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High infection risk as over 7,000 TB patients not on treatment

More than 7,000 confirmed TB patients in Kenya are walking around without treatment at the risk of death or infecting others, a report by the Ministry of Health reveals.

A countrywide survey by the National Tuberculosis, Leprosy and Lung Disease Programme found out that there are many confirmed TB cases which are unreported and are thus not on treatment.

The results of the survey, published on Wednesday, says approximately 39,100 TB cases were reported in 73 sub-counties against an expected 47,000 during the study period.

Some of the lost cases, the report says, were highly infectious patients, but not known to the national TB surveillance system called TIBU, the Kiswahili word for cure.

The survey found that one of every five positive TB cases is unknown to the national programme, indicating that the TB burden is higher than is reported.

“This is an important public health concern, as unreported patients may not be on treatment, thus continuing to transmit TB in the community or worse yet, die,” says the study.

The results of the survey were published two days before the Friday release of Global Tuberculosis Report 2016.

“The dismal progress in the TB response is a tragedy for the millions suffering from this disease,” said Dr Mario Raviglione, Director of the WHO Global TB Programme, in the Global Report.

Kenya, still among the 22 high TB-burden countries, features prominently in the Global Report 2016, mainly because of the many cases that are unreported.

Globally, of the estimated 10.4 million new cases, only 6.1 million were detected and officially notified in 2015, leaving a gap of 4.3 million.

“This gap is due to under-reporting of TB cases, especially in countries with large unregulated private sectors and under-diagnosis in countries with major barriers to accessing care,” says the report.

Other researchers involved in Kenya’s study, indicated to have fed into the global report, were from the Kenya Medical Research Institute, the World Health Organisation and the US Center for Disease Control and Prevention (CDC).

Compulsory treatment

Tuberculosis, one of the most infectious diseases in the world and now with almost impossible-to-treat strains, is a notifiable disease, making it compulsory for infected persons to be put on treatment.

In 2010, Kenya caused a global stir when two TB-infected persons were sent to jail for failing to take their medications.

Defending the imprisonment early this year, Health Principal Secretary Dr Nicholas Muraguri said safeguarding the public, under the Public Health Act, supersedes an individual’s right to comfort.

According to the Global Report, Kenya has 1,400 cases of hard-to-treat or Multi Drug Resistant TB (MDR-TB).

Kenya is now classified among 20 countries with high cases of TB, with confirmed MDR-TB and high incidence of HIV-TB co-infections.

The Kenya study, published in the International Journal of Tuberculosis and Lung Diseases and led by Dr Deanne Tollefson of CDC, shows Nairobi, Nyanza and Rift Valley, in that order, are worst in reporting.

The highest level of under-reporting occurred in Nairobi at 33 per cent, while the lowest in the North Eastern region at 12 per cent.

Without reliable TB surveillance systems, the authors warn that the national control programme is hindered from effectively managing the disease.

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