Failure to complete treatment slowing down war on Tuberculosis

Tuberculosis treatment should be improved if Kenya hopes to achieve a Millennium Development Goal target that calls for halting and reversing the prevalence of the disease by 2015.

Kenya holds the unenviable 13th position out of 22 countries with a high Tuberculosis burden globally, with the disease taking its greatest toll among the most productive age group of 15 to 44.

The recently launched Service Provision Assessment calls for an expansion of the services in government hospitals in order to curb the spread of the deadly disease.

“Facilities of faith-based organisations are more likely to provide TB diagnostic services 46 per cent, than government facilities, 38 per cent and NGOs, 34 per cent,” the report states.

Most hospitals, 91 per cent, were reported to offer TB diagnostic services compared to health centres that stood at 74 per cent.

Health facilities in Western and Nyanza provinces are most likely to offer TB services.

Dr James Aluoch, a chest specialist at The Nairobi Hospital identified three problems hindering the prevention, treatment and management of TB in Kenya.

“Administration of improper treatment regimens by healthcare workers and failure to ensure patients complete the whole course of treatment are major obstacles,” he told Nation in an earlier interview.

Treatment poses major challenges, particularly with the development of drug-resistant strains of TB. The government spends less on a patient treating ordinary TB than treating drug-resistant strains.

According to the KSPA findings, about three of every 10 facilities in the country offer TB diagnostic services.

“At the provincial level, facilities in North Eastern, 20 per cent, and Eastern province, 23 per cent, and Rift Valley, 25 per cent, are less likely to offer TB diagnostic services than facilities in other provinces.

TB being a common opportunistic infection in persons living with HIV, the report further recommends that newly diagnosed TB patients be screened for HIV and vice versa.

The World Health Organisation estimates that HIV prevalence among TB patients has been as high as 90 per cent of Sub-Saharan Africa, including Kenya, and wants the integration of testing services of the two.
Among the facilities offering any TB services, 82 per cent of those sampled report referring all TB cases for HIV testing, while another three per cent refer only those suspected to be HIV-positive. WHO describes the HIV-TB link as a “lethal combination”.

So contagious is TB that if left untreated, each person with active TB disease will infect, on average, 15 people every year. Kenya marked World TB Day two months ago.