Health
United States Foundation Donates Medical Equipments To FMC Gusau
Health
Diagnosing Cancer in a Resource-Scarce Setting: A Heartbreaking Tale of Poverty and Healthcare
By Dr Ibrahim Musa
With her beaming smile, she seemed excited that the surgeons had finally removed a growth troubling her tommy that had proven difficult to diagnose. She stretched her arm to deliver a sealed envelope containing a histology report of the growth. As an Attending, I was the only one working that day because the resident doctors were on a strike. Charmed by her smiles, I quickly opened the envelope hoping to read good news that would match her spirit and her equally excited mother. My smile froze. What should I tell her? The pathologists had made a diagnosis of a diffuse large B lymphoma. It’s quite an aggressive tumor that could overwhelm a patient within a short time.
Breaking: Nigeria Commences Maggot Therapy In AKTH
“Doctor, what is the report saying?” “You have cancer”, I replied. The devastating news instantly changed her mood. Breaking such bad news is a job no doctor wants to engage in. I explained the treatment options and the fact that there is a targeted therapy called Rituximab that could potentially improve survival if added to her chemotherapy. A vial of the drug costs hundreds of thousands and she would need at least 6 cycles within ~5 months of 3 weekly treatment. “Doctor, we cannot afford it,” her mother interjected.
Three months later, when I came for the ward round she had deteriorated badly. The growth is already back and almost 10 times bigger- obstructing her intestine and protruding on the anterior abdominal wall from her pelvis. She could barely breathe while struggling to hold on to her mother. As I watched her writhe in pain, I felt hopeless and sad. I felt defeated but beyond that I felt like we have all failed her. I silently fought tears as I struggled not to betray emotions. If I cry I would break the hearts of the people around at the time they needed me to give them hope. “You must be strong”, I told myself. But at that moment I was so sure that death would be a relief for her. She died the next morning unable to do even an X ray due to poverty. I keep asking myself what we can do to mitigate these unfortunate scenarios? Over 40% of the Nigerians live on less than $1 per day. With this extreme poverty, how do we expect them to shoulder the cost of exorbitant care from the angle of catastrophic spending?
Dr Ibrahim Musa is a consultant at Aminu Kano Teaching Hospital
Health
Kano State Stakeholders Meet to Strengthen Health Response, Focus on COVID-19 and Other Diseases
KANO- The Kano State Programs Officer for Resilient and Sustainable System for Health, Abdulhakeem Dayyab, recently led a biannual meeting in Kano aimed at bringing together stakeholders to raise awareness about deadly diseases such as HIV, COVID-19, and other severe illnesses.
The meeting sought to integrate traditional rulers into the healthcare system, ensuring the availability of health facilities in five local government areas within Kano. By involving community leaders, the aim is to facilitate smoother consultations with community members, ensuring their active participation in healthcare initiatives.
Community members, recognizing their role as privileged individuals, have taken the responsibility of ensuring the availability of health facilities, particularly at the Primary Health Care (PHC) level and dispensaries.
Abubakar Sadiq, from the Department of Public Health and Epidemiology Unit at the Kano State Ministry of Health, emphasized the significance of the response team’s role in combating deadly diseases. Their support plays a vital role in effectively addressing health challenges faced by the less privileged members of society.
The stakeholders’ meeting was convened with a specific focus on strengthening the provision of healthcare services at the community level, particularly in PHCs. The active involvement of privileged individuals in addressing health challenges aims to bridge gaps in healthcare access and ensure improved health outcomes for all segments of the population.
Health
FG Mulls Developing Lassa Fever Vaccine
The Federal Government is currently engaging with the World Health Organisation (WHO) and the Coalition for Epidemic Preparedness Innovations (CEPI) for the development of new therapeutics and a vaccine for Lassa fever.
Health Minister Osagie Ehanire, said this at a three-day National Case Management Training on Lassa fever has disclosed.
Ehanire, represented by the Minister of State, Mr Joseph Nkama said that the ministry decided to embark on the capacity building in lassa fever case management, because “we know that doing so will go a long way in reducing mortality in these patients.
“It is more than 50 years since Lassa fever was first diagnosed in Nigeria. Over the years, some states had been endemic while others record annual outbreaks.
“The ministry is engaging with WHO and the CEPI for the development of new therapeutics and a vaccine for Lassa fever.
“Over the last five years, the country witnessed a sharp rise in the number of confirmed cases of Lassa fever including healthcare worker infections, reinforcing the need to build capacities to adequately manage cases when they arise,” he said.
According to him, the ministry is committed to ensuring the decline in Case Fatality Rate (CFR) from the 2021 figure of 20.5 per cent to 19.8 per cent in 2022 continues.
