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Examining Roles Of Men In Heightening TB Cases
Published Aug 09, 2022 IN Column, HEALTHY LIVING,
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THE World health Organisation (WHO) observes that Nigeria is one of the countries with the highest TB caseloads globally and number one in Africa.

Also, the National Tuberculosis and Leprosy Control Programme (NTBLCP) expresses concerns about the high burden of TB in the country.

Worried by this, NTBLCP has declared that “Nigeria is sitting on a keg of gunpowder with 440, 000 new infections recorded yearly.”

Medical experts have, therefore, noted that TB cases have been on steady increase and there ought to be a mechanism to check the growth.

Medical statistics released by authorities show that no fewer than 207, 000 new cases of TB were identified in 2021, while there are almost 300, 000 unattended cases of TB in the country yearly.

These 300,000 cases are alleged not detected or reported and observers note that the carriers could be transmitting the disease to the society.

NTBLCP also cautioned that one un-intervened case of TB has the capacity to affect 25 other people, observing that only 27 per cent of Nigerians know that they have tuberculosis.

Medical sociologist note that the prevalent rate of TB spread by men is worrisome because of fear of social stigma in the event of diagnosis that results in being positive.

According to them, most men delay getting tested for the disease or refuse to go for test even when the symptoms are evident.

They note further that in some cases, “when married men test positive for TB, they may withhold the information from their family, increasing the rate of its spread.”

Experts note that the bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes.

The bacteria are spread when an infected person coughs or sneezes.

The symptoms occur include a cough (sometimes blood-tinged), weight loss, night sweats and fever.

Healthcare Practitioners Abatan Matthew and Ogunsakin Adesoji posit that in addition to men accounting for more than 60 per cent of those who developed TB, men also accounted for more than 63 per cent of deaths among people who had TB.

The National Tuberculosis and Leprosy Control Director, Dr. Chukwuma Anyaike, notes that stigma can affect men’s health-seeking behaviour in the country and is a factor that drives the global burden of TB.

Anyaike believes that stigma does not only harm the men affected by TB but reduce healthcare workers’ commitment to high-quality healthcare service delivery in the country.

“Excessive stress, with probable undernutrition, gives room to TB infection,” he notes.

However, experts say the ailment is curable in most cases if the right treatment is available even as drug-resistant TB is becoming more prevalent and can be fatal.

The lack of knowledge of health care workers in managing TB cases and poor interpersonal relations and communication with people who have TB have negative effects on men who are expected to adhere to the long treatment schedule for TB.

MrIsah Dogara, 39, a miner from Iowa community about 35km from Gwagwalada in the Federal Capital Territory, said his belief in traditional medicine made him to infect his wife and the late mother with TB because he feared that being diagnosed with the disease would make him vulnerable.

Dogara believed he was cursed when he started coughing and preferred to take traditional medicine.

Even though the cough became worse, he delayed seeking hospital care because he was told to give the medication some time to cure his uncontrollable cough.

He failed to recognise that the symptoms were due to TB because he called it an ordinary cough but had suffered from it for more than two years before he reported at the University of Abuja Teaching Hospital Gwagwalada, after a prolonged period of self-medication with local herbs.

According to him, it was after nine appointments with the doctors that he was finally diagnosed with TB.

He, however, said that his cousins doubted the diagnosis and advised him to go for higher traditional medication apart from the one he took earlier.

“What my cousin claimed worked for other colleagues, that were also coughing, almost ended my own life, when I saw myself in the hospital,” he said.

Dogara said that his wife and his late mother became infected, but never showed any symptoms of TB, adding that his mother died from co-morbidity of diabetes and high blood pressure while being treated for TB.

Another TB victim, Mrs Paula Bitrus, 54, who was a teacher, said she was diagnosed with multi-drug resistant TB (MDR-TB) and HIV and spent more than 21 months caring for her late husband who was paralysed and down with TB but refused to go to the hospital because of the stigma associated with it.

Bitrus noted that she contracted the disease from her husband, who she said hid his diagnosis from her and never sought medical attention, because he was an elder in the church and concerned about possible loss of status.

She said her husband died because of ‘what people will say’ syndrome, adding that her husband was afraid of taking back seat in the church and later died from inflammation in his lungs induced by severe coughing.

“The bacteria induce fevers and sweats, particularly at night. We suffered. No drug was working; accessing TB drugs without being registered in any of the health facilities was not possible.

“Eventually, blood vessels feeding the lungs rupture, further diminishing functions and contributing to increasing anaemia.

“He suffered before he finally died from pride and ego,” she narrated.

Mr Khali Adamu of Bwari Local Government Area in the FCT, narrated his experiences as an ex-convict: “I remember how I broke out coughing, accompanied by catarrh and high fever which ended up to be a TB infection. In spite of the availability of free treatment, I ran away from the Dantsoho Memorial Hospital, Kaduna, to Abuja, just because of isolation and maltreatment from health workers.

“I was poorly counselled on TB and my treatment ended up with poor outcomes because, the health workers throw my drugs at me, put my food by the door. I was not examined while I was there, they only ask me how I was feeling, from afar and they do so by speaking through the window.

“Such experience never made me to have hope in the treatment, so I stopped it. Sometimes, I can’t speak because of the pains I feel around my neck to my chest.

“They kept on telling me `to be a man,’ that I was acting like a woman inside the labour room, this was why I ran away.”

“When I got to Abuja, I met an NGO that gave me a better understanding of what I was feeling and how important it was for me to seek medical attention, that was the turnaround for me,” he added.

Adamu, who had already been diagnosed with sickle cell disease, had fluid building up in his lungs – a symptom typically associated with severe and long-term TB infections.

The idea of men being more resilient to illness also appears to be linked to perceptions about illness and severity. Men described a pattern of waiting to see if their condition would improve before they sought care, and only going to formal healthcare when the illness was at an advanced stage.

This was the case of Mr Augustine Ogar, who works with a construction company in Masaka District of Karu Local Government Area, Nasarawa State. He said when he started coughing and was not able to sleep at night, and suffered from severe chest pain.

Ogar, who is now a TB survivor, said that before he was diagnosed with the disease, he felt his problem was due to the harmattan season – and that it was the weather causing his cough.

“It is better to do a test to understand the type of sickness you have. Before I did the test, I used to go to private pharmacies and spend a lot of money. I spent up to N80,000.


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