Introduction of Strategies for control and management of Tuberculosis and Hypertension in Nigeria Assignment
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Nigeria is a wide-spread country with a huge population. Formerly, the country was under the British regime and in 1960, it got freedom as well as became an independent country itself. There are 36 states under this country and Abuja is the capital of Nigeria. In terms of size, it is two and half times larger than California and considered as the highest populated country in Africa. According to data from the United Nations, the population of Nigeria is 215, 287,378 in 2022, while 52% of the community is in urban areas. This country has achieved the 7th rank in the population list of countries (Nigeria Population (2022) - Worldometer, 2022).
The Nigerian healthcare system has faced a number of setbacks. Considering Nigeria's important location in Africa, the national healthcare infrastructure is severely lacking. In this country, medical establishments are insufficient, particularly in rural regions. Although the Nigerian government has proposed a number of changes to resolve a variety of difficulties in the health sector, they seem to have been incorporated at the state and municipal scale. For numerous years, Nigerian health care has been ravaged by infectious illness epidemics and widespread pharmaceutical contamination. As an outcome, there seems to be an urgent necessity to treat the issue. In regards to TB cases, Nigeria ranks third following Asian countries. Approximately 245,000 Nigerians starve to death of TB annually (Copenhagenconsensus.com, 2022).
Hypertension (HTN) seems to be a key cause of cardiovascular disease (CVD) all over the globe. Nigeria is considered as the most populated nation throughout Sub-Saharan Africa, therefore its health statistics serve a significant role in determining the sub-overall nation's well being. Nigeria appears to be the most impacted, with a larger volume of patients as well as lower rates of consciousness, diagnosis, and prevention, in contrast to the progress in industrialized nations. HTN is perhaps the most common CVD risk factor in Nigeria, having HTN-related problems occurring for over a quarter of emergency department visits in metropolitan clinics. The average blood pressure of Nigerians is greater than among European as well as American people.
Tuberculosis as an infectious disease
Tuberculosis is considered as a contagious bacterial illness formed by Mycobacterium tuberculosis (Mtb). Tuberculosis usually spreads between people by the airborne secretions and perhaps most usually attacks the lungs, however it potentially actually impacts the certain organ. Approximately around 10% of people contaminated with Mtb develop chronic TB illness over their lifespan; the majority of people who are afflicted manage to keep their condition under control (CDC.gov, 2022). A few of the difficulties with tuberculosis seems to be that the bacterium might remain inactive across many contaminated people for years before reactivating as well as causing symptoms. The chance of developing tuberculosis following illness appears maximum shortly after transmission as well as rises considerably in those who are already diagnosed with HIV/AIDS or have other completely impervious diseases.
The bacterium that causes tuberculosis is transmitted from an individual to another via the airflow. Whenever a patient with TB illness of the lungs or throat coughs, talks, or chants, the germs are discharged into the environment (CDC.gov, 2022). People in that area might inhale the bacterium and develop ill. Whenever anyone inhales tuberculosis bacterium, the germs potentially lodge in the lungs as well as proliferate. They can then travel via the circulation to many portions of the body, including the kidneys, spinal, even central nervous system. Persons with tuberculosis are more prone to transfer the pathogen to individuals they interact with on a daily basis. Close relatives, neighbors, even colleagues are all included.
Since the immune cells might combat the TB bacterium, certain patients get TB illness quickly after getting contaminated (around weeks). Others may have become ill months later whenever their immune cells deteriorate due to a variety of factors.
In general, 5 to 10% of people with the disease who may not undergo medication for latent tuberculosis can acquire TB illness at a certain point throughout their lifetimes. The danger of having tuberculosis illness is massively greater for those with impaired immune systems, notably those who have HIV diagnosis. People who are at a significant risk of contracting tuberculosis can be divided into two groups such as the Immune-compromised people and individuals who have just been diagnosed with the tuberculosis (TB) bacterium (TB Risk Factors, 2022). Latent TB is considered as the infectious TB.
