A review of the national tuberculosis and leprosy control programme (ntblcp) of Nigeria: Challenges and prospects

Abstract

This review evaluates the National Tuberculosis and Leprosy Control Programme (NTBLCP) of Nigeria to identify challenges and prospects for reducing the burden of tuberculosis (TB) in Nigeria.TB remains the leading cause of death due to an infectious agent globally. Nigeria has the tenth largest burden of TB cases in the world. Rates of TB morbidity and mortality in Nigeria are spiralling despite expressions of political will to control TB and a clearly articulated NTBLCP policy. This is in contradistinction to the global decline in incidence and mortality from TB recorded from 2004.Information for this review was gotten from NTBLCP annual reports and peer reviewed articles. Literature search was conducted using various databases.Through review and analysis, NTBLCP of Nigeria was found to have sub-optimal Directly Observed Treatment Short course (DOTS) population coverage with shortage of skilled TB health workers at Primary Health Care (PHC) level. There were shortfalls in TB laboratories and quality assurance services with weak integration of TB and Human Immunode iciency Virus (HIV) services. Multidrug-resistant (MDR) TB care services were ledgling and funding for TB control was inadequate. Also identi ied were weak Advocacy, Communication and Social Mobilization (ACSM) and Public-Private-Mix (PPM). There was poor implementation of TB infection control strategies in health facilities.Prospects for TB control in Nigeria included the existence of a 20 year old TB control programme. Others were the presence of political commitment by the Nigerian government and willingness of development partners to assist.Some effective TB control strategies were also examined.Key messages: Rates of TB morbidity and mortality in Nigeria are spiralling despite expressions of political will to control TB and a clearly articulated TB control policy. Following review and analysis of these TB control strategies, progress can be achieved by building upon existing resources while fostering stronger partnerships with relevant organizations.

Through service providers’ eyes: health systems factors affecting implementation of tuberculosis control in Enugu State, South-eastern Nigeria

“…This study also found that government spending on TB control was inadequate, which is similar to evidence from several studies where donors, instead of governments, drive TB control efforts (5)(6)(7)(8)(9)(10)(11)(12)(13).…”

General and Tuberculosis-Specific Service Readiness in two states in Nigeria

“…This has implication for the quality of service provided; for example, studies in Lesotho and Uganda identi ed poor sta ng situation as a major barrier to application of infection control guidelines and the effective implementation of measures such as screening for people with a cough, health education and timely sputum examination [22,24]. This has also been identi ed as a barrier to the successful implementation of DOTS in Nigeria [10,11]. There is, therefore, an urgent need to improve the sta ng situation in all the DOTS centres in order to increase e ciency and effectiveness of the services rendered and reduce heavy workload of the few available staff who are vulnerable to errors, fatigue and burnout.…”

Effects of directly observed treatment short-course education program on the knowledge, attitude and practice of community health extension workers in the management of tuberculosis in Sagamu local government, Ogun state, southwest Nigeria

“…5 At this time, the country's response to TB was still evolving and health training programs had not fully incorporated DOTS into their curricula. It is therefore unlikely that most of the participants received adequate formal instruction on DOTS in the management of TB.…”

“…3 According to national tuberculosis and leprosy control program in Nigeria (NTBLCP), Nigeria is ranked among the 22 high burden countries in the world with predisposing factors including: overcrowding, poor nutrition, poverty, improper diagnosis and treatment and poor compliance. 4,5 In an attempt to stem TB epidemic, the World Health Organization (WHO) introduced the Directly Observed Treatment Short course (DOTS) strategy. 6 The DOTS strategy lays emphasis on close treatment monitoring of TB.…”