Tuberculosis is the world’s top infectious killer disease according to the World Health Organisation. Some survivors share their journey fighting and beating TB with SODIQ OJUROUNGBE

Abdulquadri Abdusalam’s eyes still hold the haunting memories of the darkness that once engulfed him. His voice cracks as he recounts the days of his battle with tuberculosis.

Clad in a crisp white top, faded blue jeans, and a black face cap, Abdusalam sat before a room full of journalists, his eyes locked onto the past. The venue was a media workshop, but for Abdusalam, it was a platform to share his near-death experience – a testament to the resilience of the human spirit.

Abdusallam’s voice trembles as he recounts the darkest days of his battle with drug-resistant tuberculosis, also known as DRTB.

“I begged God to take my life,” he expressed, his eyes welling up with tears. “The pain was unbearable. I just wanted it to end”, he said.

Persistent chest pain

Speaking at the workshop, which PUNCH Healthwise also attended, Abdulsallam said his TB journey began five years ago while he was studying at the National Open University in Abeokuta.

Abdulsallam said he noticed a persistent chest pain, which he brushed off as a minor issue, but the agony lingered.

While his roommate attributed the persistent chest pain to smoking, Abdulsallam said he knew something was terribly wrong.

Desperate for relief, he turned to painkillers, then herbal remedies, and even consulted an herbalist in Ijebu-Ode.

While the remedies offered fleeting solace, Abdulsallam lamented that the pain intensified, accompanied by crippling coughs and blood-stained phlegm.

“I just realised I was having chest pain. I thought it was just normal chest pain, I did not even bother or even care about it. For more than three days, the chest pain continued, it did not stop and I had to tell one of my roommates. He said maybe because I used to smoke that was responsible.

“Before then, I went to buy pain relief drugs because I was thinking maybe I hit my chest on something, but the drug did not work.

“When the drugs did not work, my friend said that it was the smoke that was responsible. So, he took me to an aboki and the man gave me one drug which I started taking.

“While I got a relief from the pain, the effect of the drug was high on me to the point that I always feel like I am on another planet because the effect on me is very, very brutal. I was breaking down and I knew I was dying. So, I have to stop the drugs. I battled this for like six months”, he narrated.

Seeking spiritual solution

He added, “Before I knew it, I started coughing out blood. At this moment I think it was spiritual. And one of my friends used to say his uncle was an herbalist. So, we had to travel to Ijebu-Ode from Abeokuta.

“When we got to the herbalist and I explained everything to him, he said it was a spiritual arrow and I would need to do different spiritual stuff.”

“So, he gave me different herbs to use in stopping the coughing of blood. But despite taking the herbals, nothing changed. I was even dying, I can’t talk well, I can’t eat well. The thing has gotten to my back that I can’t even sit well.

“Most times, I have to lie down because of the severe pain. I am just helpless,” he recalled, his voice cracking.”

Diagnosed with TB

Speaking further, Abdulsallam said the pain of living with TB was quite unbearable.

“When I was going through this pain, I didn’t want my parents to know, I hid it from them. But at some point, my friend had to call my parents without letting me know.

“So, my mum came and we narrated everything to her. Alongside my mum, we went back to the herbalist and spent another three months with the herbalist. During my stay there, we did all types of rituals and spiritual things, but there were no changes.

“At a point, I started asking God for death because the pain was too much for me. I started begging God to take my life so that the pain could end.

“While at the herbalist, one of my sisters came and she suggested I should be taken to the hospital so that we don’t use spiritual things to solve medical issues.

“My sister’s husband sponsored the hospital bills, so I was taken to a private hospital. When we got there, the doctor did a series of tests and was later referred to Sacred Heart Hospital, Abeokuta”, he recounted.

At Sacred Heart Hospital, Abeokuta, Abdulsallam said he was diagnosed and confirmed to be suffering from DRTB.

On treatment, he described it as grueling, with 21 tablets daily and injectables that ravaged his body.