Hypertension a long-term condition
Hypertension seems to be a chronic condition that can be controlled but not cured. As a result, the chronic treatment approach is well adapted to the treatment of hypertension. Long term illness treatments, including such hypertension, would also have traditionally been adaptive, with patients acting as receptive potential clients of care. Several governments have formulated and executed the prolonged treatment approach throughout recent years to assure effective, proactive treatment for persons with chronic diseases. The approach as well as its guiding concepts focus the assistance and services required to provide this elevated treatment. On a worldwide scale, hypertension has indeed been identified as the leading risk determinant for early cardiac cause of death and disability.
Hypertension is indeed a long-term condition. Medications are available to moderate it, and that can be reversed. As a result, patients must adhere to their physician's recommendations for medication and dietary changes, as well as undergo frequent clinical checkups, which are often required for the rest of their lives. As an outcome, the long term care approach is well adapted to the treatment of hypertension. Hypertension, or high blood pressure, raises the chance of cardiovascular heart disease (heart attack) as well as brain hemorrhage (brain attack). High blood pressure causes the arteries to become more resistant to blood circulation, leading the pulse to put more effort to transfer the blood.
Figure: Global rate of hypertension
Hypertension is detected as well as medicated in less than half of individuals (42 percent). High blood pressure seems to be a leading cause of mortality in the globe. It affects an approximately 26% of the worldwide people (972 million people), as well as the incidence is anticipated to rise to 29% by 2025, owing mostly to surges in underdeveloped and developing countries. This LTC’s increased concentration imposes a significant substantial morbidity and mortality. It affects approximately 1.28 billion persons aged 30 to 79 globally, with the majority (two-thirds) residing in low- and middle-income nations. Around one-fifth of persons with hypertension (21%) have everything under care. An average 46% of persons with hypertension are extremely unconscious of their ailment.
Physical, psychological, socio- economic impacts of Tuberculosis and Hypertension in Nigeria
Mostly in the United States during 2020, 1,409 non-Hispanic Black or African American individuals were diagnosed with tuberculosis, representing over 20% of all of those diagnosed with the illness nationwide.
Tuberculosis statistics in Nigeria
TB is a major concern in Nigeria, yet it is one that may be efficiently addressed. TB patients including their families face enormous expenditures and suffering as a result of low detection levels with inadequate access to appropriate medication. Even in simple situations where the patient is treated, the impact to the community, primarily in missed income, is roughly 120,000 Naira, which might be disastrous for poor families. The typical time between the beginning of indications and obtaining treatment stands roughly three months, which permits the illnesses to spread faster.
According to Fadare et al., (2020), huge homelessness in Nigeria is a major concern to spreading Tuberculosis. Among most of the medical disciplines, weaker employment categories were shown to be related with negative health conditions in Nigeria. Earlier studies previously discovered a similar association, which is likely due to the increased earnings of increased forms of employment. Better-paid individuals might well have improved lifestyle circumstances and become more informed. A lower employment category is not even a determinant of poor physical wellbeing, according to the findings of this study. This is likely due to the fact that the majority of the respondents are from the identical poor socio - economic and cultural backgrounds, and therefore have comparable reactions to their physical medical conditions.
Childhood tuberculosis (TB) associated HIV syndrome are severe social medical issues that cause considerable morbidity and mortality among children. Nigeria has one of the world's highest rates of tuberculosis and HIV-related TB. In 2015, around 6000 children under the age of 15 were diagnosed with tuberculosis, accounting for about 6% of all young TB cases (Ogbudebe et al., 2018).
In terms of psychological impact, mental health problems, unpleasant psychological state and risk of stigma, sufferers' perceptions of the condition and its therapy, overall sickness and therapeutic interventions awareness, social isolation, as well as socioeconomic challenges are all linked to TB throughout the Nigerian community.
