Columns And Opinions
With all hands on deck, the world can boldly step into a new TB-free dawn
Children are taught about tuberculosis symptoms such as coughing (sometimes bloody), weight loss, night sweats, fatigue and fever in school.
Most people are, however, unaware that tuberculosis bacteria can live in the body without causing any symptoms. This is referred to as latent tuberculosis. On the surface, it may appear positive that a disease-causing pathogen can live without causing illness or spreading.
However, latent TB lies in waiting for something like another infection to reduce the host’s immunity, and then it flares up into TB disease.
This is most common in people living with HIV, where TB causes additional damage to the lungs as soon as the HIV virus begins to overwhelm the body’s natural disease-fighting mechanism. If left untreated, TB can spread to the brain, kidneys and even the spine, eventually leading to death. The World Health Organization (WHO) states that TB kills more people than HIV/AIDS.
Additionally, WHO informs us that 10.6 million people became ill with tuberculosis in 2021. A total of 1.2 million of these new TB infections were in children. In the same year, TB caused 1.6 million deaths.
The Stop TB Partnership, an initiative by the United Nations Office for Project Services (UNOPS), estimates that in 2020, 139,000 Kenyans developed TB and 17,000 of them were children.
However, due to undiagnosed latent cases, the number of Kenyans living with TB is likely to be higher. The Ministry of Health estimates that 40 per cent of cases go undetected.
Children are particularly vulnerable to TB due to a number of factors. The first is that the disease is difficult to detect in infants and young children. Children can become infected and sick with TB due to a small number of bacteria in their bodies that are difficult to detect.
Secondly, due to immature immunity, children easily get overwhelmed by TB.
Furthermore, children are 10 times more likely than adults to develop multi-drug-resistant TB. The toxic nature of the drugs used to treat the drug-resistant form of paediatric TB makes treatment particularly difficult. To make matters worse, the WHO designated Kenya as a high-burden multi-drug resistant country.
The danger of TB to both adults and children is obvious, and several initiatives have been launched to address its prevalence. In Kenya, the government has removed barriers to TB diagnosis and treatment by making it available for free in public health facilities.
The importance of a multi-stakeholder approach has never been more apparent. The Ministry of Health issued revised policy documents for dealing with TB last year, emphasizing the fact that 48 per cent of patients seek TB treatment at private health facilities.
As their first point of contact, 42 per cent of patients visit private facilities.
TB prevention and treatment do not begin in hospitals, but with the patients in the community. The number of TB cases that go undiagnosed and untreated must be reduced in order to reduce the number of new infections.
What is often dismissed as “just one of those coughs” can be TB. If the public is unaware of the disease, they are unlikely to seek treatment until serious harm has been done to their bodies. It is, therefore, important for all people to be alive to the possibility that they may have TB and go for testing.
Likewise, healthcare workers need to be more sensitive to the likelihood of TB in the patients they encounter normally for various services.
Every year on the anniversary of its discovery, the world celebrates World Tuberculosis Day to commemorate all the pain and suffering caused by the disease since Dr Robert Koch announced its discovery on March 24, 1882.
This year’s theme, Yes! We Can End TB! aims to inspire hope, raise awareness to a high level and encourage additional investment in the implementation of WHO recommendations and other methods of combating TB.
Globally, there is an ambitious, but attainable, goal of reducing TB deaths by 90 per cent by 2030. Without a doubt, if we are to enter a new decade free of TB, there is a lot of ground to cover between now and then, and not nearly as much time as we think.
Dr Mbuthia is a Consultant Paediatrician/Infectious diseases specialist at Gertrude’s Children’s Hospital.
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