November 2018

Reprieve as efforts to end Childhood TB intensify in Kenya

Created by:

Eric Kilongi, Associate Director, Communications & Media (Africa)

Country:

Kenya

Topics:

CaP TB; Tuberculosis

When Josephine Akuom’s 15-month old baby was diagnosed with tuberculosis she felt helpless. Tuberculosis is an infectious disease that, according to a recent report on pediatric TB, kills nearly 250,000 of the one million children who contract it each year.

After three months of unsuccessful treatment, Josephine grew increasingly worried about her daughter’s health. She set off on a journey- traveling more than 200 kilometers from Loorea Matet village in Keiyo to seek help at the Turkana county referral hospital in Lodwar.

The cost of travel was expensive for Josephine, but she knew it was her only chance to save her baby.

The earlier children are diagnosed and treated, the better their chances are of being cured. But not many of them are able to access the care and treatment they need.  In fact, 90% of children who died from TB worldwide went untreated, according to the  2018 pediatric TB report.

“Based on recent Kenya TB Prevalence survey findings we were required to detect about 22,000 children with TB in 2017, but we only identified 7,714 children,” said Dr. Stephen Muleshe, Head of TB care and treatment at the National TB, Leprosy and Lung Disease program.

EGPAF Kenya Country Director, Dr. Eulid Mwangi during the launch of CaP TB at Lodwar County Referral Hospital in Turkana.

Turkana county has the second highest burden of childhood TB with 433 children, after Nairobi, which has 953 children infected with TB according to the 2017 National TB report.

“Many of these children pass through the hands of healthcare workers without knowing they have TB,” added Dr. Muleshe.

In Turkana “Most of the children admitted for TB treatment in the county referral hospital come too late and more than half die”, said Joy Lipesa, the nursing officer in charge of TB treatment says.

It’s unfortunate that we lose many children due to TB in our county. Jane Ajele, Turkana County Health Minister

TB is particularly difficult to diagnose and manage in children since many do not have access to the most effective tests and child-friendly treatments.

“It’s unfortunate that we lose many children due to TB in our county,” said Jane Ajele, Turkana County Health Minister.

Apart from high numbers of children with TB, Turkana also faces the challenge of having a high number of people who do not complete TB treatment—with a ‘lost to follow up’ rate of 17%, over three times the national average.

Staff at Lodwar county referral hospital
Discussion of diagnosing pediatric TB at Lodwar county referral hospital

As Josephine’s little girl continues TB treatment, there’s comfort in knowing Childhood TB is now a priority and diagnosis will not be arduous, thanks to a new Unitaid-funded project implemented by EGPAF that seeks to end childhood illnesses and deaths due to TB.

Launched in Turkana where the need is the greatest in Kenya, the CaP TB project, short for Catalyzing Pediatric TB innovations, will leverage EGPAF’s work with the Ministry of Health and other networks to address the gaps in childhood TB diagnosis and treatment in Turkana and Homa Bay counties. The National TB program has also selected Turkana and Homa Bay to be centers of excellence for TB.

The 4-year project is expected to detect and treat at least 1,300 children with TB and help to protect more than 5,500 children with latent TB from developing active TB.

The 4-year project is expected to detect and treat at least 1,300 children with TB and help to protect more than 5,500 children with latent TB from developing active TB. Starting with 30 high volume facilities, the project will be scaled up to 50 facilities. Lessons learned from the scale-up will be used to inform national and global implementation.

CaP TB will intensify prevention efforts by screening all contacts of adults with TB and ensuring children are diagnosed at every entry. The project will establish a network of radiologists to read and interpret chest x-rays for children and strengthen sample referral system among the treatment sites.

Partners from Stop TB Kenya, National TB program, Turkana county government and Network of women living with HIV (NEPHAK) join EGPAF in celebrating the launch of CaP TB in Kenya.

“Now that diagnosis of TB in children has been made easy, we will go from house to house to ensure all children with TB are identified and treated”, Dr. Gilchrist Lokoel Director of Medical Services in Turkana county says.

The project will help to complement the investments the county government of Turkana has put in place through a strengthened workforce that has grown from 254 to more than 1,300 health care workers. The county also recently enacted the Community Health Strategy Act. This will strengthen community interventions by including screening for TB, tracing the contacts of people with TB, and ensure that patients complete their TB treatment.

Turkana traditional dancers entertain and urge people to participate in TB testing.
Josephine Akuom and her 15-month old baby at the TB center in Lodwa county referral hospital.

“As defenders of children’s health, we at the Elizabeth Glaser Pediatric AIDS Foundation are determined to help find and implement innovative and effective solutions to eliminate the impact of the TB epidemic on children and their families,” Dr. Eliud Mwangi, Country Director for EGPAF in Kenya, said.