According to a devastating cost assessment launched by Nigeria's Federal Minister of Health, TB patients as well as their families face exorbitant expenditures as well as lack economic security as a result of the condition's late diagnosis (WHO | Regional Office for Africa, 2022). Non-medical expenditures, including such increased meal purchases and transportation, have been some of the largest expenditure factors. Social assistance, medical coverage, including better TB treatment approaches might also assist to reduce internal and external healthcare expenditures. The investigation was carried out in 40 municipalities throughout 22 Nigerian states to determine the scope as well as big determinants of expenditures paid by Tuberculosis patients (WHO | Regional Office for Africa, 2022).
Considering the dynamic behavior of socio-demographic and behavioral variables is critical in controlling hypertension, particularly in Africa, where the frequency of hypertension seems to be on the rise. A research was performed to fill in the gaps in current data on these variables. Nigeria, being Africa's largest populous nation, is indeed a primary factor to the continent's growing hypertension epidemic.
As Idris & Olaniyi stated, Hypertension has been linked to several socio-demographic and lifestyle variables. The occurrence of hypertension significantly linked to marital status. Across both male and female, being married, divorced and widowed elevated the risk of hypertension by 88 percent and 57 percent, correspondingly (Idris & Olaniyi 2020). Due to increased urbanization as well as the trend toward inactive lives, lack of physical activity has now become a significant issue as a potential cause for cardiac illnesses, particularly hypertension. As argued by Ademola et al., education could be an additional socio-demographic component we discovered to be linked to hypertension. Academic achievement is thought to be a significant quantifiable indication of socioeconomic status, yet it is typically fixed by the time a person reaches maturity. The aged are more prone to hypertension. Its consciousness does have a serious influence on medicine persistence, which in turn has a significant effect on management (Ademola, Boima, Odusola, Agyekum, Nwafor & Salako 2019). The increased proportion of hypertension throughout metropolitan areas might be related to frequent stressful events, a shortage of or insufficient amount of exercise, as well as the ingestion of poor diets, including such quick meals rich in fat and protein. Such behaviors are more widespread among city dwellers (Anyabolu, Okoye, Chukwumobi & Eke 2017). The increased proportion of hypertension in metropolitan areas might be related to frequent high levels of stress, a shortage of or insufficient amount of physical activity, as well as the intake of poor diets, such as fast meals rich in salt and fat. Certain behaviors are more widespread among city dwellers in Nigeria.
Organizations and Government management of Tuberculosis and Hypertension in Nigeria
In order to minimize the chances of Tuberculosis infection to individual health, the World Health Organization (WHO) endorses implementing as well as scaling up TB preventative measures, such as follows.
Organizational: Leadership and dedication to formulating and enforcing contamination prevention policy at the medical facility (Gelaw et al., 2019),
Regulatory: Rapid identification and isolation of those suspected of having tuberculosis, as well as quick care and management of tuberculosis patients
Ecological: Rapid detection as well as isolation of those suspected of having tuberculosis, as well as quick diagnosis and treatment of tuberculosis patients
The above mentioned initiatives, such as the utilization of personal protective equipment (PPE), through combination with some other standard precautions, in medical centers.
In order to encourage and support facility-driven guides to ensure, interventions to improve infection control procedures have been implemented at each location (Balogun et al., 2019). Caregivers that completed the course utilized workshop curriculum materials and additional staff members at their institutions, while no cost initiatives had been implemented right away. Every institution received banners as well as literature about cough etiquette, cleanliness, including washing hands to display in patient waiting rooms. Materials were purchased, while minor maintenance was carried out, along with the installation of specialized sputum distribution centers in distant locations of the facility (Amole, Yusuf, Salihu, & Tsiga?Ahmed 2020).