He said such effort would continue until Lassa fever ceases to become a public health threat in Nigeria.
“The recent COVID-19 pandemic has taught the country that it cannot afford to undermine any effort put into addressing and reducing high-risk viral pathogens like Lassa fever.
“It cannot only mutate and pose a new threat, but globalization can quickly lead to the spread of the disease to non-endemic countries,” he said.
Ehanire said the country has advanced not only in the capacity to diagnose Lassa Fever but also in the sequencing of the virus genome to monitor the circulating Lassa viruses.
He said that the country’s commitment was also evident in the emphasis on infection prevention and control measures among healthcare workers (HCWs) to reduce rates of infection within healthcare facilities.
“Now we want to build capacity in case management because we know that doing so will go a long way in reducing mortality in these patients.
“This training is part of the government’s effort to further reduce mortality from Lassa fever, the ministry has not made this progress in addressing Lassa fever epidemics working alone.
“WHO has been integral in their support. Their support to the country has spanned from sensitization and training of healthcare workers to the provision of infection control commodities to treatment centres,” he said.
The minister said that the WHO also supported public awareness initiatives, surveillance and outbreak response at the state level through the emergency operations centre and at the national level.
He said that the Institute of Lassa Fever Research and Control (ILFRC), Irrua Specialist Teaching Hospital (ISTH), had been actively involved in the management of Lassa Fever patients for many years.
Ehanire said the agencies have also carved a niche for herself as a centre of excellence for the management of viral hemorrhagic fevers, despite several challenges.
According to him, there has been significant improvement in case management since ISTH became actively involved.
He said before stakeholders involvement, blood samples had to be sent to Europe and South Africa for confirmatory testing, with results being unavailable for weeks to months.
Ehanire said that the institute’s activities have also seen expansion from clinical case management to research including large-scale epidemiological studies.
He said that the Integration Consortium(IC) inaugurated at the training would be led by Nigeria working with international partners and the WHO to articulate and prepare centres for clinical trials.
“We must not forget that the COVID-19pandemic is not yet over and that some patients may have Lassa fever and COVID-19 at the same time and suffer complications from both of them.
“These patients need particular attention and timely decision-making is key in this regard.
“We have made internationally recognized giant strides as a nation, in addressing COVID-19.
“Molecular laboratories now exist in all Teaching Hospitals, Federal Medical Centres and Specialist Hospitals,” he said.
According to him, in the same vein, modern Intensive Care Units, well-equipped isolation centres and Personal Protective Equipment have been made available at these centres.
“This government is committed to addressing Lassa Fever as well as we have addressed COVID-19 so far,’’ he said.
Dr Sylvanus Okogbenin. Chief Medical Director, Irrua Specialist Teaching Hospital, said the theme of the workshop was “Reducing mortality in Lassa fever patients and building capacity for case management”.
According to him, the ministry is desirous to build a critical mass of well-trained clinicians and health care workers with the capacity for case management to reduce mortality from Lassa Fever Disease.
Okogbenin said that Nigeria has recorded the highest prevalence in the recent past, with annual outbreaks of public health concern.
He said in 2018, WHO prioritised Lassa fever as a highly infectious disease in need of urgent research and countermeasures including vaccine development.
Okogbenin said that in 2022 in week 26, the Nigeria the Nigeria Centre for Disease Control is (NCDC) has reported 829 confirmed cases with 160 19.3 per cent deaths
“A particularly worrisome aspect is healthcare worker infection and death.
“This year, 53 healthcare workers have been infected with several deaths. This workshop will also address the prevention of healthcare worker infection and death,” he said.
Okogbenin said the workshop would l also pay particular attention to the issues of pregnant women with Lassa fever disease.
He said: “ In 2022 alone, several healthcare workers across the country were infected during caesarean section following missed diagnosis in pregnant women.”
Prof. Stephan Gunther of Bernard Notch Institute of Tropical Medicine, Deputy Chairman of the Board of the Bernard Notch Institute, said the training would help the country.
Gunther said that lassa fever was always very difficult to manage in the late stage of the disease because many patients would die.
He said the country needed to know how to manage the cases of Lassa fever
“The workshop will help the health workers to properly address the cases of lassa fever in order to reduce the virus in Nigeria.
Dr Walteri Mulombo, WHO Country Representative to Nigeria, said lassa fever had been a problem for about 15 years, killing a lot of the sufferers.
According to Mulombo, the training will address issues regarding the case management, the way people are treated, the medicines they are being given, the timeliness of the treatment and with the best practices. (NAN)
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