He lamented that the side effects led to vision loss, debilitating fatigue, and zombie-like numbness.

Abdulsallam’s treatment lasted for two years, a marathon of medication, hospital visits, and unwavering determination. His mother became his primary caregiver, sacrificing her comfort to ensure her son’s survival.

“My mum was my rock. She stayed with me throughout, nursing me back to life,” he noted.

Abdulsallam’s eyes still welled up with tears when he recalled the darkest days of his battle with DRTB. The pain, the stigma, the relentless medication schedule, it was a journey that tested his resolve and pushed him to the brink.

From darkness to light

Mrs. Oluseyi Kadiri is also another TB survivor who narrated her harrowing experience with the infectious disease at the workshop.

Kadiri, who is also living with HIV, was diagnosed with TB in 2000.

The TB survivor lamented that her journey was marked by ignorance, stigma, and fear.

She recalled the early symptoms were a persistent cough that wouldn’t subside, despite trying various remedies.

For Kadiri, the road to diagnosis was long and arduous, adding that she visited numerous hospitals, undergoing countless tests, but receiving no clear answers.

“I was treated like a guinea pig. Doctors and nurses, informed and uninformed, experimented with different medications, but none worked,” she expressed.

Desperate for a cure, Kadiri said she turned to traditional remedies like using palm fronts, alligator pepper, and even spiritual interventions.

“I was willing to try anything,” she admitted. But these remedies only worsen her condition.

Kadiri said she finally received a proper diagnosis and treatment when she was referred to a specialised TB centre.

Speaking further on stigma and discrimination, Kadiri said her experience with TB was further complicated by her HIV status.

“I felt like I was living in darkness. The stigma was overwhelming, and I isolated myself from the world,” she lamented.

However, Kadiri said her story took a dramatic turn when she attended a national conference on TB.

“It was a turning point for me. I realised I wasn’t alone, and that there were others who understood my struggles,” she stated.

Empowered by this newfound knowledge, Kadiri who now runs a Non-Governmental organisation known as the Centre for Positive Health said she began advocating for TB and HIV awareness.

She noted that she started a community-based organisation, providing support and care for those affected by TB and HIV.

Today, Kadiri is a beacon of hope for others. Her organisation provides nutritional support, economic empowerment, and psychological care to those in need.

As she concludes her story, Kadiri’s voice is filled with conviction.

“I want to tell the world that TB and HIV are not death sentences. With proper care, support, and awareness, people can live fulfilling lives. I am living proof,” she noted.

Both Abdulsallam and Kadiri’s stories are not unique. Every year, millions of people worldwide contract TB, and hundreds of thousands succumb to its ravages.

For those who survive, the journey is often marked by unbearable pain, desperation, and a longing for death’s release.

For years, TB was shrouded in stigma, often dismissed as a relic of the past. Yet today, it remains one of the leading infectious killers globally, claiming approximately 1.5 million lives annually.

The disease, caused by the bacterium Mycobacterium tuberculosis, primarily affects the lungs but can also impact other parts of the body.

Available data shows that TB is the 13th leading cause of death globally, the second leading infectious killer disease after COVID-19, and is rated above the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome.

The World Health Organisation’s data indicated that about a quarter of the global population is estimated to have been infected with TB bacteria and an estimated 10.6 million people fell ill with tuberculosis – six million men, 3.4 million women and 1.2 million children in 2021.

The Global Tuberculosis Report 2022, ranked Nigeria as the sixth nation with the highest number of TB cases.

Nigeria, in 2021, reportedly contributed 4.4 per cent to the total TB cases globally.

Data showed that two-thirds of the global TB cases are found in eight countries including India, 28 per cent; Indonesia, 9.2 per cent; China, 7.4 per cent; the Philippines, 7.0 per cent; Pakistan, 5.8 per cent; Nigeria, 4.4 per cent; Bangladesh, 3.6 per cent; and the Democratic Republic of the Congo, 2.9 per cent.

