Why more needs to be done to avert TB burden in Kenya

Tuberculosis (TB) is a communicable disease that is a major cause of ill health, one of the top 10 causes of death worldwide, and the leading cause of death from a single infectious agent, according to the World Health Organization report for 2020.

The disease is caused by the bacillus Mycobacterium tuberculosis, which is spread when people who are sick with TB expel the bacteria into the air by coughing.

The disease typically affects the lungs (pulmonary TB) but can also affect other parts of the body (extrapulmonary TB).

WHO estimates that about a quarter of the world’s population is infected with TB, with prevalence in Kenya at 140,000 infections as per the 2020 Ministry of Health report.

According to the head of the Division of National TB Leprosy and Lung Disease Program (DNTLD-P) in Kenya, Dr. Waqo Ejersa, TB can affect anyone anywhere, but most people who develop the disease are adults, with more prevalence in men than women.

“There are more cases among men than women, and 30 high TB burden countries account for almost 90% of those who fall sick with TB each year.”

He adds “TB is a disease of poverty, and economic distress. Vulnerability, marginalization, stigma and discrimination are often faced by people affected by TB.”

It is estimated that 33000 lives were lost in 2020 alone out of the disease in Kenya. The country also recorded 961 Drug-Resistant cases.

However, TB is curable and preventable. About 85% of people who develop TB disease can be successfully treated with a 6-month drug regimen; treatment has the additional benefit of curtailing onward transmission of infection. Since 2000, TB treatment has averted more than 60 million deaths, although with access still falling short of universal health coverage (UHC), many millions have also missed out on diagnosis and care. Preventive treatment is available for people with TB infection. The number of people developing infection and disease (and thus the number of deaths) can also be reduced through multisectoral action to address TB determinants such as poverty, undernutrition, HIV infection, smoking, and diabetes.

Meanwhile, myriad challenges continue to push back the efforts made in curbing the disease. Among them is the current Covid 19 pandemic. Waqo explained that, “Negative impacts on essential TB services include the reallocation of human, financial and other resources from TB to the COVID-19 response.”

He adds, “We’ve put guidelines to make sure the gains don’t drain away amidst the pandemic. On the flip side, it had a lot of positive impact on other health programs including TB. We can proudly say that we have better equipped health facilities than before the pandemic which is a gain for the sector.”

Efforts to curb the disease prevalence have been put into place. They include incorporation of programs and collaborated efforts through partnerships, technical assistance with a global perspective, capacity building and financing.

Centre for Health Solutions -Kenya (CHS) is one such partner who has been supporting Kenya’s DNTLD-P in reducing the occurrence and number of deaths due to Tuberculosis (TB) through Tuberculosis Accelerated Response and Care II (TB ARC II) activity with funding from United States Agency for International Development (USAID) Kenya.

USAID TB ARC II activity in collaboration with DNTLD-P is improving TB case finding through active case finding initiatives in all counties; promoting access to high-quality patient-centered services for TB, drug-resistant TB, and TB/HIV; preventing TB transmission and disease progression; strengthening TB service delivery platforms; accelerating research and innovation.  The goal is to decrease the incidence of TB and TB-related morbidity and mortality in line with the 90-95-0 targets to end the TB epidemic.

“These partnerships are crucial in enhancing the fight against TB. We thank our partners especially for helping us in capacity building, funding, and the technical assistance which have seen numerous gains attained.” Concludes Waqo.

Written by Gerard Nyele.