In order to restrict the amount probable TB patients remained among other Nigerian patients including the medicare staff, institutions created procedures to track typical patient long waits as well as guarantee that they obtained accelerated care. The NSP-TB emphasizes medical service administration in order to provide widespread access to powerful, patient-centered TB preventative measures, diagnostic, as well as therapeutic services (Dokubo et al., 2016). Different national institutional and legislative regimes control the diagnosis, monitoring, therapy, and nursing of tuberculosis, as well as provide constitutional protections for tuberculosis patients and others at risk. Despite this, the regulatory atmosphere for TB control has always been insufficient owing to the unavailability of TB-specific statutory provisions, rules governing the purchase of anti-TB drugs, as well as a coherent mandate on the consensual and unintended detachment of TB patients (Ogbo et al., 2018). It proficiently helps to balance individuals with TB's human rights with protecting the community primary care.
Cardiovascular ailment is the leading cause of mortality in Nigeria, accounting for one out of every 10 fatalities. The Nigeria Hypertension Control Initiative (NHCI), a government project to regulate high blood pressure (commonly referred as hypertension) as well as promote cardiovascular health, was unveiled by the Federal Ministry of Health's Noncommunicable Disease Division (Isiguzo et al., 2022). The National Hypertension Control Initiative (NHCI), that combines hypertension diagnosis and services in primary health care facilities, began with 12 sites in Ogun and Kano states and therefore eventually expanded to 600 sites across both regions (Resolvetosavelives.org, 2022).
High blood pressure has been one of the leading causes of coronary heart disease, which takes the life of over 234,000 Nigerians each and every year (Resolvetosavelives.org, 2022).
Nigeria would also have made it a priority of lowering the incidence of elevated blood pressure as well as early death from non-communicable illnesses by a half by 2025. This same NHCI, which was just created, would make a substantial contribution to all these federal advancement plans, as well as speed up significant movement toward the Sustainable Developmental Objectives including comprehensive medical care. This should be accomplished through expanding as well as expanding exposure to inexpensive, extensive, elevated hypertension diagnostic and intervention programs at the public hospitals and other healthcare sectors, delivering such essential facilities to the fingertips of common Nigerians.
Prevalence of Hypertension and its associated factors throughout Nigeria
According to Ajayi et al., discovered a significant incidence of hypertension. One-third of the people polled were hypertensive. This study has ramifications for public health since it puts one out of every three individuals in the community at risk of cardiovascular disease. The majority of the hypertensives were likewise unaware of their condition before the study. They highlighted the importance of taking immediate steps to raise awareness and implement interventions for hypertension preventative measures and initial recognition, particularly between many people under the age of 30 as well as those who are overweight or obese (Ajayi IO, Sowemimo IO, Akpa OM, Ossai NE 2016).
Comprehensive government initiatives for adequate hypertension management throughout all public and private hospitals in Nigeria must consider individuals' socioeconomic situations, attitudes, as well as worries about their disease (Banigbe, Itanyi, Ofili, Ogidi, Patel & Ezeanolue 2020). Such variables must be investigated, while effective interventions must be designed to enhance the result. By enhancing the work environment and working circumstances of health professionals, demographic change of physicians as well as other qualified medical caregivers to rich nations could be delayed. In order to facilitate communication between usual approaches with conventional standards in hypertension treatment, generic healthcare professionals must receive training and professional development in conclusive proof hypertension management, as outlined in hypertension standards.
Challenges and barriers faced by service users and healthcare professionals
Several of the difficulties faced by healthcare workers in both the governmental and private sectors of Nigeria were related to inadequate logistical management. The operational infrastructure required to trace patients who were abandoned to follow-up, undertake interaction monitoring as well as surveillance, record the information, as well as write reports was either absent or inadequate, forcing several healthcare workers to boost their income with individual profits (Adejumo, Daniel, Adepoju, Femi-Adebayo, Adebayo & Airauhi 2020). A similar finding was reported from Uganda, wherein TB Preventive initiatives and TB patient follow-up have been hampered by a shortage of funding.