However, while ending the TB epidemic by 2030 is among the health targets of the UN SDGs, a total of 1.6 million people, who died from TB in 2021, including 187, 000 people with HIV, makes this target appear daunting.

Linking TB to spiritual attack

Many of the experts who spoke at the workshop raised concern over the low awareness of tuberculosis among Nigerians, saying that only 30 per cent are aware of its associated risks and threats.

The experts lamented that the lack of awareness among the people had remained a barrier to the government’s efforts in combating the disease in the country.

They noted that ignorance made many people link TB to spiritual attacks rather than seeking medical help.

The Coordinator of the Lagos State TB, Leprosy, and Buruli Ulcer Control Programme, Dr. Olusola Sokoya, who revealed that treatment and diagnosis of TB was free, said in 2023 alone, over 18,000 people were diagnosed with TB in Lagos.

Presenting the keynote address at the three-day media training with the theme: “Strengthening Media Partnership and Collaboration for TB Control in Lagos State, Sokoya lamented that only 30 per cent of the Nigerian population is aware of signs and symptoms of TB.

He expressed concern about the low level of awareness, pointing out that, although TB continues to be a prevalent health issue, only 27 per cent of the population could identify its signs, making it extremely difficult to control the spread

Sokoya referenced the 2022 Global TB Report, which highlighted that 2.9 million TB cases were missed globally, with Nigeria among the five countries accounting for over 50 per cent of these.

He disclosed that Nigeria currently ranks 6th globally and 1st in Africa for TB prevalence with 11 per cent of cases undetected.

“To successfully combat TB, at least 80-90 per cent of the population must be educated on its symptoms,” Sokoya said.

“However, with current awareness levels sitting at only 27 per cent, Nigeria is trailing far behind in efforts to contain this disease.”

The event, spanning three days, aimed to foster stronger media collaboration to boost public awareness and empower Nigerians with the knowledge to detect and prevent TB.

Sokoya noted that without major improvements in public awareness, the goal of eliminating TB in Nigeria would remain elusive.

He added that TB often thrives in conditions of poverty, overcrowding, and poor nutrition, it can affect anyone, regardless of socioeconomic status, especially those in close contact with infected individuals.

The expert urged stakeholders to scale up educational campaigns that target all segments of society.

Speaking further on the TB situation in Lagos, Sokoya said the prevalence rate of TB in Lagos is 332/100,000 population, while the incidence rate is 219/100,000 population.

He added that a total of 31, 459 (50,00018541) 65 per cent cases were missed in 2023 and 18,541 cases were detected in the same year.

He urged media practitioners to play a pivotal role in informing the public and helping reduce TB’s spread across the country.

Also, another TB expert, Dr. Babajide Kadiri,said there were misconceptions that TB was caused by witchcraft or a curse from the gods.

While stressing that these misconceptions were untrue, the physician explained that TB germs are released into the air when a person with TB of the lungs coughs or sneezes.

Kadiri, however, stressed the importance of media helping in sensitisation of the people through routine health programmes to inform Nigerians about the signs and symptoms of TB.

He also suggested the inclusion of TB messaging during health-related advocacies to stakeholders.

Stigma and Social Isolation

Many of the experts who spoke at the workshop, including the TB survivors, lamented that TB’s stigma persists, fueled by misconceptions and fear.

They expressed concern that many TB patients often face social exclusion, economic hardship, and emotional turmoil.

They stated that this social exclusion not only compounds the emotional burden of the illness but also discourages others from coming forward for testing and treatment.

“People still associate TB with poverty, filth, and social failure. These misconceptions lead to fear and discrimination, making it difficult for patients to seek the help they need,” Shokoya noted.

Echoing these sentiments, Kadiri said her relationship with her family has gone sour.

“When I was diagnosed, friends stopped visiting, and even some family members kept their distance. It was heartbreaking.”

Changing the narrative

To combat stigma, workshop participants discussed the importance of public education and awareness campaigns.

