 And this is the breakfast in Plostivio, Africa, time for the second conversation. Today's World Tobaccoist Day and Tobaccoist Remains one of the world's deadliest infections killer. Now, each day over 4,100 people lose their lives to TB and close to 28,000 people fall ill with their preventable and curable disease called Tobaccoist. Global efforts to combat TB have saved and estimated 66 million lives since 2000. However, COVID-19 pandemic has reversed the years of progress made in the fight to end TB. For the first time over a decade, TB deaths increased in 2000, that's in 2020. The theme for World Tobaccoist Day 2022, Invest to End TB, Save Lives. We're now being joined by Dr. Ibrahim Omar Gano with the Kano State Ministry of Health. Dr. Ibrahim Gano, it's good to have you join us. Good morning and thank you for having me. All right, let's talk about today, what's the significance of having this conversation and what's the significance of today? Today is a day that the entire world comes together and always when we have this day on the 24th of March each year, it's a day to actually talk about TB, and to commemorate the over 140 years or so of a lifetime of achievement in the discovery of the quality of TB, that is macrobacterium tuberculosis. But to also look at the challenges faced by the world in terms of controlling and then ending the TB disease. And it's a day that we always remember the number of the human lives that have been affected or infected by the deadly disease, which happens to be the second most infectious disease worldwide. All right, Dr. Omar Gano, the world or Nigeria seem to be doing so well in the fight against TB, until 2020 with the COVID-19. It does do almost all efforts were just drifted towards ending the pandemic. Now, what do we really have right now? What are the incident rates like now specifically in Nigeria? Can you give us some figures to work with? Yes, worldwide from the year 2020 to that, a little over 60 million lives have been set worldwide. However, with the coming of the pandemic of COVID-19, reverse has been made of over 10 years achievement in the control of TB. And that has really hampered the efforts being put together by all stakeholders as well as institutions, government, and partners to curb the disease. This year alone, we are having this situation whereby a number of individuals have been affected or infected with TB, but because of the pandemic, they have no ease of access to commencement or treatment. And that has really affected a lot in terms of care and support for TB. In terms of burden, we are taking off Nigeria as the first country in Africa with the highest TB burden, as well as number six in the world. And there have been also hit by COVID-19. A lot has to be made in terms of making efforts to actually bring the information to the people and make sure that people who have TB or have symptoms of TB come to the aid of the system in terms of getting diagnosed and treated for TB. More so symptoms-wise, it happens that some of the features or symptoms of TB also happens to be similar to COVID-19. And that has to do with the risk perception and the communication in terms of people understanding that this symptom that you have, it could also be TB or it may not be TB. So in essence, symptoms of TB also have similar to COVID-19. And then in terms of investment, we are making a lot of attention being pushed towards COVID-19 as a global pandemic. But we have to also remember that TB, as the epidemic, is also there with us. And a little over 400 people are affected or infected by TB every day in the world. Very scary statistics that you have mentioned. But let's come back to the fundamentals. And look at, you know, with LASA fever, you would definitely say, keep your environment clean, avoid rats and what have you. And so with the malaria, you talk about mosquitoes. What should we know about tuberculosis? What you should know about tuberculosis is that it's an airborne disease. It's a disease that is transmitted from one person to another. And it's a disease that is transmitted through coughing, sneezing, laughter, or even talking. And it's a disease that is affected by or that is influenced by in the nature of where people live in terms of crowdless, in terms of personal and environmental hygiene, in terms of good air quality, in terms of better ventilation and air flow. And it's a disease that if not diagnosed and treated on time, an infected person or an infectious person can transmit it to at least 10 to 15 people every year. I give you a look at the numbers. If you have the people infected by TB that are not diagnosed and put on treatment, chances are they have the risk of infecting 10 to 15 individuals in 12 months. And look at the statistics. We are taking of a country that is the most populous in African continent. We are taking of the most populous black nation in the world. And we are taking of one of the few countries in the world that has large population and then expanding population. So what we are saying is the rate of infection can be enhanced by the way we live and by the way people understand. So it's important that anybody who is coughing for at least two weeks or more should go to the nearest facility and get tested for TB, for example. And if I have to be positive for TB, you pay that person on treatment because that is the only way you can break the chain of transmission and then stop the