Partnering to End TB in Nigeria

Effective screening for tuberculosis (TB) and tuberculosis preventive treatment (TPT) can prevent TB infection including for people living with HIV. TPT is a proven course of treatment that can prevent TB disease and has been shown to reduce TB-related mortality among people living with HIV (PLHIV) by 37 percent. When taken with antiretroviral therapy (ART), TPT can lower the risk of TB disease for PLHIV. TB remains a public health threat in Nigeria, with an estimated 63 deaths per 100,000 among PLHIV.

Since 2001, the U.S Centers for Disease Control and Prevention’s (CDC) has partnered with the Federal and State Ministries of Health in Nigeria and other implementing partners to scale-up HIV and TB testing, treatment, and prevention services. In addition to TB disease surveillance and laboratory services, CDC provides leadership in TB/HIV collaborative efforts to address both diseases, and TB infection prevention control programs.

Strong collaborations have provided meaningful progress in tackling these dual epidemics in Nigeria and community members and colleagues also play an essential role in this effort.

Mary with her adoptive mother after completing TB treatment

Everyday Advocates

An Educator’s Passion

After a difficult pregnancy, Mary’s mother passed away shortly after her birth, and unfortunately, her father remained uninterested in her care. Due to difficult living conditions, Mary’s older sister, a secondary school student, became her primary provider soon after birth.

Her sister often brought Mary to school to ensure Mary was cared for. On such an occasion, a teacher noticed Mary had a severe cough. After several weeks of observation, it became clear to the teacher that Mary’s condition was not improving.

The teacher was aware of appointments for clinical assessments at the local maternity at Bowen University Teaching Hospital; a CDC supported facility in [Insert City and State]. On July 30, 2021, Mary was diagnosed with TB at ten months old. Following the diagnosis, the teacher’s resolve to help Mary deepened. She attempted to register Mary at a local orphanage so she could receive the necessary social support; however, Mary was rejected due to the TB diagnosis.

Knowing Mary needed more support than her family could provide with limited resources, the teacher began the process of legally adopting Mary. The teacher and her spouse were given TPT to administer to Mary as part of her TB treatment. As of January 2022, Mary had successfully completed her TB medication and is free from TB in her new home.

“I was a shadow of myself, and I thought my life was over.

Adeyemi Babatunde serves an essential role in his community as a fish distributor. His health is vital to his work, and when Adeyemi experienced a period of prolonged illness, he visited Bowen University Teaching Hospital, where he was diagnosed with HIV and TB.

Adeyemi at Bowen University Teaching Hospital after completing TB treatment

“I was a shadow of myself, and I thought my life was over,” Adeyemi shared. At the hospital, Adeyemi immediately began ART and TB treatment. However, during his course of treatment, Adeyemi started to feel better and grew tired of all the medications. “I thought I was doing fine and at a point got tired of taking my medications.”

Due to incomplete treatment of the TB infection, Adeyemi developed drug-resistant TB. Drug-resistant TB is harder to diagnose and can require up to two years of treatment, costing 10-30 times more to treat than the non-resistant type of TB. Because TB is airborne and contagious, the continued spread of drug-resistant TB could threaten the larger community. Proper treatment was paramount for Adeyemi and helped ensure the safety of those around him. “With the support of the TB officer and the counselors, I was able to complete my TB treatment successfully, and I am currently adhering to ART,” added Adeyemi.

The impact of treatment was not lost on Adeyemi. Now healthy, he advocates for his colleagues to get tested for HIV and TB. Adeyemi has even referred a coworker to the same hospital where he was diagnosed and treated. The colleague was evaluated and diagnosed with TB and is currently on treatment.

Building Community Partnerships

With CDC’s support, APIN Public Health Initiatives (APIN) works closely with the State Ministries of Health to strengthen TB and HIV activities in Nigeria. This partnership works to:

  • Enhance case worker capacity in TB and HIV programs;
  • Support increased TB case finding by providing free chest x-ray services for those newly diagnosed with HIV;
  • Conduct contact tracing of all TB cases.

APIN also supports HIV testing services for all presumptive and diagnosed TB cases at supported sites through the provision of HIV test kits. Services are provided at 37 facilities (17 Prevention of Mother to Child Transmission sites and 20 ART sites) in Oyo, Nigeria. Through the collaborative effort between clinics and community advocates, presumptive TB cases are successfully linked to diagnostic and treatment services.