Participants discussed various strategies for effective public education.

Engaging community leaders, leveraging social media, and utilising local health workshops were identified as powerful tools to reach diverse audiences.

They emphasised that communities may develop a better-informed viewpoint by providing accurate information on tuberculosis, including its causes, symptoms, treatment options, and preventive measures.

“We need to change the narrative around TB. Education is key. People must understand that TB is a treatable disease, not a mark of shame,” Shokoya urged the journalists.

The highlights of the workshop were the discussion about Tuberculosis Preventive Therapy, also known as TPT, which was designed to prevent the development of active TB in individuals who are at high risk.

Speaking at the workshop, the programme coordinator for the Journalists Against AIDS, Olayide Akanni said TPT is a course of one or more anti-tuberculosis medicines given to only people who have been exposed to it and are at a higher risk of developing TB disease than the general population.

Akanni said TPT, which includes short-course options such as 12 weeks of isoniazid and rifapentine (3HP) and 1 month of daily isoniazid and rifapentine (1HP), is effective at preventing people exposed to TB from having the disease.

She stressed that household contacts of people diagnosed with tuberculosis are two populations at high risk that could benefit from TPT.

Addressing Nigeria’s high TB burden

The 2019 Annual Report of the Federal Ministry of Health, Department of Public Health, titled, ‘National Tuberculosis and Leprosy Control Programme,’ stated that Nigeria has the highest burden of TB in Africa and is among the eight countries that accounted for two-thirds of the global TB burden.

Former Director of Public Health, Federal Ministry of Health, Dr. Umo Ene-Obong, said there has been a consistent increase in the number of TB cases notified in the country in the past four years.

The increase recorded between 2018 and 2019 was the highest ever since the programme was established in 1989, he revealed.

Ene-Obong noted that the number of TB cases notified increased by 13 per cent, which is from 100, 653 in 2018 to 120, 266 in 2019, saying that 76 per cent of the states (28) recorded an increase while 24 per cent (9) of the states recorded a decrease in TB notification.

He said, “Taraba State has the highest increase of 49%. The increase in case notification in five of the states include Taraba (49%); Cross River (45%); Katsina (42%); Niger (40%); Akwa Ibom (28%); and Bauchi (26%); doubled the value for the national increase of 13%.

“77 per cent of the United Nations High-Level Meeting target for TB diagnosis and treatment was achieved in 2019, while the number of people placed on TB preventive therapy remains extremely low.

“Despite the achievement in case notification, the treatment coverage is still low at 27% with a huge number of missing TB cases. Finding the missing TB cases and placing them on treatment including rapid scale-up of TB preventive therapy remain the key priority of focus of the programme in 2020.

“The programme in order to achieve this will rapidly scale up TB services to over 5, 000 health facilities; and expand TB diagnostic services with the installation of over 100 new genexpert machines.

“Additionally, the WHO-recommended MDRTH regimen and the shorter TPT regimen will rapidly scale up in the country. The government will also be mobilising additional resources to fill the current huge gap in TB funding to prevent tuberculosis in Nigeria.”

Meanwhile, a Professor of Medicine and a Pulmonologist, Olufunke Adeyeye said respiratory hygiene is an essential part of medical practice that can help curtail the spread of TB.

Adeyeye said people must know that droplet infections like sneezing, coughing and indiscriminate spitting can lead to widespread infections.

“Respiratory hygiene involves not spitting anyhow, not coughing anyhow, covering your mouth when you cough, and spitting into a tissue and disposing of it hygienically,” she advised.

Adeyeye, who is also the Head, Department of Medicine/ Respiratory Unit, LASUTH, said, “What you are doing is limiting what is in your body or your chest to yourself and you are not putting it out in the air for others to carry.

“Definitely, when you are not doing this, the droplet of whatever you have in your body will go into the air and another person will pick it.

“So, respiratory hygiene is hand washing and you might use a mask when you feel others will be exposed to the infection.”