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TB CONTROL IN KENYA
Tuberculosis remains a major cause of morbidity and mortality in Kenya. It affects all age groups, but has its greatest toll in the most productive age group of 15 to 44 years. The major factor responsible for the large TB disease burden in Kenya is the concurrent HIV epidemic. Other factors that have contributed to this large TB disease burden include poverty and social deprivation that has led to a mushrooming of peri-urban slums, congestion in prisons and limited access to general health care services. In the last decade TB case notification had been increasing at an average of16% annually, however, there has been a decline in TB cases from 2005 following a decline in TB/HIV cases that began in 2004.
In order to address the new challenges posed by the tuberculosis epidemic in the face of the HIV epidemic and the socio-economic environment, the ministry of health through NLTD-P has identified the following areas for increased support: Strengthening of the human resource capacity at all levels for effective coordination of TB control activities, decentralization of TB control services down to the community level to increase access to these services, a stronger collaboration between TB and HIV control programs in order to promote delivery of integrated TB/HIV services, private public partnerships to increase the number of private providers integrated into the TB service provider network and a sustained public education campaign coupled with health care worker training and support to promote early care seeking and adherence to treatment at community level and better TB case management by health care providers. In the last few years great strides have been made in all these areas thanks to the many stakeholders dedicated to making a difference.
The NTLD-P is implementing initiatives towards achieving internationally agreed TB control targets. The immediate short-term goal is to achieve the 70/85 targets – that is to detect 70 % of infectious TB and cure 85% of the detected cases and then sustain this effort over a long time. The TB MDG to have halted and begin to reverse the incidence and mortality due to TB by 2015 has been met and the NTLD-P has begun to implement the post 2015 Global TB
Strategy that consists of 3 major areas as follows:
- INTEGRATED, PATIENT-CENTRED CARE AND PREVENTION
- Early diagnosis of tuberculosis including universal drug-susceptibility testing, and systematic screening of contacts and high-risk groups
- Treatment of all people with tuberculosis including drug-resistant tuberculosis, and patient support
- Collaborative tuberculosis/HIV activities, and management of co-morbidities
- Preventive treatment of persons at high risk, and vaccination against tuberculosis
- BOLD POLICIES AND SUPPORTIVE SYSTEMS
- Political commitment with adequate resources for tuberculosis care and prevention
- Engagement of communities, civil society organizations, and public and private care providers
- Universal health coverage policy, and regulatory frameworks for case notification, vital registration, quality and rational use of medicines, and infection control
- Social protection, poverty alleviation and actions on other determinants of tuberculosis
- INTENSIFIED RESEARCH AND INNOVATION
- Discovery, development and rapid uptake of new tools, interventions and strategies
- Research to optimize implementation and impact, and promote innovations
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