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Confronting the silent killer
Samuel Otieno and Edith Fortunate tell of the TB strain that is resistant to drugs, and renewed prevention and treatment efforts.
Samuel Otieno and Edith Fortunate tell of the TB strain that is resistant to drugs, and renewed prevention and treatment efforts.
July 30, 2007
East African Standard
More than 200 people infected with highly contagious multi-drug resistant tuberculosis (MDR-TB) are living amongst us.
The fact that the public and the victims are unaware of the looming danger of spiraling infection is sending shivers among experts.
To assuage the situation, the Government has identified 40 of these victims, who will undergo treatment at the Kenyatta National Hospital. Doctors at the largest referral hospital in East and Central Africa will from next month start administering the treatment, the first of its kind in the country.
Already, the Global Fund has provided Sh52 million towards the exercise. It is estimated that each patient will require Sh1.3 million for the two-year treatment.
Kenya ranks 10th among nations most affected by TB worldwide, with about 70 people succumbing to the disease daily. Statistics further paint a bleak picture.
Experts say hundreds of many more Kenyans infected with the disease are roaming freely, infecting others.
A person can live with latent TB for years
One in three people in the world has latent TB, while in countries with high HIV prevalence, more than 50 per cent of the population has this condition.
"In such countries, the likelihood to get active TB increases because the immune system cannot suppress the disease efficiently," Dr Joseph Sitienei of the TB programme at KNH told The Big Issue.
A person can live with latent TB for years, but if the immune system is weakened, the infection will quickly turn active, doctors say.
In 2005, the Government recorded an increase of 7,234 TB cases from 108,000. Sitienei said 52 per cent of 115,234 TB cases are HIV-related, while 11 per cent are children.
Ms Ida Jooste, Internews resident adviser, says Nairobi, Coast and Kisumu are the MDR-TB hot spots.
Among the symptoms displayed by a sufferer of active TB are fever, night sweats, weight loss and a chronic cough.
Sitienei says the disease can be confirmed through X-Rays and laboratory tests, but adds: "Some cases can be difficult to diagnose and confirm."
But with the model MDR-TB treatment set to start in a week’s time, hope for hundreds of TB patients would be rejuvenated.
Region is not yet prepared to deal with XDR-TB
At KNH, medical workers have been taken through training in handling MDR-TB, including detection, isolation and treatment.
Isolation has especially been emphasised, and patients would be placed in separate rooms to eliminate infection.
The Government requires that those labeled TB victims come to health facilities accompanied by close relatives, who would keep track of the treatment record.
But in this ray of hope lies a dark stripe. Early this year, an international medical organisation, Medecins Sans Frontieres, released a report showing that treatment will succeed in barely more than half of the MDR-TB patients.
It said most of them would develop extensive drug resistant (XDR) TB regardless of the quality of care, as insufficient research and development on new drugs and diagnostics has left health staff without the right tools to treat the disease.
When resistance of major TB drugs emerges, doctors are forced to use the older, less effective medicines.
Local medical experts warn that the region is not yet prepared to deal with XDR-TB, which has claimed more than 100 lives in South Africa.
The disease kills more than 95 per cent of its victims, even under the most advanced medical care, experts say.
Major outbreaks would overwhelm resources in poor countries
It is these complications that require proactive measures to spread MDR-TB, which was first detected in Kenya in the late 1990s. According to scientists, major outbreaks of the two TB strains would overwhelm resources in poor countries.
The main cause of resistant TB has been associated with HIV, poverty, poor drug management, overcrowding and inadequate medical infrastructure.
But this could be limited by ensuring that national TB programmes are effective and health-care workers efficient. Drug interaction and the potential for many side effects are frustrating the treatment of MDR-TB and HIV simultaneously.
MSF notes that with the available tools, a losing battle is being fought. Current research efforts are not keeping pace with the need for better tests, drugs and vaccines despite the urgency of the situation.
But still, the Government is not giving in. It has established a system for monitoring and evaluation of MDR-TB patients to ensure a high cure rate.
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