DRUG-RESISTANT TUBERCULOSIS IN NORTHERN NIGERIA: BURDEN, BARRIERS, AND HEALTH SYSTEM CHALLENGES

Abstract

Drug-resistant tuberculosis (DR-TB) remains a major public health challenge in Nigeria, especially in the northern region where weak health systems, poverty, conflict, and stigma exacerbate the problem. This review assesses the epidemiology, diagnostic landscape, treatment challenges, and health system factors influencing control of DR-TB in northern Nigeria. A systematic review on this topic was conducted on retrieved peer-reviewed articles, national reports, and other literatures from 2010 to June 2025 using PubMed, AJOL, Google Scholar, and Science Direct. Studies focusing on DR-TB epidemiology, diagnosis, treatment, and health systems in Northern Nigeria were included. Northern Nigeria shows rising DR-TB prevalence, particularly in Kano, Bauchi, and conflict-affected states. Key drivers included diagnostic delays, poor treatment adherence, drug stock-outs, and weak referral systems. While WHO-recommended diagnostic tools like GeneXpert and community-based treatment strategies are in place, access is uneven due to geographic, infrastructural, and workforce limitations. High stigma and limited community engagement further hinder detection and adherence. Health system weaknesses—such as inadequate laboratory capacity, poor funding, and weak data systems—pose significant barriers to achieving “End TB” targets. Addressing DR-TB in northern Nigeria requires a multifaceted response that goes beyond clinical care. Strengthening diagnostic infrastructure, decentralizing treatment, improving drug supply chains, enhancing community engagement, and addressing stigma are key to improving DR-TB outcomes.