spread of the disease because an infectious person who is not treated or treatment, who has not been commercial treatment, who is in interaction with other individuals has the risk of infecting 10 to 15 people. And we are taking of people attending events, attending to activities in the world. I mean, in their daily activities, going to the market, going to market places, going to weddings, funerals, gatherings, in churches, mosque, in other places, even in their workplace. These individuals, who happens to interact with others and are infectious or symptomatic and they happen to have TB, for example, they have the risk of transmitting that disease. Dr. Ibrahim Omarogano, can you quickly tell us what exactly is responsible for TB? I mean, just like we have mentioned, it's a good thing to know that it's a disease that is communicable, I mean, it can be transmitted from one person to the other. But what is really responsible for this? At tuberculosis, OTB, in short, is caused by a bacterium. It's a vaseline, it cannot be smoothened, it's a naked eye, and it's called macobacterium tuberculosis. That is a positive agent for TB. So it has nothing to do with lifestyle, behavior, so... Lifestyle behavior, they give room for ease of spread of disease. Because just like I said, the way people live, the way people interact, the way people behave, for example, so people who have the attitude of, for example, exploiting themselves to places where you have risk for, for example, putting your lab at risk or maybe putting things at risk that has to do with your system, your protecting mechanisms, your lungs because it's an airborne disease, so it easily gets spread through the lungs. So when you have something that harasses or affects negatively your system, your airways, it can put somebody at risk. There are other medical conditions, for example, that can also influence. For example, the attitude of people, their way of life, for example, if you take alcoholism, for example, take cigarette smoking, take other medical conditions like diabetes, like for example, heart disease, you know, all these conditions and attitudes or behaviors that can also influence and make ways or make it easier for the spread of TB among individuals because it's important about the rate of protection or the level of protection of somebody's airway to actually resist and actually contend in the event that somebody inherits the bus light because it's an instant that somebody inherits the bus light. The bus light will now undergo various changes, transformations, for example, growth and mutations, I mean, divisions, and then the bus light will have to divide from 1, 2, 3, 4, from 40 air, like that, like that. So those modifications and actually growth of the bus light is influenced by many factors. All right, Dr. Omar Oganor, can you actually be infected with tuberculosis and not really have active TB? It's very possible. It's very possible. A lot of people have the bus light but they don't have the disease. That's what you call tuberculosis infection or TB infection. Those individuals have the bus light and they keep having the bus light in their system. Somebody with intact immunity with no immunocompromised status or nature can have the bus light for as many years as possible. And somebody who has been vaccinated with BCT, for example, can also have that protection. But it's important to remember there are two ways that somebody can have active TB. One is infection from another person immediately, for example. The other one is by the activation of the latent or dominant TB infection. And that infection that has stayed with somebody's system for quite some time with decreased immunity, with so many changes in the body system or the status of somebody's immunity or protection can also give room for the activation of the dominant TB infection. And that is one of the reasons why it's important to always test and to always watch for symptoms in somebody. Somebody can have it and somebody can have the infections of the disease. All right, but then again, since you can be infected, I know it can properly be managed, but whatever happened or happens to an infected lung that has been affected with tuberculosis, over time, even if a person has been, maybe screened to be free from that particular disease, would you still be able to use that particular lung after you've been killed? Of course, that's the reason why it's always good to diagnose on time and put people on treatment on time because the longer the infection, the higher the infected dose of the baseline, the higher when somebody has depressed immunity, the more likely it has the possibility of destructive effects on somebody's lungs. For example, somebody who has had, who is already malnourished, for example, or has immunocompromised immunity, or is already a jet, or has some other infections or maybe disease conditions or other medical conditions and then has not been diagnosed on time and placed on treatment on time, they have chances of having more effects to their lungs, which can lead to, for example, other complications, which can be semi-permanent or permanent, for example, like fibrosis or maybe disrupting lung disease or other complications that may happen to their lungs. They have also the risk of having some, maybe opacities happening in their lungs or maybe having some consolidations and those things can be destructive to their lungs in the long