In Nigeria, hypertension is generally poorly detected as well as managed in basic healthcare environments. In such basic healthcare centers, there seems to be a dearth of really well and skilled health-care staff, as well as insufficient clinical equipment. There have been insufficient quantities of skilled experts even in intermediate and higher medical care institutions. For two main reasons, the impact on the health-care system is considerable. To begin with, the therapeutic personnel shortfall has resulted in a greater patient-to-doctor proportion throughout the medical infrastructure (Oguanobi, 2021). Nigeria does have roughly 35,000 doctors functioning through its healthcare delivery system, with such a predicted demographic of 211,400,708 individuals in 2021.
Implication for policy and delivery of the service
Nigeria Country Scorecard of controlling TB
According to Ogbuabor & Onwujekwe, in order to fulfill the health system's aims, the government must use strategic policy frameworks, effective supervision, collective action, rules and benefits, software implementation, as well as transparency. Choices in the National Tuberculosis Control Program (NTP) would have to be evidence-based, value-driven, accessible, comprehensive, as well as sensitive to the demands of the entities served by the TB programme; some who develop as well as manage recommendations should always be held responsible (Ogbuabor & Onwujekwe, 2019).
The FMoH and stakeholders received technological assistance from WHO Nigeria in developing a consensual hypertension procedure, instruments for project management, as well as conducting preliminary assessments of the collaborating health institutions. The strategy implementation of health professionals at the provincial and hospital levels on hypertension treatment was also sponsored by WHO Nigeria in partnership with RTSL and FMOH (Albutt et al., 2019).
Year after year, Nigerian health care has been hit by a slew of contagious illness epidemics. As a result, action is required to address the issue. In conclusion, it can be stated that being a huge populous country, Nigeria needs to make their health infrastructure more strong to prevent hypertension and Tuberculosis.
Adejumo, O. A., Daniel, O. J., Adepoju, V. A., Femi-Adebayo, T., Adebayo, B. I., & Airauhi, A. O. (2020). Challenges of tuberculosis control in Lagos state, Nigeria: a qualitative study of health-care Providers' perspectives. Nigerian medical journal: journal of the Nigeria Medical Association, 61(1), 37.
Albutt, K., Sonderman, K., Citron, I., Nthele, M., Bekele, A., Makasa, E., ... & Johnson, W. (2019). Healthcare leaders develop strategies for expanding national surgical, obstetric, and anaesthesia plans in WHO AFRO and EMRO regions. World journal of surgery, 43(2), 360-367.
Anyabolu, E. N., Okoye, I. C., Chukwumobi, A. N., & Eke, O. D. (2017). Hypertension and its socioeconomic factors in a market population in Awka, Nigeria. American Journal of Medical Sciences and Medicine, 5(3), 40-48.
Banigbe, B. F., Itanyi, I. U., Ofili, E. O., Ogidi, A. G., Patel, D., & Ezeanolue, E. E. (2020). High prevalence of undiagnosed hypertension among men in North Central Nigeria: Results from the Healthy Beginning Initiative. Plos one, 15(11), e0242870.
CDC.gov. (2022). TB and Black or African American Persons. Retrieved 23 April 2022, from https://www.cdc.gov/tb/topic/populations/tbinafricanamericans/default.htm
Copenhagenconsensus.com. (2022). Nigeria Perspective: Tuberculosis | Copenhagen Consensus Center. Retrieved 23 April 2022, from https://www.copenhagenconsensus.com/publication/nigeria-perspective-tuberculosis#:~:text=Nigeria%20comes%20third%20behind%20only,of%20all%20deaths%20in%20Nigeria
Dokubo, E. K., Odume, B., Lipke, V., Muianga, C., Onu, E., Olutola, A., ... & Maloney, S. (2016). Building and strengthening infection control strategies to prevent Tuberculosis—Nigeria, 2015. Morbidity and Mortality Weekly Report, 65(10), 263-266.
Fadare, R. I., Akpor, O. A., Ifechukwude, I. G., Richard D, A., & Bello, C. B. (2020). Nurses’ safety in caring for tuberculosis patients at a Teaching Hospital in South West Nigeria. Journal of Environmental and Public Health, 2020.
