At least 40,000 Kenyans may be walking around with undiagnosed tuberculosis, a public health concern because the disease can spread when a person carrying the bacteria sneezes or coughs.
An analysis by the Ministry of Health suggests that although Kenya has made progress in diagnosis, thousands of people with active TB are never diagnosed, never treated and many die without proper treatment.
Medical Services PS Mary Muthoni said the ministry estimates that in 2022, at least 42,000 Kenyans with active TB were never diagnosed nor treated.
“In 2022, Kenya recorded a staggering 90,841 TB cases, a significant increase from the 77,854 cases reported in 2021,” Muthoni said at the launch of the TB Strategic Plan 2024-2028 in Nairobi.
“Alarming as this figure is, it represents only 68 per cent of the estimated 133,000 TB cases that were likely to emerge that year, leaving 32 per cent undiagnosed and untreated.”
When a person develops active TB, the symptoms such as cough, fever, night sweats, weight loss may be mild for months. This can lead to delays in seeking care, and result in transmission of the bacteria to others.
People ill with TB can infect from 10 to 15 others through close contact in one year.
Without proper treatment, up to two thirds of the sick people will die, according to the World Health Organization.
“The emergence of drug-resistant TB cases, totalling 756 in the same period, highlights the urgent need for a comprehensive and coordinated response,” Muthoni said.
The new strategic plan will be used to raise more money to fight tuberculosis in Kenya.
“It's important to acknowledge the financial constraints we face, especially with shrinking external funding. The strategic plan, therefore, becomes a vital advocacy tool for resource mobilisation across all sectors, including the private sector,” she said.
Dr Abdourahmane Diallo, the WHO country representative, said Kenya has made progress towards ending TB, even though it is among the seven high TB burden countries globally that exceeded the End TB Strategy milestone for TB incidence and mortality.
“A 38 per cent reduction in TB incidence against a target of 20 per cent, and a 54 per cent reduction in the number of TB deaths against a target of 35 per cent compared to 2015 was reported [in Kenya] in 2022,” he said.
The ministry also launched the Paediatric Algorithm and Short-term Regimen and TB Laboratory Operational plan and Quality management framework.
“The adoption of the simplified diagnostic algorithm will ensure diagnosing TB in children is made easier, contributing to increased, early and more accurate detection,” Diallo said.
Usaid Health, Population and Nutrition director John Kuehnle, said Kenya is well aligned with the global goal of eliminating TB by 2030.
He urged Kenya to embrace new tools and strategies, such as the digital chest x-ray fitted with artificial intelligence for TB screening, and more sensitive point of care WHO recommended rapid molecular diagnostic tests like truenat.
Other tools include the next generation whole genome sequencing for better prevention and treatment, shorter treatment regimen and digital adherence technologies to improve adherence for good treatment outcomes.
“Beyond that, we must also leverage available expertise, and use data to guide our programmes,” he said.
In March last year, a WHO analysis showed Kenya has reduced by 35 per cent of people dying from TB, compared to the deaths recorded in 2015.
The country also reached the target of reducing by 20 per cent new tuberculosis cases compared to those in 2015.
The targets are part of the World Health Organization’s End TB Strategy, which aims to end the disease by 2030.
The country is among the only seven countries in Africa that made that progress. The others are Eswatini, Mozambique, South Sudan, Togo, Uganda and Zambia.
“The question is no longer about whether we can end TB, but how fast we must act to reduce the disease burden, save lives and maintain a high momentum towards a TB-free world,” WHO regional director for Africa Dr Matshidiso Moeti said.
Still, awareness about the disease remains low with the government now being challenged to invest in TB awareness, especially at community level to make as one of the preventive measures.
“Prevention means that we have created awareness among the population, we have told them what they need to do about prevention so that we can reduce new infections,” National Coordinator of Stop TB Partnership Kenya, Everlyn Kibuchi, said.