run or even for maybe for many, many years in their lifetime or even for the rest of the time. That's the reason why when somebody is lytomatic, it's always good to diagnose on time and place somebody on treatment on time because while they are breaking the transmission, too, you are preventing the possible long-term effects of the infection in somebody and then you are also having to mitigate or minimize any possible side effects or drop-drop interaction that somebody may have because that person who may be having a symptom of TB, even that person has TB and has been diagnosed on time, will now prevent the other, probably other medical conditions that somebody is on or maybe some other medication that somebody may be on because it's good to remember somebody can also have TB infection right on other treatments for other diseases. Yes, so as we begin to course this conversation down, I know that you have mentioned persistent cough or coughing as one of the symptoms but which might not necessarily be until the individual gets tested. So you have mentioned symptoms. What are the symptoms, I mean likely possible symptoms that one could look out for the case of TB? Yes, so it's important because cough is a common symptom but there are individuals who may not have cough for that pain, we said. So it's important to remember cough is one of the symptoms. Other symptoms for TB are fever, weight loss, or night sweat. You call it drenching night sweat because it's usually at night, those some may even have sweat during the daytime but you know with weather conditions and things like that, you find that there are some levels of sweating that somebody experiences that I would do normality but cough, fever, weight loss, night sweat, these are the cardinal symptoms of TB and anybody with these symptoms should watch the nearest hospital for testing. And it's also good to remember that somebody may have extra pulmonary TB because there is a TB infection that affects early lungs as a primary source of infection but there is a kind of infection that affects other systems in the body. For example, kidney, liver, abdomen, intestine, you know all those, even brain, joints, balls, and even spinal cord or even the spine. So these are our body parts that can be affected by, I mean that can be affected by TB infection and where somebody has other systems affected by the TB baseline symptoms related to those areas would also be manifest in addition to cough. So that's why other constitutional symptoms for TB, weight loss, fever, and night sweat should also be considered when somebody comes and presented the facility with this history of cough and then with other symptoms in the body. Some may have cough a lot and then the other, some may even have weight loss or maybe chest pain or maybe back pain. It's only when they cough. So all these symptoms happen and then when they happen we should always think of TB and we should always go to the nearest hospital for testing. Dr. Omar, just before we go, the team for this year is Investum to NTB Saves Life. So it brings me to the question of management and treatment for TB. So far, how accessible is it for Nigerians? Is the treatment affordable though Nigerians have access to this quality treatment for tuberculosis? All right, so it's good to remember that there are two phases to this very important point. One, TB is an infectious disease that can spread from one person to another and there's a global effort to contain the epidemic and Nigeria have been part of that and then as part of the nation high-level mission as well as commitment of the entire countries in the world to end in TB by 2030 and then allow the sustainable development of 2035. The universal push to ensure every passing in the world has uninterrupted access to high quality and the TB drugs is being implemented in Nigeria. What am I saying? Every passing infected with TB has to be placed on the standard that which are recommended treatment for TB which is provided at no cost to the patient but it's not at no cost to the patient because governments and partners globally and in this country have put hands together, put two socials together from diagnosis to treatment. Secondly, with the pandemic of COVID-19 now, we know the investment for TB is still inadequate and then with this pandemic and the reversal of 10 years of TB controlled efforts in the world. It calls for more investment, more resources, more money in terms of awareness creation, in terms of sensitization, in terms of programs like this that will make individuals to be aware of TB and the ones that have symptoms come for treatment, in terms of more investment for diagnosis because we know our equipment for TB diagnosis are not covering the entire places in the world. All right, Doctor. We can do more for that. All right, thank you so much. I'm Dr. Ibrahim Omar-Ghanu. Thanks for your thoughts and thanks for all that you have shared concerning TB as we celebrate the day today. Thank you so much. Thank you so much. All right, Dr. Ibrahim Omar-Ghanu is with the Canada State Ministry of Health and that's the size of the show for today. If you missed out on any part of the conversation, it's all right to follow us on Facebook, Twitter and Instagram and do subscribe to our YouTube channel Plus TV Africa and Plus TV Africa Lifestyle. Many thanks for watching. I am Messi Boko. 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