Implementing TB Surveillance in Nigeria: Best Practices, Challenges and Lessons Learnt

Introduction: TB Surveillance is a critical component of the global TB response. Comprehensive, accurate and timely information on TB is crucial for an effective TB control program hence the need for a robust tuberculosis surveillance system in all countries that contribute to the global burden of TB including Nigeria. Against this backdrop, an intervention was set in motion to triangulate the information from the health data reporting systems towards improving the overall surveillance system for TB in the country. Objectives: This article highlights the best practices, lessons learnt and challenges associated with the implementation of TB surveillance in Nigeria. In resource-limited settings such as Nigeria where health systems including health information management are sub-optimal, there is a heavy reliance on national and sub-national TB surveillance systems. TB data is mainly reported through the National Tuberculosis Control, however the integrated disease surveillance and response (IDSR) system also provides a platform for TB data collation through the LGA and State disease surveillance and notification officers. Conclusion: Implementing TB surveillance in Nigeria brought to fore the need for a wider engagement of all health facilities in TB control. As a dividend of the TB surveillance intervention, quality of care was improved in the private health sector through effective linkages to the commodity management system of the NTP and the national treatment guidelines. Strengthening community health surveillance system was identified as a critical element of Tuberculosis control. Also, the efficiency birthed by the integration of TB surveillance into the IDSR structure opened up other potential opportunities such as a unified capacity building of community informants on all notifiable diseases and the integration of reporting and risk communication for all health issues at the community level.

Implementation of the Active TB Case Finding in Nigeria;Processes, Lessons Learnt and Recommendations

Introduction: Tuberculosis remains a major public health issue in Nigeria with the country ranking seventh among the 30 high TB burden countries. Nigeria is among the three countries that account for half of the 4.3 million “missing” TB cases globally. One untreated TB case is able to infect about 10 - 20 people annually. Hence, it is pertinent that TB is controlled effectively through the use of active case finding strategies to find the missing TB cases. Objective: This article highlights the best practices and key lessons learnt during the implementation of the active house to house TB case finding strategy in Nigeria. Lessons Learnt and Recommendations: Strategic community engagement, massive awareness creation using mass media and local means of communication, mapping of locations where registered TB cases live, to inform home visits for contact tracing and strengthening of laboratory systems, are viable mechanisms to improve TB case finding. Conclusion: Active TB case finding interventions should be implemented in the context of a strengthened diagnostics system, strategic community engagement and media involvement.

Findings from a Windshield Survey Conducted in an Internally Displaced Community in Nigeria

Introduction: Civil unrest in the north-eastern part of Nigeria has led to displacement of populations and this has resulted in many negative health implications for the displaced persons. Internally displaced persons (IDP) often have poorer health outcomes than the general population due to limited access to health services and other basic amenities. Globally, Nigeria is among the countries with huge health inequalities resulting from unequal access to health services. This contextual issue is reflected in the living conditions of internally displaced populations in the country. A windshield survey was conducted in one of such IDP camps located in Kuchingoro, a central location in the federal capital territory of Nigeria, to describe the living conditions of the occupants and the implication for health outcomes. Objective: This article highlights the health issues faced by the internally displaced persons living in Kuchingoro, Abuja. This population was chosen because of the large size of the IDP camp and its strategic location in the federal capital territory of Nigeria. Conclusion: People living in the IDP camp of Kuchingoro are exposed to myriads of health issues as a result of poor access to clean water, hygiene facilities, foods with nutritional value and health services. The poor sanitary conditions of the camp often result in cholera outbreaks and other health issues. Women, the elderly and the very young are the most vulnerable to poor health outcomes as identified by the survey. Efforts should be made to improve the daily living conditions of the dwellers of the Kuchingoro IDP camp with particular emphasis on water, sanitation and hygiene and the provision of accessible and good quality health services. Government should also ensure the creation of employment opportunities towards empowering the occupants to improve their quality of life.