How better diagnosis helped Kwale boy beat TB

In 2019, Roselyn Akoth relocated her son from Ahero in Kisumu to Kwale, where she lived after separating from her husband.

As the boy struggled to settle in the new environment, he developed a strange disease, prompting them to visit more than 10 hospitals in search of a cure.

Eventually, he had to drop out of school due to the strange illness that had weakened him.

The mother of three resolved to take her son to a public hospital in Tiwi. He was diagnosed with tuberculosis and immediately put on treatment.

“His health status improved, but six months later, he relapsed. We went for another test that confirmed he still had TB,” Ms Akoth said, adding that the boy was bedridden for two years.

When his health deteriorated, Ms Akoth would rush to different hospitals, where she claimed he was rejected after medics realised his TB strain was highly infectious and could spread.

He had also developed a lump in his neck.

“He was very thin and his bones were protruding. He wasn’t eating, whatever he swallowed, he vomited,” said Ms Akoth, who sells omena for a living.

She had to close her business to take care of her son, who by then was getting frequent seizures.

But at the onset of the Covid-19 pandemic in 2020, he met Samuel Gichui, a clinical officer at Diani Health Centre, who offered to treat him at home. The medic tested the boy again and the results showed he had drug-resistant TB.

“Mr Gichui realised one of the prescribed drugs had severe side effects, causing anaemia, and immediately stopped him from taking it. He referred my son to Msambweni Hospital, where he was admitted for a blood transfusion,” she said.

When the boy’s condition improved, he was enrolled in Standard Four.

“He had to go back from Standard Six to Four because he had not attended school for some time,” she said. 

“He wanted to drop out of school because he thought he was too old to be in Standard Four, but I managed to convince him to stick it out. Due to stigma, I couldn’t take him to a public school, but I am struggling with his fees in private school.” 

Mr Gichui, who is the area’s leprosy and TB coordinator, said treating drug-resistant TB is costly, running up to Sh1 million for one case.

Some of the drugs also have negative effects on patients, as was the case with Ms Akoth’s son.

“It also takes a longer duration to treat, so you need to counsel the patient to adhere to medication,” he said. 

“The patient was very ill when I started treating him. At 17 years, he was 17kg. At some point, we were forced to transfuse after the blood level went to four pints, forcing us to drop some of the drugs that were leading to that.”

Mr Gichui has been managing 70 cases since last year.

In Kwale, TB is prevalent among the elderly, especially men.

In 2020, Kenya recorded 72,943 TB cases, of which eight percent (5,663) were children, according to the Ministry of Health.

The 2016 prevalence survey showed that the country nearly missed 40 percent of the estimated cases, said Dr Patrick Amoth, the acting director-general for Health.

Most health interventions for TB control, he said, have largely been concentrated in public facilities.

The Covid-19 pandemic threatened years of progress in TB control, he said.

“The disruption in the healthcare system caused by the pandemic resulted in a reduction in the number of TB patients diagnosed and a rise in those interrupting treatment,” he said. 

“Similarities between TB and Covid-19 present an opportunity to control these diseases effectively without significant additional stress on the country’s health system.”

Godana Mamo, Coast regional officer with the Centre for Health Solutions, which supports TB control activities, decried the lack of enough modern equipment to test for the disease.

Mr Mamo, a clinical officer, urged counties to increase lab diagnosis and treatment, particularly in paediatrics, to improve the management of drug-susceptible and drug-resistant TB.

TB remains a global and national public health concern. Globally, 104 million people are infected and 1.5 million die each year.

With nearly 2.5 million suffering from the disease and more than 660,000 dying in 2019 in sub-Saharan Africa, Kenya, in its national strategic plan to curb the disease, wants to cure at least 597,000 cases by 2023.

Kenya is already making great strides. Between 2015 and 2019, it reduced TB deaths by over 30 per cent and new cases by 20 per cent.

[email protected]