Tuberculosis

To find and treat more tuberculosis cases in Nigeria, the Institute of Human Virology Nigeria (IHVN) and the National Tuberculosis and Leprosy Control Programme (NTBLCP) have launched a mobile application for screening and notifying TB cases by private healthcare providers.

Announcing this recently, the IHVN Chief Executive Officer, Dr. Patrick Dakum, said that the application, Mobile Application for Tuberculosis Screening (MATS), launched in June was a game changer in the provision of real-time and online information on progress made by private-for-profit facilities, faith-based organisation facilities, patent medicine vendors, community pharmacists, private laboratories and other TB referral entities.

He said: “The application is already being used in Edo, Delta, Cross River, Akwa Ibom, Benue, Oyo, Ondo, Osun, Ogun, Kogi, Niger, Sokoto, Plateau, Nasarawa, Kaduna, Anambra, Enugu, Rivers, Imo, and Abia states.

“Since MATS was launched on June 1st, 2020, there has been an increase in the TB screening efficiency and linkage between facility and community-based units. More than 19,000 people have been screened resulting in the identification of 1,286 TB presumptive individuals and 52 confirmed TB cases enrolled on treatment,” he said.

The IHVN CEO explained that individuals who visit private health providers in the community are screened with standard TB symptom checklist on the app.

Thereafter, appropriate referral of clients or samples for diagnosis and treatment is initiated.

“Private providers can download the app from the Google Play Store or via a web link, register as a user and start using the app once activated by a TB treatment facility. All screening data from the various referral entities can be viewed on the treatment facility’s dashboard and a summary on the mobile app,” he said.

NTBLCP Monitoring and Evaluation Manager, Dr. Obioma Chijioke- Akaniro added that the app simply shows the efforts directed towards finding tuberculosis cases. “The simplicity of MATS makes it attractive to the private sector especially as they may not oblige to filling cumbersome tools,” she said.

Dr. Chijioke-Akaniro said that MATS will be continually upgraded based on feedback from its users.

The application was developed and redesigned by PharmAccess to suit the peculiarities of private health providers in line with the national algorithm for TB screening and diagnosis.

Upgrade and deployment of the application is implemented by IHVN under the Public Private Mix (PPM) grant funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“The private sector in Nigeria contributed 14% to the total national TB case notification in 2019. It is expected that the MATS app will contribute immensely to the actualization of the goal of the grant which aims to improve public private sector contribution to the national TB case notification from 11 per cent in 2017 to 35 per cent in 2020” Dr Dakum said.

Lung cancer is the second most common type of cancer in adults in the United States. It is also the leading cause of death from cancer.

Lung cancer treatment is much more effective when the disease is in its earlier stages. However, most people with lung cancer do not experience symptoms until the disease has spread.

Some people experience subtle symptoms of early stage lung cancer, but these symptoms more often stem from other health issues or factors such as smoking.

Below, we describe early symptoms of lung cancer, as well as risk factors and when to see a doctor.

Possible signs and symptoms of early stage lung cancer

According to the American Cancer Society (ACS), most types of lung cancer do not cause symptoms until they have spread to other areas.

However, some people experience subtle symptoms during the earlier stages of the disease.

The early lung cancer symptoms that we describe below usually result from some other cause. However, people who experience these symptoms should consider visiting their doctors as a precautionary measure.

Sudden weight loss

The American Society of Clinical Oncology report that weight loss is often the first noticeable sign of cancer.

They estimate that 40% of people who receive a cancer diagnosis experience unexplained weight loss during that time.

Cancer can cause weight loss for many reasons, including:

  • changes to immune function
  • changes to metabolism
  • changes to hormones
  • a sudden loss of appetite
  • difficulty swallowing

Shortness of breath

Shortness of breath and wheezing can also be early symptoms of lung cancer.

Some people may experience a slight cough in addition to shortness of breath. Others may have difficulty catching their breath but have no cough.