Idris, A., & Olaniyi, O. (2020). ANALYSIS OF ECONOMIC BURDEN OF HYPERTENSION IN NIGERIA. Nigerian Journal of Economic and Social Studies, 62(2).
Nigeria Population (2022) - Worldometer. (2022). Nigeria Population (2022) - Worldometer. Retrieved 23 April 2022, from https://www.worldometers.info/world-population/nigeria-population/
Ogbuabor, D. C., & Onwujekwe, O. E. (2019). Governance of tuberculosis control programme in Nigeria. Infectious diseases of poverty, 8(1), 1-11.
Ogbudebe, C. L., Adepoju, V., Ekerete-Udofia, C., Abu, E., Egesemba, G., Chukwueme, N., & Gidado, M. (2018). Childhood tuberculosis in Nigeria: disease presentation and treatment outcomes. Health services insights, 11, 1178632918757490.
Oguanobi, N. I. (2021). Management of hypertension in Nigeria: The barriers and challenges.
Resolvetosavelives.org. (2022). Resolve to Save Lives: New program announced to lower high blood pressure in unreached communities across Nigeria. Retrieved 23 April 2022, from https://resolvetosavelives.org/about/press/new-program-announced-to-lower-high-blood-pressure-in-unreached-communities-across-nigeria
TB Risk Factors. (2022). TB Risk Factors. Retrieved 23 April 2022, from https://www.cdc.gov/tb/topic/basics/risk.htm
WHO | Regional Office for Africa. (2022). Nigeria study confirms that TB is utterly impoverishing for many in the country. Retrieved 23 April 2022, from https://www.afro.who.int/news/nigeria-study-confirms-tb-utterly-impoverishing-many-country
Ogbo, F. A., Ogeleka, P., Okoro, A., Olusanya, B. O., Olusanya, J., Ifegwu, I. K., ... & Page, A. (2018). Tuberculosis disease burden and attributable risk factors in Nigeria, 1990–2016. Tropical medicine and health, 46(1), 1-11.
Balogun, M. R., Sekoni, A. O., Meloni, S. T., Odukoya, O. O., Onajole, A. T., Longe-Peters, O. A., ... & Kanki, P. J. (2019). Predictors of tuberculosis knowledge, attitudes and practices in urban slums in Nigeria: a cross-sectional study. Pan African Medical Journal, 32(1).
Gelaw, Y. A., Williams, G., Soares Magalhães, R. J., Gilks, C. F., & Assefa, Y. (2019). HIV prevalence among tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis. AIDS and Behavior, 23(6), 1561-1575.
Amole, T. G., Yusuf, A. H., Salihu, A. S., & Tsiga?Ahmed, F. I. (2020). Prevalence and predictors of depression among tuberculosis patients in Kano, North-West Nigeria. Nigerian Journal of Medicine, 29(3), 369-376.
Romanowski, K., Campbell, J. R., Oxlade, O., Fregonese, F., Menzies, D., & Johnston, J. C. (2019). The impact of improved detection and treatment of isoniazid resistant tuberculosis on prevalence of multi-drug resistant tuberculosis: a modelling study. PLoS One, 14(1), e0211355.
Ademola, A., Boima, V., Odusola, A., Agyekum, F., Nwafor, C., & Salako, B. (2019). Prevalence and determinants of depression among patients with hypertension: A cross-sectional comparison study in Ghana and Nigeria. Nigerian journal of clinical practice, 22(4), 558-558.
Isiguzo, G. C., Santo, K., Panda, R., Mbau, L., Mishra, S. R., Ugwu, C. N., ... & Atkins, E. R. (2022). Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study. Global heart, 17(1).
Ajayi IO, Sowemimo IO, Akpa OM, Ossai NE. Prevalence of hypertension and associated factors among residents of Ibadan-North Local Government Area of Nigeria. Nig J Cardiol [serial online] 2016 [cited 2022 Apr 27];13:67-75.