Background
Tuberculosis (TB) is a chronic infectious disease caused by the bacteria mycobacterium tuberculosis; almost every organ in the body can be affected, but the lungs account for more than 80% of TB cases. Tuberculosis that affects the lungs is known as Pulmonary Tuberculosis (PTB), while those that affect other organs are known as Extra Pulmonary Tuberculosis (EPTB) (Federal Ministry of Health, 2010).
The most common source of infection is an untreated case of pulmonary tuberculosis (PTB). Tiny droplet nuclei containing tubercles are released when such a person coughs, spits, or sneezes. These droplet nuclei are transmitted by inhaling them (Federal Ministry of Health 2010).
Today, tuberculosis remains a massive global public health issue. It is estimated that there are one billion infected people worldwide, with 10 million new cases and more than 3 million deaths each year. Tuberculosis kills more people than any other infectious disease (WHO, 2008).
It was estimated that it caused a global emergency in 2008, with 1.8 million deaths worldwide out of over nine million cases. The estimated global incidence rate fell to 139 cases per 100,000 populations in the same year, after peaking at 143 per 100,000 in 2004. However, this decline was not uniform across World Health Organization (WHO) regions, with Europe failing to record a significant decline and instead appearing to have reached a stabilization rate (WHO, 2009).
In the WHO African region, with an estimated population of 836,670,000 in 2010, TB incidence was 2,300,000, prevalence was 2,800,000, and deaths were 250,000. (World Health Organisation, 20I0). Nigeria, which ranks tenth among the world’s 22 high TB burden countries, has a prevalence of 133 per 100,000 people, with 93,050 cases reported in 2010. 2011 Federal Ministry of Health
Treatment success, as measured by a standardized process of treatment outcome monitoring (TOM), is one of the pillars of TB control, and is recognized as a key programmatic output alongside case detection. In response to this rationale, a World Health Assembly (WHA) resolution was passed in 1991, adopting two global TB control targets: detect at least 70% of new infectious cases and cure at least 85% of those detected. These goals were linked to the Millennium Development Goals, and the Stop TB Partnership set 2005 as the deadline for completion (Dye, Maher, Espinal and Raviglione, 2006).
For the first time since the target was established in 1991, the global treatment success rate exceeded the 85 percent mark in 2008, with a percentage of 87 percent for patients starting treatment in 2007. (WHO, 2009). Furthermore, treatment success rates were not maintained or improved in all WHO regions between 2006 and 2007, with the exception of the European region, which had the lowest success rate globally at 67 percent (WHO, 2009).
In Europe, the importance of improving treatment outcome monitoring (TOM) has long been recognized. In 1998, the WHO and the International Union Against Tuberculosis and Lung Disease issued a joint statement emphasizing the need for standardization and evaluation of treatment outcomes for TB patients in the WHO European region.
including those in countries with low and intermediate incidence ( Veen, Raviglione, Reider, Migliori, Graf, and Grzemska, 2008) Nigeria’s TB control program adopted the global target of detecting 84% of estimated TB cases and curing 87% of detected cases by 2015 using the Directly Observed Treatment Short Course Therapy (DOTS) strategy (WHO, 2010). While the latter goal appears to be more attainable, with Nigeria recording 73 percent treatment success by 2004 cohort, the case detection rate remained low at 22 percent, compared to the global figure of 37 percent (WHO, 2007).
The German Leprosy Relief Association, a non-governmental organization for tuberculosis control, has now sponsored Edo State. The German Leprosy Relief Association provides logistical support for tuberculosis control in Edo State. Tuberculosis hospital, Irrua is a referral center in Edo State’s Ethiope East Local Government Area. It also serves as a referral hospital for other areas of the state and surrounding areas. Because of the introduction of DOTS therapy (Directly Observed Treatment Short Course), the Tuberculosis Centre in Irrua now has 7 wards with 104 beds and an average of 350 patients per year (Tuberculosis referral Hospital Records, 2007).
Indigenes of Irrua, a major community in Edo State where the hospital is located, appear to be very afraid of the widespread spread of pulmonary tuberculosis infection due to the number of TB patients seen in their community through referrals from other places.
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