New efforts to end child tuberculosis in counties

In 2017, Kenya planned to find and treat about 22,000 children with tuberculosis, based on figures from the tuberculosis prevalence survey of 2015.

However, according to Stephen Muleshe, the head of tuberculosis care and treatment at the National Tuberculosis, Leprosy and Lung Disease Programme, only 7,714 such children were identified for treatment.

Most of the children (953 of them) were in Nairobi, followed by Turkana County with 433 children.

“Many of these children pass through the hands of healthcare workers without being diagnosed,” said Dr Muleshe.

Joy Lipesa, the nursing officer in charge of TB treatment at the Lodwar County Referral Hospital in Tur-kana, said that most of the children admitted for tuberculosis treatment come in too late, and more than half succumb to their illness.

Moreover, added Job Okemwa, the Turkana County TB and leprosy coordinator, one in four patients diagnosed with tuberculosis in the county this year were children. This is higher than the national prevalence estimate of between 10 to 15 per cent.

LAUNCH

The tuberculosis problem in children is compounded by the lack of child-friendly diagnostic tests and treatments. In Turkana, 17 per cent of diagnosed patients do not complete treatment.

A new project launched in Turkana and Homa Bay counties, seeks to end childhood illness and deaths from tuberculosis, by addressing the gaps in diagnosis and treatment.

Lelio Marmora, the executive director of Unitaid, which is funding the project, noted that to reach more children for urgent treatment, there is need for child-friendly and innovative models of care.

The four-year project implemented by the Elizabeth Glaser Paediatric Aids Foundation and the Ministry of Health, seeks to diagnose and treat at least 1,300 children with tuberculosis, and prevent more than another 5,500 children with latent tuberculosis from developing active tuberculosis.

The programme will be implemented in 30 facilities which serve the most patients, and scaled up to 50 facilities, before being implemented at the national and global scale.

Through the project, all people who come into contact with adults suffering from tuberculosis will be screened, and children will be screened during every hospital visit.

A network of radiologists will be established to read and interpret chest x-rays and the referral system linking the treatment sites will be strengthened.

“Now that diagnosis of tuberculosis has been made easier, we will go from house to house to ensure all children with the disease are identified and treated,” said Turkana Director of Medical Services Gilchrist Lokoel, adding that the recently enacted Community Health Strategy Act will strengthen community interventions, by including tuberculosis screening, tracing of the people who are in contact with tuberculosis patients and ensuring that patients complete treatment.