Javan Okoth* was suspended from a school in Kabondo, Homa Bay County last year, soon after being diagnosed with tuberculosis.
The principal argued that he would expose other students to the infectious airborne disease, and therefore sent him home and asked him to return only after duly completing treatment.
Javan who was due to sit KCSE that year, was reluctant to go home; he worried that his absence from school would affect his performance.
It took threats of stern action against the school for Javan to be re-admitted after a week at home. The 18-year-old teenager suspects he might have contracted the respiratory disease at a video hall where he used to watch football and movies frequently.
Such “halls” are actually tiny, overcrowded rooms with little or no ventilation, one of the leading factors that make a healthy person vulnerable to contracting TB. The airborne disease spreads from an infected person when he or she coughs or sneezes, releasing germs into the air.
“The germs may remain suspended in the air for long – especially where there are restrictions in air flow. This explains why proper ventilation is a preventive measure for TB, and overcrowding and poor housing are risk factors for the spread of the disease,” says Dr Samuel Masini, the assistant director of public health.
Many Kenyans are therefore at risk of contracting TB merely by sharing a poorly-ventilated environment with an infected person who is not yet on treatment.
Tuberculosis remains the one of the world’s most deadly infectious diseases, second only to HIV/AIDS. It can be spread in churches or matatus, whose windows are often shut, especially in the mornings and evenings during rush hour, when most passengers complain about chilly weather if the windows are opened.
“A person without the disease will inhale the germs which then get lodged in the lungs. Most of the time such germs will be kept in check by the body’s immunity and cause no disease. It is a condition known as latent TB or TB infection,” Dr Masini explains.
However, if immunity is lowered, as is the case with HIV, diabetes and malnourished patients, the germs multiply and become full-blown tuberculosis. Nevertheless, TB patients should not be quarantined unless they are also suffering from other serious infections or if they refuse to take medicine. This is because TB drugs work quickly to render the patient non-infections within 72 hours after the patient is put on medication.
Globally, over two billion people carry the bacterium that causes TB, with approximately 15 million people suffering from an active infection at any given time.
A 2016 Kenya TB prevalence survey indicated that tuberculosis cases have risen from 266 per 100,000 people in 2015, to 558 per 100,000 people in 2016. This comes to about 138,105 new cases annually, making Kenya among the 14 countries that have the highest burden of TB in the world.
The biggest challenge in bringing the number down, is that diagnosis is often delayed, and most patients do not adhere to treatment and complete the full dose. This leads to multi-drug resistant TB.