When Mallama Samira Ibrahim of the Dan-Shayi community in Rimigado local government area (LGA) of Kano State first noticed her son (name withheld) had a persistent cough, she assumed it was a minor infection.
Her five-year-old son had always been active, running around their small compound, but in recent weeks, he had grown noticeably weaker. His nights became restless, filled with violent coughing fits and fever.
“I gave him herbs, thinking it was just a cold. But he kept losing weight, and his appetite disappeared,” she recounted.
Desperate for answers, she took him to a patent and proprietary medicine vendor (PPMV), where he was prescribed antibiotics.
“When my son’s condition failed to improve, I visited a primary healthcare centre. The doctors suspected tuberculosis (TB) and sent us for a lab test. The results confirmed multidrug-resistant TB (MDR-TB) – a strain that does not respond to standard treatment,” she said.
According to the World Health Organisation (WHO), MDR-TB is a form of TB resistant to at least the two most potent anti-TB drugs – isoniazid and rifampicin. This resistance typically develops when patients fail to complete their full course of treatment, when treatment is inconsistent, or when incorrect drugs are administered.
Since standard drugs are ineffective, treating MDR-TB requires longer, more complex regimens, often including second-line medications that are more toxic and expensive. Additionally, treatment success rates tend to be lower.
MDR-TB poses a significant public health challenge as it is harder to diagnose and treat, requiring more intensive healthcare resources to manage both the disease and its transmission.
For six months, Ibrahim and her son made frequent trips to Aminu Kano Teaching Hospital, one of the few facilities offering MDR-TB treatment.
“The journey was grueling. The cost of transportation and the time lost from work added to the emotional burden. More challenging was ensuring my son adhered to the daily painful injections and potent medications,” she recalled.
“He cried every time they gave him the injection. Sometimes, he refused to take his medicine because it was too bitter.”
At first, his condition appeared to improve. But three months into treatment, his cough worsened.
“The doctors explained that drug-resistant TB was harder to treat and missing doses could make the bacteria even more resilient.”
Despite every effort, her son’s tiny body could not withstand the prolonged, aggressive treatment. One night, struggling to breathe, he passed away in her arms.
“Losing him to TB was the most painful thing I’ve ever experienced as a mother,” she said, tears streaming down her face.
Her story underscores the immense challenges caregivers face when managing drug-resistant TB in children, highlighting the urgent need for robust support systems and accessible healthcare services.
According to WHO, Nigeria ranks among the top 10 countries globally with the highest burden of drug-resistant TB.
Despite improvements in TB control programmes, the emergence of drug-resistant strains has created a growing health crisis over the past decade.
Data from the National TB and Leprosy Control Programme (NTBLCP) estimates that approximately 21,000 Nigerians develop drug-resistant TB annually, yet only about 2,600 receive proper treatment.
A systematic review found that among new TB cases in Nigeria, six per cent were multidrug-resistant, while 32 per cent of previously treated cases showed resistance.
A public health specialist with the Federal Ministry of Health, Dr. Clement Adesigbin emphasised that these figures highlight the urgent need for improved diagnosis and treatment.
“There are significant disparities between urban centres like Lagos and rural areas, where access to modern diagnostics remains limited,” he said.
In many Nigerian communities, stigma and misinformation remain major barriers to TB diagnosis and treatment.
Ms. Mariam Suleiman, a community health worker in Gezawa LGA, Kano State, explained: “Many families hide their TB diagnosis due to fear of social exclusion. This delays treatment and increases the risk of transmission.”
Head of childhood tuberculosis at NTBLCP, Dr. Urhioke Ochuko added: “Awareness campaigns are essential, but we must first dismantle the myths and misinformation surrounding TB. Only then can we ensure that parents seek help early for their children.”
He explained that cultural misconceptions often equate TB with curses or personal failure, leading to delayed diagnosis and unnecessary suffering.
“This does not only endanger individual lives but also contributes to the wider spread of the disease,” he said.
A TB specialist in Kano, Dr. Ni’ima Lawal highlighted the promise and limitations of modern diagnostics.
“While we have increased the number of GeneXpert machines, many communities still lack access to early detection tools. Children are particularly vulnerable due to their weaker immune systems,” she said.
She stressed the importance of aggressive contact tracing and community awareness programmes to curb the spread of TB.
Dr. Luke Olatunji, a pulmonologist, pointed out systemic barriers in both urban and rural settings.
“In many parts of Nigeria, particularly rural areas, quality healthcare remains a distant dream. Mobile clinics and improved diagnostic facilities are urgently needed to reach those at risk,” he stated.
The Nigerian government, in collaboration with WHO, USAID and other international partners, has launched several initiatives to tackle TB.
Free TB testing and treatment are now available in public health centres.
Active case-finding campaigns, like the “Check Am O!” campaign, encourage early detection.
Mobile clinic pilot projects aim to extend diagnostic services to remote areas.
Despite these efforts, challenges remain, particularly in ensuring these services are accessible and widely known among all segments of the population.
Public health experts insist that increased funding, enhanced community outreach and sustained policy commitment are essential to bridging these gaps.
For families and caregivers, early detection is key. Minister of Health and Social Welfare, Prof. Muhammad Ali Pate urged Nigerians to seek medical help immediately if a child has a persistent cough lasting more than two weeks.
He advised Nigerians to engage in local TB awareness campaigns and seek support from organisations like NTBLCP and local NGOs.
“To learn more or find assistance, contact the Nigerian TB hotline or visit the Ministry of Health’s website for updated information on local TB clinics and free treatment programmes,” Pate advised.
As Nigeria marks World TB Day 2025, Ibrahim’s story and the voices of experts and community members serve as a stark reminder that TB is not merely a statistic. It is a human tragedy that demands urgent, compassionate and coordinated action.
By prioritising early diagnosis, reducing stigma, expanding access to treatment and increasing funding, Nigeria can move closer to eliminating TB as a public health threat.
