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Maplecroft rates Nigeria, Chad and Ivory Coast most at risk from Tuberculosis

Poverty and AIDS driving upward trend in Africa

04/02/2010

A new study ranking 196 countries on their vulnerability to Tuberculosis (TB) has named Nigeria, Chad and Ivory Coast as the nations most at risk from the disease.

The Tuberculosis Risk Index (TBRI), developed by Maplecroft, uses 10 separate indicators to measure the impacts of TB in each country, including: incidence, prevalence, mortality, treatment success and the capacity of a country to contain infectious diseases.

Africa is by far the region most at risk with 23 out of the 25 most vulnerable countries. Nigeria, Chad, Ivory Coast, Angola, Uganda, Burundi and Sierra Leone are rated most at risk.

Tuberculosis Risk Index 2010

Legend
Extreme risk
High risk
Medium risk
Low risk
No Data

Rank	Country	Category
1	Chad	Extreme
2	Côte d'Ivoire	Extreme
3	Nigeria	Extreme
4	Angola	Extreme
5	Uganda	Extreme

Rank	Country	Category
6	Burundi	Extreme
7	Sierra Leone	Extreme
8	Mali	Extreme
9	Tanzania	Extreme
10	Mozambique	Extreme

© Maplecroft 2010

TB is curable, but underfunded health services in Less Economically Developed Countries (LEDCs) means that the inter-relationships with poverty and the disease are inescapable. The World Health Organisation estimates that 92% of TB cases and deaths occur in low income and lower-income nations and according to Maplecroft's Poverty Index, more than half of the 30 countries most severely affected by poverty are also severely affected by TB.

Nigeria is of particular importance to business, especially the extractive sector because of its mineral and energy resources. According to Maplecroft, companies with interests in the region should pay particular attention to implementing systems to manage the disease in their workforce.

Aside from poverty, there are three major factors contributing to Nigeria's poor rating in the TBRI. Firstly, the growth in foreign direct investment has led to increased development of the communications infrastructure, facilitating the rapid spread of TB, as people move more freely around the country. Secondly, as employees increasingly congregate in larger workplace facilities their susceptibility to the spread of TB rises. Lastly, Nigeria has a high prevalence of HIV/AIDS and mortality rates from TB are much higher in HIV sufferers, resulting in 25% fatalities.

The number of adults and children in Sub-Saharan Africa living with HIV has increased from 19.7m in 2001 to 22.4m in 2008. The increase in people living with HIV and their subsequent vulnerability to TB infection means that even where HIV infection rates are dropping, those surviving with HIV, and potentially contracting TB, pose a greater burden on health services and risk to businesses. Interrupted treatments and poor medical resources have also increased the incidence of multi-drug resistant TB (MDR-TB), exacerbating the struggle faced by health authorities.

Up to 75% of cases of TB are diagnosed in the working population, aged between 15-54 years. Businesses can help to mitigate the risk by providing regular health screenings; educating the workforce; and, collaborating with existing programmes led by NGOs and governments . Simple measures such as better ventilation and dust control in the workplace can also assist in reducing business risks from TB.

“Addressing TB can assist in developing a healthy, skilled workforce and the secure environment and economy that is essential to business development.”

– Daniella Ferrol-Schulte, Environmental Analyst at Maplecroft.