Nigeria to receive WHO drugs for extensively resistant TB

Nigerian Institute of Medical Research (NIMR) has said that the first batch of drugs to treat cases of Extensively Drug-Resistant Tuberculosis (XDR-TB) is due to arrive in the country next week.  The drugs, courtesy of the World Health Organisation (WHO), are expected to treat some TB patients that are already resistant to first and second-line drugs.

Head of the NIMR TB research group, Prof. Oni Idigbe, on the occasion of the World Tuberculosis Day 2015, commemorated in the institute on Tuesday, told reporters that Nigeria had made steps to go beyond the Multi-Drugs Resistant TB (MDR-TB) and into the XDR-TB for effective treatment intervention.

According to him, “Nigeria is on top of TB cases and we have donor partners that have been supporting us with drugs for MDR-TB. I just came out of meeting that has started ordering drugs for XDR-TB. Government is doing the very much they can do but 80 to 90 per cent of our support now are donor driven,” he said.

Idigbe explained that while first-line drugs are used for treatable TB cases, second-line drugs apply to cases that have developed resistance (Multi-Drug Resistant TB). But where there is resistance to MDR-TB drugs, the anti-XDR-TB is required.   He added that the world had in fact gone beyond anti-XDR-TB drug.

“In India, there have been cases that are known to be resistant to all known TB drugs.”   TB organism in a patient can become resistant to treatment drugs if the patient fails to use the prescribed drugs religiously or if the healthcare giver does not prescribe the exact number of approved combination.

“Drug resistance is very much with us. By 2013/14, the WHO has recorded about 480,000 cases of Multi-Drug Resistant TB (MDR-TB). MDR-TB is also in Nigeria and we are concerned because those that have contacted it can no longer be treated with the first-line anti-TB drugs, which are quite cheap and less toxic.

“They will now be treated with the second-line drugs. These are very expensive, very toxic and take longer period of treatment. You need between one and one-year plus for treatment, whereas it is six months in the case of susceptible TB. So, MDR-TB is a growing problem.”

Continuing, he said Nigeria had been able to come up with a national policy to diagnose and treat MDR-TB at the 14 wards dedicated to MDR-TB treatment across the 36 states. Because of the increasing number of cases now seen, Nigeria has also gone beyond the wards into adopting community-based management of MDR-TBs. He advised that all hands must be on deck to collectively tackle TB cases, often predominant in communities, by creating awareness and going for treatment in cases of persistent cough. Diagnosis and treatment of TB at the DOT centres are free.

Notwithstanding several efforts to tackle the TB problem globally, Idigbe said achieving zero infection would be a tall order before 2025 or 2030. “This is so, because with all the money put into TB, we know we have diagnostic tools, drugs that can cure, structures for protective management, WHO still needs a minimum of $200b to be able to effectively carry out all the strategies on ground for TB.”

Chief Research Fellow and Consultant Paediatrician, Dr. Nkiruka David, added that TB is also common among children, but doesn’t come with cough symptoms like it is the case with adults.   “They are often undetected and that is why we must raise awareness. It is treatable within six months, but it has to be properly diagnosed first,” David said.