In Kenya, following the global trend, TB is the biggest killer of people living with HIV. Because of this our Linking Organisation KANCO is advocating for better integration of the response to TB and HIV in the country.
“An estimated 25-30% of people living with HIV in Kenya have undiagnosed TB, so improved integration of TB and HIV screening services is essential if we are to see an end of TB related deaths among people living with HIV”, says Evelyne Kibuchi, KANCO’s Senior TB Advocacy Manager. “Integration should be put into practice at all levels from advocacy to implementation. For instance all people living with HIV should be screened for TB when they attend health facilities, and started on treatment immediately if the result is positive”.
Kibuchi and her colleagues work to educate and sensitise key stakeholders about the issues surrounding HIV/TB co-infection. “Our advocacy efforts target both local government and international donors and are geared towards ensuring that the two diseases are addressed using a common approach and that there are adequate funds to do this” she says.
This work has already seen key achievements: KANCO was successful in advocating for the inclusion of TB indicators in the HIV national plan and for the inclusion of TB indicators in the national reporting tools. More recently TB control received a boost in the national budget with an increase of KSh 50 million for TB control.
Worryingly, Kenya has seen an increase in multi-drug resistant TB (MDR-TB), with over 700 confirmed cases. KANCO continues to advocate for comprehensive treatment and management of MDR-TB, calling for better access to diagnosis, a sustainable supply of drugs, better support to patients and full implementation of disease control policies.
With early detection and treatment with the right medication, TB is a curable disease. So reaching communities with accurate information about the dangers of TB and the importance of treatment is essential. This is especially important for a country with an estimated HIV prevalence of 6.3%, as the risk of developing TB is 20-37 times greater in people living with HIV than for those who are not infected.
“Recognising the key role of patients and communities in the response, the first ever group of former multi-drug resistant TB patients in Kenya has now been formed” Kibuchi says. “They are committed to using their experience to educate communities and advocate for better TB control. Engaging former patients has been an effective strategy to sensitise communities on the importance of completing TB treatment, as this is one of the key factors in drug resistance.”
As part of this work KANCO’s partner the HAKI Self-Help Group recently coordinated a door-to-door sensitisation exercise in Kianda village, part of Nairobi’s Kianda region after increased reports of residents being infected affected by the disease. Sensitising residents is especially important for poor communities who have limited access to information.
Former TB patients joined volunteers who went from house-to-house and reached over 300 residents with information about TB. A number of people who had defaulted on TB treatment were identified, and the former patients counselled on how important completing the course of medication is. They were then referred on to services so they could resume their treatment.