May I know my TB status please?
Today is International World AIDS Day. I am attending the national event in Kenya which is being held in Nyayo stadium, one of the main football stadia in Kenya. HIV testing is being conducted.
I walked in to the small white tent with anticipation. I wanted to know my HIV status. I was received by this pleasant lady. She looked really confident and skilled in what she was doing. It did not bother her that her job entailed delivering news that would change one’s life forever.
She counseled me first. Among others, she wanted to know how I would receive the news whether positive or negative. “I am ready for whichever results” I responded. She proceeded to gently prick my finger to draw blood after carefully wiping it with a spirit swab. She put a few drops of blood in to a thin test strip. She continued engaging me in a conversation as we waited for the results. Two lines would mean positive results; one line would mean I am negative.
After a few anxious minutes that felt like ten years, she pulls the HIV test strip and asks me to look keenly and read the results myself. She then again counsels me on the results I have just read.
Meanwhile, I request to know if I could be having TB. I ask her to screen me for TB. Not that Ihave any symptoms, but I know and it is necessary to be screened for TB to rule out TB as well.
“We are not conducting TB screening for today” she responded. “We only do HIV” She continued. “What a wasted opportunity!’ I thought to myself.
TB is the leading killer of the people living with HIV. In fact, according to WHO Tuberculosis report 2015, TB had over taken HIV become the leading killer among communicable diseases. In Kenya, about 33% of all TB cases are also HIV positive.
As such integration of TB in to HIV programs has been recommended as a strategy to reduce the burden of TB among Persons living with HIV. To cement this recommendation, Global Fund (GF) gave a directive that countries with high TB and HIV burden should develop a single combined concept note for TB and HIV. Kenya was one these countries.
It is only prudent that the collaboration and integration between the two diseases is done not only at the concept note level but at all levels from the national policy making levels to the very bottom implementing levels of service delivery. An opportunity was lost to screen me for TB, many TB cases were missed today and will continue to be missed unless the call for comprehensive integration is heeded. Small wonder then that the most recent report indicates that Kenya is missing about 50% of all TB cases.
We look forward to World TB day 2017 for another opportunity to reduce the burden of TB among people living with HIV.
By Evaline Kibuchi
