WHICH WAY FOR KENYA IN THE FIGHT AGAINST TUBERCULOSIS?

 

On the 24th of March, Kenya released the result of the first ever national TB prevalence survey since independence.

The survey revealed disturbing details that almost half of the TB cases in Kenya (40%), go undetected and therefore untreated.

According the report, there were 558 per 100 000 compared to the WHO estimate of 233 per 100 000. Overall, the highest burden of TB is among adults in their most productive years aged 25-34 years. Men in this age bracket bear the highest burden of TB. The prevalence of TB in men is actually twice as high as that of women.

Majority of the people found to have TB had not sought health care because they perceived their symptoms as being mild.  A quarter of those found to have TB did not have any symptoms.  The current practice of relying on the four cardinal symptoms mainly- cough of more than two weeks, fever, night sweats and weight loss for TB screening may be contributing to many cases being missed.

It also emerged that Over 50% of the TB cases did not have a cough of more than two weeks. These cases were only identified because of abnormal chest x ray. This makes X ray a key diagnostic method as opposed to relying on use of microscopy.

Way Forward for Kenya

There is need to have concerted efforts to find the missing TB cases, treat them and cure them.

Kenya has purposed to develop and implement targeted approaches for communication, TB screening and active case finding among young men and the elderly.

There is also a need to carry out targeted screening and active case finding among high risk groups including men, urban slum dwellers, employers, informal labour sector, schools and colleges.

Health interventions in schools have been known to be very effective and fruitful. Efforts are being made to expand school health programs to include TB and target children as real agents of change.

Target messaging and health education to key affected populations is also being considered as a way of making people more aware about TB and also encouraging people to seek early intervention for any symptom.

“The parliamentary TB Caucus shall ensure all the recommendations made in this report are that are within their capacities are implemented. Committed Hon. Stephen Mule the Chair of the Africa Parliamentary TB Caucus during the dissemination of the findings . In a war zone, one is advised to know and understand the enemy before the strike. Understand their strength, their approach, size them up and know their weakest point. We now know our enemy. We know the size of the TB epidemic, concluded Hon. Mule.

To address the high TB prevalence in the urban areas, Kenya will be focusing more on urban specific interventions in cities and major towns.

Chair of the Parliamentary TB Caucus, Hon. Stephen Mule (left) and the Head of Clinical Services at the Ministry of Health, Dr. Izaq Odongo (right) during the Kenya TB Prevalence Survey Report dissemination forum

The sure way to achieve the World Health Organization’s End TB Strategy is to make TB everyone’s business. The private sector and the unconventional players in the fight against TB must be engaged in TB screening, diagnosis and treatment. United we can end TB.