Kenya: Curbing the spread of TB in infected households
Elsie, Bernard and their five children share a tiny tin-walled single room in Nyalenda, an informal settlement in Kisumu, in Kenya's Nyanza Province. They are both infected with HIV and TB.
Infection control at home
"We can't infect them [children] with HIV that easily unless
something bad happens, but we know if we don't take care, we
could give all of them TB," Elsie, told IRIN/PlusNews.
Studies
show
that children are likely to acquire TB infection from adults
living in the household as well as those having a relationship
with them or the family but living away.
Good hygiene practices are an important component of TB
infection control and prevention, but maintaining them is not
easy in an informal settlement, where houses are crammed
together and sanitation facilities hard to come by.
Regular hand-washing, good ventilation, and coughing and
sneezing away from other people are all useful tools in TB
prevention. Through a community-based organization, Hygiene at
Home, Elsie and her family have been receiving lessons on how to
have good hygiene in their household.
"When the house is this small, even if you sneeze or cough away
from the rest, that ‘far away’ is still close - you
can't help it. We have no proper toilets, and water is scarce
and you can't use the little available to wash your hands all
the time," Elsie said.
"Now I make sure I have some water in my house just for
hand-washing, and I have a tin where my husband and I can spit
sputum and close it again tightly... the children are a little
safer," she said.
Peninah Sewe, the coordinator of the Hygiene at Home initiative,
told IRIN/PlusNews that if TB infections in informal settlements
were to be contained, proper hygiene was vital.
"Hygiene in health facilities is emphasized, but little is done
to promote hygiene amongst TB-infected households, which is
important. People living in poor conditions must be helped to
keep good hygiene within their homes," she said. "Providing
people with handkerchiefs, giving them antiseptics or soap to
take home might appear small-time gestures, but are very
important in keeping infections under control."
Through a network of volunteers, Hygiene at Home contacts
households in informal settlements in Kisumu and educates them
about how to prevent the infection from spreading.
"We teach them how to sneeze and cough in a way that protects
the person closest to them. We also teach them how to use small
amounts of water to ensure good hand hygiene," Sewe told
IRIN/PlusNews.
Kenya is ranked at 13 on a list of 22 countries with the highest
TB burdens in the world, and has the fifth highest burden in
Africa.
Senior government officials say they recognize the need to
improve prevention methods in tandem with treatment programmes.
"As we step up treatment programmes, we might hit a brick wall
when we don't promote measures that help in curtailing new
infections or re-infections, because… our treatment
programmes are strained," Joseph Sitenei, director of the
National Leprosy and TB Control Programme, told IRIN/PlusNews.
Door-to-door initiatives could have more impact than big
campaigns. "There are campaigns on prevention covering even
issues like hygiene, but many people cannot conceptualize
them,” Victor Amata, a clinical officer, told
IRN/PlusNews. “With face-to-face initiatives, where
households are visited, it easy for them to understand."
PlusNews
http://www.irinnews.org/Report/95523/KENYA-Curbing-the-spread-of-TB-in-infected-households
