Double threat: TB and HIV Co-infections on the rise
The report indicates that 70 per cent of new pulmonary TB cases were tested for rifampicin resistance
What you need to know:
- Overall, the country’s TB incident cases (new and relapse) were at 88,895, a case detection rate of 74 per cent.
- However, data from the report shows that at least 26 per cent of cases go unreported.
A recent report from the Ministry of Health (MOH) has sounded the alarm over a rising tide of TB/HIV co-infections in the country. The national co-infection rate has increased to 25 from 23 per cent in 2022 according to the National Tuberculosis,Leprosy and Lung Disease programme.
Published earlier this week, the findings show that in 2023, counties in western Kenya, including Kisumu, Homabay, Siaya, and Busia had the highest co-infection rates with at least three counties exceeding 50 per cent.
Busia County accounted for 40 per cent co-infection rate. The Ministry has emphasised the need for intensified collaboration between healthcare providers to combat this growing issue. In contrast, counties like Baringo, Mandera, and Wajir reported significantly lower rates of 14 per cent, 3 per cent, and 1 per cent, respectively.
Despite significant progress in HIV treatment, with ART uptake reaching 98.2 per cent in 2023, concerns remain about TB case detection and treatment completion, particularly among high-risk groups.
Overall, the country’s TB incident cases (new and relapse) were at 88,895, a case detection rate of 74 per cent. However, data from the report shows that at least 26 per cent of cases go unreported.
Dr. Immaculate Kathure, head division of tuberculosis and other lung diseases at MOH reported that Kenya detected 97,126 TB cases in 2023, representing a 7.2 per cent increase from the previous year. This translates to a 78 per cent treatment coverage rate, with 8.5 per cent of cases being previously treated.
“While Kenya transitioned from the list of high-burden drug resistant tuberculosis (DRTB) countries, DRTB remains a threat that could undermine the gains so far realised, ”she said. She further explained that the age distribution of TB cases in Kenya indicate that children aged 0–14 years accounted for 12,884 cases (13.3 per cent) of the total notified cases.
“The 25-44 age group had the highest number of TB cases, accounting for 63 per cent of the total cases,” she said.
Dr Kathure explained that intensified efforts to find and treat TB patients led to a 7.2 per cent increase in treatment initiation compared to 2022. These efforts included active case finding, targeted outreach, and the use of AI-powered X-rays. As a result, 78 per cent of the estimated 124,000 people with TB in Kenya received treatment.
While 1,200 cases of drug-resistant TB were identified, 706 of these individuals were diagnosed and started on appropriate second line treatment. The report indicates that 70 per cent of new pulmonary TB cases were tested for rifampicin resistance.
Rifampicin is a powerful antibiotic commonly used in the treatment of tuberculosis. It is essential for treating drug-resistant TB, which is a strain of the bacteria that is resistant to standard TB medications. For previously treated TB patients, the testing rate was slightly higher at 73 per cent.
Additionally, surveillance for drug-resistant TB among all forms of previously treated TB patients increased from 57 per cent in 2022 to 60 per cent in 2023 and targeted high risks groups that include people living with HIV, all household contacts of people with pulmonary TB and other risk groups (health care workers, prisoners and clinical at-risk groups).
Last year, there were 113,355 contacts of bacteriologically confirmed pulmonary TB cases that were reported and were symptomatically screened for TB disease.
“This number is still sub optimal in terms of coverage which points to low screening and reporting rates among contacts, ”the findings highlight.
Dr Kathure further disclosed that in 2023, the percentage of drug-susceptible tuberculosis (DSTB) cases that were bacteriologically confirmed increased to 56,333, translating to 58 per cent, a 1 per cent rise from the cases in 2022.
“Nandi County achieved the highest percentage of bacteriologically confirmed DSTB cases at 83 per cent (895) followed by Marsabit and Mandera with 74 per cent (684) and 75 per cent (667) respectively. Other counties that showed improvement included Meru) , Garissa), Machakos), Uasin Gishu, Elgeyo Marakwet, and Pokot, all exceeding 70 per cent, ”she said.
Public Health and Professional Standards, PS Mary Muthoni said the health ministry had put in place strategies that will nip TB in the bud. “The strategies being implemented include improving access to drug susceptibility testing (DST) through timely availability of laboratory commodities and the use of stool GeneXpert Ultra for diagnosis of TB in children below 10 years. The government is also expanding the use of chest X-rays (CXR) for screening the contacts of DR-TB contacts, and strengthening healthcare workers capacity for early detection and effective management of DR-TB through ongoing training and support,” she told Healthy Nation.
