The poor most affected by tuberculosis

The revelation that 90 per cent of tuberculosis (TB) cases in the country are among HIV negative persons should be a big concern. In every 100,000 people, 558 have TB. This means there are about 251,100 cases of TB. Of these, over 225,000 are HIV negative.

Globally, at least 1.3 million people died of TB in 2016 and were HIV negative, compared to 374,000 recorded for HIV positive persons. Kenya Medical Association boss Dr Stella Bosire said there is no clear data on key, vulnerable and underserved populations considering TB is a ‘poor people disease’ yet they are the most affected persons.

However, while the documented number of deaths are on the decline from 11,149 in 2011 to 4,735 in 2016, the risk is still as high due to lack of policies, a clear treatment plan and increased populations especially in informal settlements.

Though TB drugs are free, patients still pay for examinations like X rays and scans. There is also still no clear policy on how to manage TB cases of patients who default treatment. Previously, the government would arrest and confine such individuals to hospitals, until they clear their dosage as mandated by the Public Health Act. But in 2016, the court ruled against the practice as inhumane.

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However, defaulting leads to drug resistance and this means the government has to purchase stronger drugs which are expensive. Also if one is infected by a drug resistance person, the disease becomes even more difficult to treat.

There is no harm in bringing back the isolation wards as they will help manage cases of treatment defaulters. However, this should be done in a humane way without imprisoning or detaining a patient without enough counseling. Also, a lot of advocacy is needed to encourage taking of the drugs despite their extreme side effects.

The drugs may be free, but they have to be accompanied by a good diet. While providing food for the low income earners may be a far-fetched idea, vitamin supplement can be an alternative.