Cough

A slight cough that does not go away can indicate early stage lung cancer. Some people assume that this cough is only a result of smoking.

A person who regularly coughs because of another lung condition may notice changes in their cough, and these can likewise indicate lung cancer.

Also, a cough that produces blood may result from lung cancer or another issue with the lungs. Anyone who experiences this symptom should see a doctor.

General fatigue

Lung cancer can cause the number of red blood cells in the body to drop. The medical term for this issue is anemia.

Because red blood cells carry oxygen, a person with anemia may not take in enough oxygen to support their body’s needs. This can result in tiredness and fatigue. Severe fatigue can make it difficult to function on a day-to-day level.

Shoulder, chest, or back pain

Most people with lung cancer do not feel pain or other symptoms during the early stages. This is because there are very few nerve endings in the lungs.

However, pain can occur when lung cancer invades the chest wall, ribs, vertebrae, or certain nerves. For example, Pancoast tumors, which form at the very top of the lungs, often invade nearby tissues, causing shoulder pain.

As a tumor develops, a person may begin to feel pain in their:

  • arms
  • chest
  • back

Hoarse voice

A person with lung cancer or another respiratory disease may develop a hoarse, raspy voice.

This can happen if a tumor presses on the laryngeal nerve, which is located within the chest. When the nerve is compressed, it can paralyze a vocal cord, causing the voice to change.

Risks

According to the Centers for Disease Control and Prevention (CDC)cigarette smoking is still the biggest risk factor for lung cancer, accounting for 80–90% of lung cancer-related deaths.

Other risk factors for lung cancer include:

  • using other tobacco products, such as cigars or pipe tobacco
  • inhaling secondhand smoke
  • being exposed to radon gas, possibly from materials within the home
  • working with dangerous chemicals, such as asbestos, arsenic, or diesel
  • living in a highly polluted area
  • having other lung conditions, such as chronic obstructive pulmonary disease
  • having a family history of lung cancer

When describing risk, organizations and experts sometimes use the term “pack-year.” A pack-year refers to the number of cigarettes smoked per day each year. So a person with a 30 pack-year smoking history may have:

  • smoked one pack per day for 30 years
  • smoked two packs per day for 15 years

The ACS recommend yearly lung cancer screenings for people aged 55–74 who:

  • currently smoke or have quit smoking in the past 15 years
  • have at least a 30 pack-year smoking history
  • currently smoke and are receiving counseling to help them quit
  • are aware of the potential benefits and harms of screening
  • have access to a facility that has experience with lung cancer screening and treatment

Screening cannot detect every instance of lung cancer, but it does lower a person’s chance of dying from the disease.

Smokers vs. nonsmokers

According to the CDC, people who smoke are 15–30 times more likely to die from lung cancer than people who do not.

Meanwhile, according to statistics from 2013–2014, about 1 in 4 people who do not smoke, including children, are exposed to secondhand smoke. This increases their risk of developing the disease.

Quitting smoking at any age can lower the risk of lung cancer.

When to see a doctor

The symptoms above usually result from issues other than lung cancer. However, anyone who experiences any of the following issues should visit a doctor:

  • a cough that lasts longer than 2–3 weeks
  • a persistent cough that worsens
  • a cough that produces blood
  • aches or pains when breathing or coughing
  • persistent shortness of breath
  • persistent tiredness or fatigue
  • recurrent chest infections
  • unexplained weight loss

Summary

Lung cancer is the second most common form of cancer. It can affect anyone but is particularly prevalent among people who smoke.

Usually, lung cancer does not cause symptoms until it has spread. As a result, it is not always possible to detect lung cancer in its earliest stages.

Nonetheless, some people experience subtle symptoms during the initial stages. It is important to recognize these because treatment is typically more effective when a person receives it early.

Anyone who experiences early symptoms of lung cancer should see a doctor. In many cases, something other than cancer is the cause. Still, it is best to seek medical advice as a precaution.