Tuberculosis (BCG) vaccine not enough protection against TB infection

Receiving vaccine for tuberculosis (TB) during childhood does not totally cover an individual from getting infected with the disease, a health expert, Odume Betrand has said.

Bacilli Calmette-Guerin (BCG) is the vaccine for the prevention of TB and often administered to children at birth. However, there are some exceptional cases where people who had received the vaccines still get infected with the disease.

This could explain the reasons why there are TB cases recorded even among children or people who were given BCG vaccines at birth.

Mr Betrand, senior programme specialist, TB/HIV, United State Centre for Disease Control, said the vaccine would only reduce the severity of the disease, if contacted, because some people already have latent TB.

He said if a person is coughing for more than two weeks, they should suspect TB and go for a test. The test and treatment is free, in government facilities.

‘Investing in research’

The specialist, at the Pre World TB Day in Abuja on Thursday, said lots of new TB can be prevented with early diagnosis if people present their cases to the health facilities on time.

He lamented that Nigeria ranks at one of the highest prevalent TB countries that are still taking about detecting and treatment of the disease, while many developed countries are beginning to talk about preventive means to stop the disease.

“Receiving the BCG vaccine as a child might not deter an individual from getting infected with TB. It can only cause the infection to be mild and not as severe as in people who did not receive the vaccine”.

He said TB prevention is necessary to ending TB, globally. Mr Betrand said there is a frontline target issue around vaccine, for the prevention of TB.

“We cannot talk about ending TB without a candidate vaccine. We need to be talking about investing in the research on vaccine. There are many on-going TB vaccine researches, but none has been certified,” he said.

TB remains the world’s deadliest infectious killer.

Each day, nearly 4500 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease.

The national professional officer, TB, Ayodele Awe, said there is a need to raise awareness on TB in Nigeria in other to find most of the missing cases.

He said for this to be achieved, the media has a lot of work to do in the eradication of the TB in the country.

“We need the media to rise up to the task of raising awareness and enlightenment on TB in Nigeria. Most people do not know the symptoms of the disease. This has also affected their health seeking behaviour.

“TB is diagnosable, treatable and curable, but the burden of the disease in Nigeria is further fuelled by the huge number of missing cases, which serve as a pool of reservoir for the continuous transmission of the disease.

“The only way to arrest them is when they present themselves to the health facilities for treatment.”

Mr Awe said the theme for this year’s world TB day in Nigeria is “It is time –with the slogan, ‘enough is enough’”.

“We have been on this business for a long time. I have been working on TB in Nigeria for 30 years and we kept getting same report. We are meant to be detecting 400,000 TB cases yearly but we are only reporting 100,000, meaning we are missing 300,000 cases, each year.

“Every TB case not detected can be a risk to 10 to 15 persons. TB causes ill health for approximately 10 million people each year.

“The federal government and partners have provided about 300 health centres where TB can be treated and the treatment is free. Unfortunately, only about 27 per cent of Nigerians know the symptoms of the disease. We need the press to educate people on the disease and take it serious just like the way you did with Ebola and HIV. You need to do so for TB too.”

Mr Awe lamented that the limited diagnosis machine was part of the reason why Nigeria has been missing lots of cases. He said there is a need to improve diagnosing TB in the country because the common methods – microscopic slide test and culture of sputum samples- is no longer effective, and, therefore, misses lots of cases.

“We have 774 local governments in Nigeria and barely all of them do not have the geneXpert machine to diagnose TB. We only have two mobile TB trucks for TB diagnosis and treatments. That is not enough for a country as big as Nigeria. If every state can have at least one mobile TB truck, it will go a long way to fight TB,” he said.

Drug-resistant TB

Speaking on effort government is making in finding the missing cases, Adebola Lawanson, National Coordinator, National Tuberculosis, Leprosy and Buruli-Ulcer Control Programme, said OPD screening for TB has been instituted and is currently being scaled up to include all health facilities in the country.

She also lamented the proportion of TB missing cases among children as the country was able to notify only seven per cent of estimated TB cases in 2017.

“The increasing pool of drug resistant TB in the country continues to be a major threat to the control of TB in Nigeria. Nigeria is sixth high Multi-Drug Resistance –TB (MDR-TB) burden countries and is among 10 countries that accounted for 75 per cent of the incidence treatment enrolment gap for DRTB globally,” she said.

Ms Lawanson, however, said the major challenge for finding missing cases is the low awareness among people about the disease.

She said there are only 394 diagnosis machines in 315 local government Areas out of 774 LGAs in Nigeria.

“TB diagnosis is also a challenge as Xpert MTB/RIF, which is the first line of test for the diagnosis of TB in the country, has a coverage of 41 per cent,” she said.