Tuberculosis: Kenya’s Persistent Health Challenge

Tuberculosis (TB) continues to be a leading health threat in Kenya, reflecting a global epidemic with significant local implications. According to the World Health Organization (WHO), lower respiratory diseases, including TB, rank as the fourth leading cause of death worldwide. In Kenya, the 2024 Economic Survey highlights TB as the foremost cause of mortality, overshadowing other diseases in its impact. With approximately 130,000 new TB cases reported annually, the disease’s grip on the nation remains firm, particularly alarming given that around 50,000 of these cases are also HIV-positive, which exacerbates the severity and fatality of TB.

Dr. Andrew Owuor, a specialist pulmonologist, explains that TB is caused by the bacterium Mycobacterium tuberculosis. This bacterium predominantly affects the lungs but can also impact nearly any part of the body except the nails, hair, and teeth. TB is categorized into two primary forms: Pulmonary TB, which affects the lungs, and Extra-pulmonary TB, which affects other parts of the body.

Pulmonary TB, constituting about 90% of all TB cases, is highly contagious. It spreads through airborne droplets when an infected person coughs or sneezes. This form of TB presents symptoms such as a persistent cough, chest pain, and coughing up blood. The widespread nature of Pulmonary TB highlights its severe impact on public health, particularly in regions with high transmission rates.

In contrast, Extra-pulmonary TB, though less common, requires urgent attention due to its diverse manifestations and severe symptoms. This form includes TB Meningitis, which affects the brain and spinal cord; Skeletal TB, targeting bones and joints; Genitourinary TB, impacting the kidneys, bladder, and reproductive organs; Gastrointestinal TB, affecting the digestive system; Cutaneous TB, manifesting on the skin; and Ocular TB, which can lead to vision problems by affecting the eyes.

Symptoms of TB vary depending on its type. For Pulmonary TB, common indicators include a persistent cough, fever, chest pains, weakness, night sweats, and weight loss. A chronic cough with sputum production is particularly characteristic of Pulmonary TB. On the other hand, Extra-pulmonary TB symptoms can be more complex, varying based on the affected organ system.

Diagnosis of TB involves a series of tests to confirm the presence of the disease. The process often begins with sputum analysis, where the patient’s sputum is examined under a microscope or through advanced tests like the GeneXpert test. Imaging tests such as chest X-rays can suggest the presence of TB, but definitive confirmation requires microbiological evidence to ensure accurate diagnosis and appropriate treatment.

Preventing TB involves a combination of strategies. Vaccination plays a crucial role, with children in Kenya receiving the BCG vaccine at birth to prevent severe forms of TB. Besides vaccination, additional preventive measures include wearing masks, ensuring well-ventilated living spaces, and maintaining a balanced diet to bolster the immune system and reduce the risk of TB.

Kenya’s battle against TB underscores the importance of continued vigilance and effective public health strategies. As the nation grapples with this persistent health threat, efforts to enhance awareness, improve diagnostic and treatment facilities, and promote preventive measures remain essential in reducing TB’s impact on the population.