a chest physician at the Lagos University Teaching Hospital (LUTH).
Oretayo Oni, a medical doctor in Lagos also says “it wouldn’t be far-fetched to find that a metropolitan city with very active and rather porous borders will have a significant change in medical statistics. We are after all the largest metropolitan city (population-wise) in Africa.”
Drug-resistant TB (DR TB) is spread the same way that drug-susceptible TB is spread. TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.
In 2015, an estimated 480 000 people worldwide developed MDR-TB, and an additional 100 000 people with rifampicin-resistant TB were also newly eligible for MDR-TB treatment.
“What is spurring the increase in drug resistance include poor drug quality, poor drug combination, and the HIV epidemic. When patients do not complete their medication when they are treated for the first time, they are at increased risk of developing multi-drug resistance tuberculosis, or if the initial treatment was not appropriate. it makes treatment more difficulty as readily available drugs are no longer effective,” says Dania.
According to her, “when individuals are exposed to a patient who has multi-drug resistance tuberculosis, they are also at risk of getting that same resistant strain. Because patients have responded poorly to treatment, other members of the society are at risk of getting infected with the disease as well.”
Dania advices prevention saying “what can be done to curtail it is that anyone who notices they have been coughing for more than two weeks should report at the nearest tuberculosis treatment centre, so they can be identified on time and treatment commenced. They should also try to get treatment from their right places so that they can get the appropriate medication to start with.”
From the analysis of 974 isolates, an unexpectedly high prevalence of multi-drug-resistant (MDR) strains was found in new (6 %) and retreatment patients (35 %) across all sentinel sites, with the highest prevalence amongst retreatment patients in Bamako, Mali (59 %) and the two Nigerian sites in Ibadan and Lagos (39 % and 66 %). In Lagos, MDR is already spreading actively amongst 32 % of new patients. Pre-extensively drug-resistant (pre-XDR) isolates are present in all sites, with Ghana showing the highest proportion (35 % of MDR). In Ghana and Togo, pre-XDR isolates are circulating amongst new patients.
Oni expresses the thought that prevention can only be anchored on intensive surveillance.
“Low index of suspicion for TB, being on the lookout for symptoms should involve residents of the state and health professionals, and those being treated should be adequately observed to ensure drug compliance,” says Oni
