The rising threat of multidrug-resistant tuberculosis (MDR-TB) in Kenya has become a significant public health concern, with only a fraction of patients receiving adequate treatment. This leaves the majority at risk, contributing to the continued spread of the disease. Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, primarily affects the lungs but can also impact other organs such as the brain, spine, and kidneys. It spreads through the air when an infected person coughs, sneezes, or talks. Despite being curable with timely treatment, TB remains a substantial global health challenge.
Kenya is one of the 30 high-burden TB countries worldwide, underscoring the severity of the disease in the region. In 2023, the country reported 223 TB cases per 100,000 people, signaling an escalating crisis. The same year, TB claimed 32,000 lives in Kenya alone. Globally, TB continues to be a leading infectious killer, with 1.25 million deaths recorded in 2023, 161,000 of which involved individuals living with HIV, further complicating treatment and management efforts.
The standard TB treatment lasts six months, though the duration may vary based on the type of TB and the patient’s response to medication. However, treatment defaulting is a major challenge in Kenya. Stigma associated with TB remains one of the primary drivers of the rise in cases. This stigma often discourages patients from adhering to treatment plans or taking necessary precautions, which complicates efforts to control the disease. Many people associate TB with poor hygiene, poverty, or its contagious nature, leading to shame and reluctance to seek treatment.
As a result, some patients abandon their medication or fail to complete the full course, contributing to the development of drug resistance. When patients begin to feel better early in the treatment process, they may neglect basic precautions such as covering their mouths when coughing, maintaining hygiene, or adhering to dietary guidelines. Additionally, failure to strictly follow the prescribed medication regimen accelerates resistance. Some patients miss clinic visits, unknowingly developing resistance, and may discover they are still infected or have been reinfected after completing their medication.
The consequences of MDR-TB are profound. It results in higher mortality rates, longer and more expensive treatments, and places immense strain on the healthcare system. Social and economic impacts are also significant, as patients are often unable to work, leading to financial hardship. Furthermore, the healthcare system faces an overwhelming rise in cases, further straining resources.
One of the challenges in combating MDR-TB is antibiotic misuse. Incomplete treatment, misuse of antibiotics, and limited access to healthcare exacerbate the spread of the disease. Many patients, feeling better early in their treatment, discontinue medication, allowing the bacteria to develop resistance. Delayed diagnoses and overcrowded living conditions also contribute to the spread, preventing many from seeking necessary care.
TB patients are advised to adhere strictly to their treatment regimens, attend clinic visits, and maintain good hygiene to prevent further transmission. The World Health Organization highlights that TB can spread even when individuals do not feel sick, as only a small percentage of those infected will develop active TB disease and experience symptoms. Common signs include a persistent cough, chest pain, weakness, fatigue, weight loss, fever, and night sweats. Because the disease can develop slowly, it is often easy for individuals to unknowingly spread it to others.
Individuals at higher risk, such as those living with HIV or in close contact with TB patients, should get tested for TB. Practising good hygiene is essential, including wearing a mask, covering the mouth and nose when coughing or sneezing, and avoiding close contact with others. In healthcare settings, the use of respirators and proper ventilation is critical in reducing TB transmission.
Drug-resistant TB requires alternative treatments, as it does not respond to standard antibiotics. The Ministry of Health in Kenya has implemented strategies to address MDR-TB, such as improving early detection and diagnostic services, particularly in underserved areas. Educating patients about the importance of completing the full course of treatment and providing support to improve adherence is crucial in reducing the risk of resistance.
As multidrug-resistant tuberculosis continues to rise, concerted efforts are needed to combat its spread. By improving access to treatment, encouraging adherence, and addressing the stigma surrounding TB, Kenya can take vital steps toward reducing the impact of MDR-TB and ultimately controlling its spread.
