As the global community moves towards a TB free world and the achievement of SDG 2030, Nigeria still has the highest burden of Tuberculosis in Africa despite numerous intervention programmes by national and international government agencies. These interventions have focused on programmatic framework, outcomes and few on the TB clients. Very few studies have reported changes in key indicators of TB clients. The TB clients in Nigeria give an insight into the various intervention programmes done and their effectiveness. This research summary compares selected key indicators of TB clients in Nigeria over 5 years (2012-2017) using data from the National Knowledge, Attitude and Practice survey 2012 and 2017.
Knowledge of HIV infection as a risk factor for TB

Figure1: Proportion of TB patients who knew HIV infection is a risk factor for TB
The proportion of TB patients in Nigeria that knew that HIV infection is a risk for TB decreased minimally from 26% to 25% between 2012 and 2017. This pattern was not constant however in all the states. This minimal decrease may reflect the level of health education available for the TB patients in Nigeria presently
HIV Test and results

Figure2: Proportion of TB clients who had HIV test done

Figure3: Proportion of TB patients who collected HIV test results
The proportion of TB patients that were tested for HIV and collected their results improved over the last five years. Nationally, there was a 10.7% increase between 2012 and 2017, while there was 6.6% increase in proportion of TB patients that collected their test results.
Cough

Figure4: Proportion of TB patients who presented with cough > 3 weeks
The proportion of TB patients who presented with cough > 3 weeks to health care facility decreased by 8.9% from 2012 to 2017. This may be because the national guideline now specifies cough > 2 weeks for TB testing now. Also, patients might have had an intervention before presenting at the health facility.
Self-medication

Figure5: Proportion of TB patients who used self-medication
The proportion of patients who used self-medication on the suspicion of TB increased between 2012 and 2017 by 5.3%. This increase may be due to weakness in community sensitization, focus of the intervention programmes and the health seeking behaviour in Nigeria communities.
Diagnosis

The period of diagnosis within three weeks of the onset of symptoms was assessed in 2012 and 2017. There was a 2.8% decrease nationally in proportion of TB patients that were diagnosed within three weeks of onset of their symptoms.
Policy Recommendations:
From the above research summary, the key indicators for TB clients have not improved between 2012 and 2017. Based on this, the following policy recommendations are made:
- Strengthening of integration of TB programmes into existing health care system and not as “stand alone” programmes
- Full engagement of the community in sensitization, implementation, monitoring of the TB programmes in individual community
- Efforts should be made to ensure prompt diagnosis by the use of gene expert and other technologies. In addition, commencement of the medication should be immediately diagnosis is made
“KNOW YOUR STATUS”
These are three words that are central to the control of HIV/ AIDS globally. As the world celebrates the world AID day, it is best to reflect on what it really means and how it aligns with global goals and the SDG of 2030. These words resound with some points to every individual:
- Get tested for HIV and collect your results
- Stay healthy and ensure people around you are healthy when you get your results
(If your test result is negative, continue living with precautions and activities that would ensure you remain negative, and if you test positive, go to the nearest health facility immediately to get anti-retroviral so you can stay healthy and ensure you do not spread the virus)
- Encourage your partner and friends to get tested for HIV
By taking these few steps individually, we can all make the progress towards achievement of the 2030 goal of ending the burden of HIV thus making the SDG a reality.