Leprosy, TB curable – Experts

Recently media reports indicated that Anambra state recorded 14 new cases of leprosy. With an estimated 3,800 Nigerians infected with the disease‎, experts have warned that many more people are suffering in silence as adequate statistics on leprosy‎ cannot be collated due to the high level of discrimination and stigma attached to it.
Experts call it a neglected disease. Leprosy is a contagious disease that affects the skin, mucous membranes and nerves, causing discoloration and lumps on the skin and, in severe cases, disfigurement and deformities. Leprosy is now mainly confined to tropical Africa and Asia.

In April 2014, stakeholders further warned that the stigma suffered by people affected by leprosy is causing under reporting of new cases among people living with the condition, thereby preventing them from seeking treatment until it is too late.

According to the National Director of the  Leprosy Mission-Nigeria (TLM), Dr. Sunday Udo, more Nigerians need to be enlightened that leprosy infection is curable and there is no reason to stigmatise those infected with the disease.
He said: “The last fight against leprosy is the stigma. It is a very deep issue that we need to find a way to break the reign of stigma”. A further look at the statistics released by TLM showed that Grade-2 disability—the deformities that set in when leprosy is untreated—rose to 14 percent in 2012, up from 12 percent in 2010. Also, the proportion of children affected rose to nine out of every 10″.

But the National Coordinator of the National TB, Leprosy and Buruli Ulcer Control Programme, Dr. Gabriel Akang told Daily Sun that Nigeria is doing well with the management of  the disease. He said: “We are the custodian of the country’s data on leprosy. We are saying that Nigeria was able to meet the target of 1/10,000 cases of leprosy. This is the elimination target. But the fight is not over especially as we have been able to identify cases of child leprosy and this means, we have transmission of the disease going on in some communities. So, we have to get to these communities and start treatment early because by so doing we cut the spread of infection. We have started our community outreach and we will continue with awareness campaigns so that once people feel the symptoms of leprosy, they will come out for treatment. You might see people whose fingers and toes are already gone, but they have been treated and cured of the disease. But because we cannot really take these people off the streets, some of  them opt for begging.”

Speaking on how stigma has led to people not coming out for treatment and the state of treatment centers, he said: “Most of the people who have been treated, government settles them in rehabilitation centers. I know that in Edo state, government even provided feeding and gave them stipends. But one person sneaked to the road side and by the time he came back, he had more money than what he gets from government. So others joined him on the street to beg. In different states, people affected by leprosy have been rehabilitated, some taught skills and even given special shoes but they want to fend for themselves on the streets. Apart from government, our partners too have been involved with assisting them.”

The saving grace for the management of Tuberculosis or TB, is that it is now categorised with AIDS and Malaria, following the HIV/AIDS pandemic. TB is an  infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease. Nigeria ranks 11th among the 22 high burden countries that account for 80 percent of the Global TB burden. The World Health Organisation (WHO) in the 2013 Global TB Report estimated that a total of 180,000 TB cases occur annually in Nigeria.

Again, according to Abang, a collaborative effort between the three levels of government has ensured that  Nigeria effectively combats the disease. Now Nigeria has an estimated four thousand ‘DOT’ centers where TB is managed. He also explained that those with multi-drug resistant TB need not lose hope as government has what it takes to provide second line treatment for TB.

He said: “When people hear that we have four thousand DOT clinics for TB, they would imagine a fully fledged clinic of a sort. But the DOT centers are buried right inside hospitals and health centers across the country. What happens in our DOT centers is that health workers give the patients their drugs and they observe them taking the drugs and the patient makes a daily visit to the clinic so that he can be properly monitored. On the issue of diagnosis, we have what we call ANP microscopy and in hospitals as well as health centers in the country, we have where the sputum can be taken for the ANP microscopy test.

“We’ve had successes with managing multi-drug resistant TB, but with a lot of challenges. We’ve had up to sixty percent success rate. We even had a female patient  who had multi-drug resistant TB who was successfully treated. She was appointed our ambassador. But I must tell you that it can be quite challenging for a patient to go through a one year-eight month treatment which includes taking injections for eight months.”

However, most cheering is the news that Nigeria can now deal with Buruli ulcer. Buruli ulcer is a chronic debilitating skin and soft tissue infection that can lead to permanent disfigurement and disability. It is caused by the Mycobacterium ulcerans bacterium and it is found among those who live in the riverside.

Abang who warned that native doctors lack the ability to treat patients with Buruli ulcer, urged that families and communities report cases of individuals with large wounds. He said: “Like I said, not many people know about this disease, so they take those suffering from it to traditional healers. Sometimes, surgeons try to deal with this ulcer by using skin grafts. But no matter how much you do a skin graft, it will fail because the basic infection has not been treated. So we are making sure that more people know about this disease and that we have an anti-biotic based treatment that we use to treat it. But the diagnosis must be made in a PCR laboratory using a skin swab. After treatment, the wound will heal fast and corrective surgery will be effective.

“I can tell you that people that live within the border town of Ogun state and Benin Republic have been crossing over to Benin Republic to receive treatment. But now in Nigeria, the World Health Organisation is assisting us to provide free treatment for people. So, we are calling on people that if you see anybody with a large wound, please tell them to reach out for treatment as it is free.