SEATTLE, Washington — Tuberculosis remains the fourth highest cause of death in Kenya. Approximately 560 per 100,000 people are affected by the disease. To reduce the impact of tuberculosis in Kenya, the Kenyan government and other organizations and programs are taking proactive and innovative measures to diagnose and treat Kenyans with tuberculosis. These include Kenya’s National Tuberculosis Leprosy Diseases Program, USAID and Malteser International
Challenges to Fighting Tuberculosis
Those with vulnerable immune systems are at the greatest risk of getting sick and/or dying from tuberculosis. This includes the very young and the very old as well as those infected with HIV. Poverty is also a significant factor because tuberculosis is common in crowded urban slums. Several challenges make tuberculosis testing and treatment difficult in Kenya where both tuberculosis and HIV are prevalent.
Tuberculosis is treatable with antibiotics although the treatment generally takes six to eight months. It is imperative that patients continue to take the antibiotics until they are no longer testing positive for tuberculosis. If the full course is not taken, the disease can become antibiotic-resistant. A multidrug-resistant strain of tuberculosis has posed a significant challenge in Kenya. Without adequate testing equipment, it can be difficult to tell the difference between strains. Patients sometimes suffer for months on treatment plans that end up being ineffective
Furthermore, many health facilities lack adequate testing equipment and the resources to initiate treatment for those suffering from tuberculosis. Additionally, the cost of health examinations, including X-rays and scans, can prevent patients from seeking diagnosis and treatment. In part, these problems stem from a significant lack of funding in Kenya for tuberculosis. The national relies heavily on external funding for HIV, tuberculosis and malaria, which can have negative impacts on the level of healthcare available to Kenyans.
To tackle some of these challenges, the government has renewed its commitment to fighting tuberculosis in Kenya. Dr. Cleopa Mailu, the Cabinet Secretary of Health stated that “the government was committed to making TB diagnostics accessible.” Specifically, the government will be working to ensure that Chest X-rays are able to be done for all patients suspected of having tuberculosis.
The Kenyan government is also committed to working within communities to increase awareness of tuberculosis symptoms. It encourages getting tested if citizens think they might have tuberculosis. The government wants to make GeneXpert, an diagnostic technology that diagnoses tuberculosis, more available since it is the most reliable testing method. These machines can help patients get effective treatment immediately.
Kenya’s National Tuberculosis Leprosy Diseases Program
Kenya’s National Tuberculosis Leprosy Diseases Program (NTLD-P) is run by the Ministry of Health. Established in 1980, the program works to combat lung disease, leprosy and tuberculosis in Kenya. NTLD-P has developed several strategies to diagnose and treat tuberculosis. Strategies include providing preventative treatments and vaccinations for those at high risk of tuberculosis as well as patient-centered care and support while diagnosing and treating tuberculosis.
There are policies being put into place to develop a universal health coverage policy that will reduce the costs of treatment. It will also work to increase the funding of tuberculosis research. The program is also working more broadly to develop policies designed to alleviate poverty as this will play a key role in reducing tuberculosis cases.
Since 2018, the United States government has supported NTLD-P through a program known as Tuberculosis Accelerated Response and Care II (TB ARC II). It has provided key funding for tuberculosis initiatives. The program will be active through 2023 with a budget of almost $35 million. Key achievements include providing technical support and assistance to tuberculosis treatment sites, helping transport samples from health facilities to the national tuberculosis reference lab and supporting clinical review team meetings to coordinate and improve health services.
Malteser International is working to fight HIV/AIDS and tuberculosis in Kenya, specifically through programming in the slums of Nairobi. The unhygienic and crowded conditions in the slums cause tuberculosis to spread quickly. The high rate of HIV in these areas also makes the population more vulnerable.
Malteser International has been working in Kenya since 2001 in a specific slum with approximately 800,000 inhabitants. Its approach includes providing and supporting health services while training medical staff and setting up laboratories for diagnosis. It has established a total of eight laboratories as well as voluntary counseling and testing rooms in the Nairobi slums. It is also working to ensure health facilities have the supplies necessary for diagnosis and treatment, in part, by ensuring facilities are connected to the Ministry of Health and can get drugs directly through them.
Additionally, Malteser International is working to educate the population. It has trained volunteers known as Community Health Workers to interact directly with the people to help get them to the health facilities for diagnosis and treatment when needed. Malteser International also provides personal care and advise relatives on how to care for those with tuberculosis or HIV/AIDS.
To continue the fight against tuberculosis in Kenya, it is crucial that initiatives from the government and organizations like USAID and Malteser International continue and expand. Ensuring everyone in Kenya has access to conveniently located facilities, high-quality equipment and well-trained medical professionals will require a lot of funding. But, this funding will go a long way in decreasing tuberculosis in the nation.
– Sara Olk