Lack of TB ward a disaster in the making

February 24, 2012 2:31 pm
Senior TB Advocacy Manager Evaline Kibuchi/MUTHONI NJUKI

, NAIROBI, Kenya, Feb 23 – The government has been urged to fast-track the construction of an isolation ward for TB patients in Kenya.

The AIDS NGO Consortium (KANCO) through its Senior TB Advocacy Manager Evaline Kibuchi told Capital News that despite Sh40 million having been set aside in 2005 to put up a ward at Kenyatta National Hospital (KNH), the isolation ward had not yet been completed seven years down the line.

“The construction began in 2008, but even with all that, the ward is not complete. I feel it is not acceptable. How can you continue putting up a ward for seven years? This money was put to reduce new infections and it is not really giving us this value,” she decried.

Kibuchi expressed fears that the number of new TB infections will continue to increase for as long as those infected mix in public transport, at the hospitals and any other common places due to lack of an isolation programme.

She pointed out that TB patients commute on a daily basis to health centres for medication especially for the injections that are part of the long treatment that take months to cure TB.

Kibuchi further asked the government to allocate a budget for treating Multi Drug Resistant TB (MDR TB) in the country instead of relying wholly on the Global Fund.

“The government has done something on TB, but treatment has been availed through Global Fund especially for MDR TB. There has been dwindling interest in donors support to health programmes in developing countries,” she said. “If the government does not take up the responsibility of managing MDR TB we are likely to be in a situation where we don’t have drugs to put these people on, meaning there will be new infections.”

Unfortunately, Kenya which is ranked number 13 out of the 22 countries classified to bear 80 percent of the TB global burden is now grappling with two strains of TB which are quite expensive to treat.

Kenya has handled 600 cases of Multi Drug Resistant TB (MDR TB) and three cases of Extreme Drug Resistant TB (XDR TB) which saw two of the patients die while the other fully recovered.

According to Kibuchi the two strains commonly occur after a patient develops resistance to TB treatment.

This requires that the patient gets a different combination of drugs to treat the MDR TB, which if the patient again develops resistance to, becomes XDR which requires yet another combination of treatment, different from the first line and second line treatment.

Patients with TB for the first time require treatment for six months.

Patients with MDR require two years of treatment where they take medication on a daily basis for 24 months. Kibuchi said the treatment for one patient with MDR TB costs Sh1.5 million.

This cost excludes transport to the hospital, treatment of side effects and other expenses involved during the lengthy treatment.

A patient with XDR TB is put on treatment for three years at a cost of Sh3.3 million.

Kibuchi explained that the challenge is that a patient with XDR or MDR will infect people with the strain they have.

She regretted that despite the emerging challenges of dealing with drug resistant TB, the government was yet to complete the isolation ward meanwhile, TB infection rates in the country continued to rise.

“There is this patient suffering from MDR TB living with his relatives in the same house, sometimes poorly ventilated. We have the patients commuting every day in congested poorly ventilated matatus, most likely they do not wear masks as recommended, the person is posing a risk to unsuspecting Kenyans,” she asserted.

Kibuchi however raised concerns over the stigma against people wearing masks in Kenya explaining it was one of the major reasons why people with TB avoided the masks intended to protect other people.

“They feel stigmatised, so they avoid wearing the masks, this is simply because of lack of knowledge. If every Kenyan knew that the reason why this person is wearing a mask is to protect me and you, then you would appreciate when you see someone wearing a mask. In fact you tell them thank you for taking care of my health.”

Resistance to TB treatment is commonly caused by lack of adherence to treatment or infection from one person to another.

TB which is airborne is quite infectious especially among people with compromised immunity systems making it riskier for HIV positive people, people with cancer, diabetes and people with poor nutrition according to Kibuchi who was concerned that many Kenyans do not seek medical attention even after experiencing symptoms like continued coughs, sweats in the night and serious loss of weight which are associated with TB.

“They only rush to chemists and shops to buy pain killers, which only suppress the pain leaving the disease there. As a result many patients present TB cases at late stages. Other people even die without knowing if its TB that has killed them,” she warned as she urged Kenyans to also protect themselves by ensuring they live in well ventilated houses and that they travel in well aerated public transport.


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