Are Weak Health Systems a Brewing Ground for Multi-Drug-Resistant Tuberculosis?

ABSTRACT

Multidrug-resistant tuberculosis (MDR-TB) posses a huge threat to public health in Nigeria and most of sub-Saharan Africa where weak health systems exist. Diagnostic facilities and drug treatment of MDR-TB are largely unavailable in several countries in sub- Saharan Africa; and where treatment is available treatment outcome has been poor. This case report illustrates challenges in the implementation of basic Directly Observed Treatment (short-course) (DOTS) and its impact on the control of MDR-TB in sub-Saharan Africa. The case notes of a 48-year-old widow; who had been on treatment for smear-positive TB between 2004 and 2008 in Jos; Nigeria; were reviewed. Failure of basic DOTS and delayed diagnosis of MDR-TB were identified as potential challenges in control of the disease on the African continent. This case report illustrates weaknesses in the health system in sub-Saharan Africa in the area of TB control and how this could contribute to the development and spread of multidrug and possibly extensively drug resistant (XDR) TB