The Kenyan government has deployed 6,000 volunteers to scout for possible tuberculosis patients across the country for free drugs therapy.
Prevalence of TB cases in Kenya has prompted the government and donors to turn to social model in a bid to win the war against the deadly diseases.
The model ensures that TB patients get the best social support available, which removes stigma that sent patients to an early grave.
The model will be replicated in other TB high-burden countries like Tanzania and Uganda. New cases of TB discovered in Kenya dropped from 116,000 in 2007 to 99,152 last year, in the wake of improved access to testing services offered for free by the government.
Dr Joseph Sitenei, the head of the Division of Leprosy, Tuberculosis and Lung Diseases at the Ministry of Health in Kenya said the innovative TB fighting model adopted by Kenya has enabled the country to move from position 13 to 15 of the league of 22 high-burden TB countries that account for 80 per cent of all TB cases in the world.
“Kenya is way ahead in fighting TB even compared with wealthier countries like South Africa. In five years, the country will get out of the league of 22 high burden nations,” he said.
The success is attributed to the unique model that has made TB infections to be a community issue rather than a personal problem.
The government is currently working with more than 6,000 volunteers spread across the country with their work cut out to monitor possible TB cases. The programme is to have one volunteer monitoring 20 households.
“When volunteers suspect a TB case, they approach the person and offer education on the next steps to be made, which is testing,” said Dr Sitenei.
After diagnosis, the patient is assigned to a community health worker or a volunteer to monitor the taking of drugs and response in a model known as Directly Observed Treatment.
This is what assisted Stephen Anguva, a resident of Kangemi, an urban settlement in Nairobi to recover.
His persistent cough in 2009 became worse and he started losing weight. His relatives attributed it to witchcraft and started administering herbal medicine, falling prey to the many unregulated herbalists operating mainly in the urban settlements.
But one day, a volunteer spotted him and advised that he goes for TB testing, which returned positive results. He was put on drugs therapy and recovered in two months, resuming his work as a water vendor as he continued with the treatment.
Mr Anguva was also educated about TB and how it is managed and has joined others in a welfare group known as “Pamoja TB Group,” composed of anti TB advocates.
To aid such advocates and TB spotting volunteers, the government has invested in Gene Xpert Machines to establish diagnosis centres in as many parts of the country as possible.
With the Gene Xpert technology is the fastest molecular analysis system.
The other advantage is that testing centres do not need rows of equipment and extensively trained staff to access molecular testing, an ideal future for Kenya where medical laboratory skills are in shortage.
TB testing centres have been increased from less than 1,000 a decade ago to the current 1,882 sites. According to Dr Sitenei, a new $13 million grant approved by the Global Fund in the past week will be used to increase the number of testing centres.
The money will also be used in a door to door anti-TB campaign in Kenya’s coastal city of Mombasa and its environs which has the highest number of TB cases per capita, partly blamed on high level of poverty.
The other target for enhanced anti-TB care will be prison facilities, which account for 1 per cent of all TB cases in the country, according to the Ministry of Health.
“We have to do this to ensure that we eradicate TB in Kenya by 2050,” said Dr Sitenei.
A mobile web-based application known as TIBU (Kiswahili for treat) is being used to improve the monitoring of TB patients on drugs and improve the mode of data collection future planning.
Dr Sarah Massaut, the Kenya Country Director of KNCV Tuberculosis Foundation, said Kenya has achieved 75 per cent of tuberculosis detection, the highest level of achievement in the continent. Also, 87 per cent of Kenyans with TB now access free medicine.
The success of Kenya’s treatment for TB has however come with consequences. TB patients from neighbouring countries where free treatment is not offered are streaming into the country, said Dr Sitenei.
This is forcing the government to spend money on non-Kenyans as those patients cannot be denied treatment just because they are not Kenyans.
But the worst development has been the fact that the TB refugees have a high incidence of Multidrug Resistant Tuberculosis (MDR TB).
While a normal case of TB costs $25 and six months to treat, that of drug resistance TB costs $6,000 and 2 years to treat – a difference of 2,400 per cent in the cost of treatment.
Dr Sitenei said majority of Kenya’s 600 cases of drug resistance TB are refugees. The number shot from 225 cases in 2012 because of the influx of non-Kenyan patients.
In the current financial year, Kenya government has allocated $3.5 million to provide free medicines for managing TB and a further $2.3 million for the purchase of microscopes to improve TB testing capacity.
Kenya government meets 70 per cent of the funding needs of TB patients with the rest of the money coming from development partners like the United States Agency for International Development (USAID), and Global Fund among others.
In total, Kenya requires $42 million dollars every year for proper management of TB issues.
Source: The East African