Nairobi — Tuberculosis (TB) remains a global health concern, with 10.6 million people falling ill with the disease worldwide and 1.3 million dying from it by 2022, according to the World Health Organization. According to the 2022 Global TB Report, after a sharp decline in the number of reported cases in 2020, the world is once again experiencing an overall increase in new TB case notifications.
Kenya is considered a high TB incidence country, with 133,000 people falling ill in 2021 and an estimated 57,000 cases going undiagnosed or unreported in the same year, according to WHO data.
Tuberculosis is a bacterial infection affecting primarily the lungs. It predominantly spreads through the air when an infected person coughs, sneezes, laughs, or even talks. Latent tuberculosis is a condition in which bacteria can live in the body for a long time without causing symptoms. When a person exhibits symptoms such as coughing, weight loss, night sweats, fatigue, and fever, they may be suffering from
TB. In children, TB can also present with poor weight gain.
Diagnosing TB in young children is often more difficult and takes longer since many of them don't know how to cough up sputum for testing. However, specialised healthcare workers with experience working with children have a few tricks up their sleeves to get samples for testing, and caregivers who suspect their children may have TB should take them to their nearest health centre for testing. Early diagnosis and treatment serve as a vital defence against the complications associated with the disease.
Children's immune systems are weaker than adults, making them more susceptible to tuberculosis. In Kenya, children account for 9% to 10% of all reported tuberculosis cases. Infants and young children are especially vulnerable to tuberculosis, which can lead to severe or even fatal cases.
However, it is worth noting that the treatment of tuberculosis in paediatric patients is slightly more complicated due to restrictions on the medications that can be used. While they can be prescribed anti-TB medications for 4 to 9 months, some medications are not recommended for children under the age of 12, even though this is the most vulnerable age group.
Despite the challenges, advancements in treatments are making it easier to treat TB in children in the present day. Shorter treatment regimens are available, but they may not be used for younger children. Additionally, where syrups may not be available, tablets that can be dispersed in water can be administered to kids who have TB.
Notably, the legendary Bacille Calmette-Guerin (BCG) vaccine has long been effective in lowering the TB burden among Kenyan children. Thankfully, the country has achieved impressive coverage of the BCG vaccine, with 93% of children receiving the vaccine within a few days of birth. The vaccine prepares the immune system to detect and combat tuberculosis infection. While it does not guarantee complete immunity, it does significantly reduce the risk of severe TB forms.
This impressive vaccination rate demonstrates Kenya's commitment to child health and should be applauded. Public health campaigns have successfully highlighted the BCG vaccine's lifesaving potential. Furthermore, by expanding outreach programs and training community health workers, Kenya has promoted equitable access to vaccination services, reaching even remote areas that were previously inaccessible.
The advantages of this success go far beyond immediate health gains. Kenya ensures the future health and well-being of its children by protecting them from tuberculosis. Healthy children can attend school on a regular basis, contributing to the economy in the long run while building fulfilling futures. Furthermore, lowering the TB burden on the healthcare system frees up resources to address other pressing health needs.
Despite being classified as a high-incidence country, Kenya is undeniably making significant progress in protecting its population from disease. According to World Bank data, the incidence of tuberculosis per 100,000 people has steadily declined, from 646 in 2006 to 237 in 2022.
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However, Ministry of Health reports from 2023 show that 40% of Kenyans with tuberculosis go undiagnosed and spread the disease unknowingly, resulting in an increase in the total number of infections. In addition, 22,000 children become ill with tuberculosis each year.
While Kenya's accomplishments thus far serve as an admirable model for other countries fighting childhood tuberculosis, now is not the time to rest on our laurels. Early detection, effective treatment, and improved living conditions are still critical components of TB control. The country's success in ensuring widespread use of the BCG vaccine and other TB control measures suggest that the fight can be
won and that Kenya can join the rest of the world in eliminating tuberculosis by 2050. Kenya is creating a generation that is less susceptible to tuberculosis, paving the way for a future free of this devastating disease by leveraging the power of vaccination and prevention.
The writer is a Paediatrician at Gertrude's Children's Hospital. Her e-mail address isagisaek@yahoo.co.uk
