Why Tuberculosis Testing Remains a Priority in Nigeria

Slug: why-tuberculosis-testing-remains-a-priority-in-nigeria
Meta title: Why Tuberculosis Testing Must Stay a Priority in Nigeria: Challenges, Impacts & Solutions
Meta description: Discover why Nigeria must keep tuberculosis (TB) testing at the forefront—explore low detection rates, high disease burden, testing gaps, and how better diagnostics can save lives and curb spread.

A silent heavy burden

In Nigeria today, Tuberculosis looms large. With an estimated incidence of 219 per 100,000 population, the country faces a significant TB burden. datadot+2kncvnigeria.org+2
Adding to the urgency, Nigeria is one of eight countries that accounted for more than two-thirds of global new TB cases in 2023. World Health Organization+1
Yet despite this scale, only a fraction of the estimated cases are detected and notified. In 2019 it was reported that just about 24–27 % of cases were being captured. PMC+1
This gap between the true number of people with TB and those diagnosed means many remain untreated, continue to spread TB in their communities, and face increased risk of death.

Why testing matters so much

Early detection saves lives

When TB is detected early, patients can start treatment before severe disease or extensive lung damage sets in. That improves survival and reduces transmission to others.

Breaking transmission chains

One untreated infectious TB case can infect 15-20 people in a year. ntblcp.org.ng+1 Testing identifies cases, triggers treatment, and interrupts further spread.

Aligning with SDGs and national goals

Nigeria’s commitment to the World Health Organization’s End TB Strategy means scaling up testing, diagnosis, treatment and prevention is fundamental. Without improved testing, targets cannot be met.

Addressing hidden sub-populations

Testing is especially critical in underserved areas, among children, people with HIV, and urban slums where TB burden is high but diagnosis is low. For example, in 2023 case finding among children in Nigeria was far below target. ntblcp.org.ng+1

The main testing challenges in Nigeria

Gap in case detection & notification: Many cases are missed. In 2020 only about 138,591 cases were diagnosed out of an estimated 452,000. tbassessment.stoptb.org+1
Limited access to diagnostic services: Only a small proportion of health facilities provide TB services. PMC+1
Stigma and low awareness: Many people delay going to clinics because of fear, misinformation, or lack of access. gh.bmj.com
Infrastructure constraints: Availability of rapid molecular diagnostics (e.g., Xpert MTB/RIF), reliable labs, trained staff and supply chains remains inconsistent across states.
Children and latent cases under-tested: Notification in children remains low and many latent or asymptomatic cases are invisible to health systems.

What improved testing looks like

Wider deployment of rapid diagnostics – molecular tests that detect TB and rifampicin resistance faster.
Active case-finding outreach – mobile screening drives in high-burden zones, contact tracing, community health worker programmes. (Pilots show improved yield) PMC
Stronger linkage of diagnosis to treatment – identifying a case only matters if treatment follows; diagnostics and logistics must be connected.
Better data & surveillance – digital systems to monitor testing coverage, geography of missed cases, and performance of diagnostic services.
Equity-focused strategies – targeting underserved, rural, urban-slum and informal-settlement populations where access is weakest.

Why Nigeria cannot afford to lose focus

Every missed case is a gamble: unchecked spread, more drug-resistance, more deaths.
Testing is cost-effective: diagnosing TB early prevents months of sick leaves, loss in productivity, and high treatment costs later.
Health systems built for TB testing often strengthen diagnostics for other diseases too (HIV, COVID-19, respiratory infections) – so the investment pays off broadly.
With population growth and urbanisation, the TB risk is increasing; testing must scale ahead of transmission.

Final thoughts

In Nigeria’s fight against tuberculosis, testing is the cornerstone. It is the door through which diagnosis, treatment, prevention and eradication enter. Without ample, timely, accessible and reliable diagnostics — the vast number of TB cases will remain hidden, untreated and ever-transmissible.
The ambition to end TB by 2030 is real only if Nigeria steps up testing, closes the gaps and makes diagnosis everywhere, for everyone. Because until every person with TB is found, no one is truly safe.

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