Mwangi, who has been HIV positive since birth almost died when he contracted TB.

By Lynn Sereya

Every 24th March, the world commemorates World Tuberculosis (TB) Day. TB is a disease that affects the lungs. It is curable, but with a potential to advance to other parts of the body if left untreated. It is also highly infectious, especially at its active stage.

To commemorate this day, National AIDS Control Council unveil TB and give it a human face through the story of Mwangi (not his real name) who is  a  TB survivor and a TB and HIV champion. Mwangi and his brother have been HIV positive since birth, and they have both learnt to live with this condition. Their father died while Mwangi was still very young, prompting his mum to take up all the responsibilities of fending for the family.

No more school

The daily struggles led to premature ending of the two boys’ education, forcing the mother, who was a house cleaner, to relocate to the countryside. Mwangi took up menial jobs like peddling water to fend for himself and send little money to his mother back in the village.

Even though such jobs were strenuous and with little pay, they were not readily available. The strain occasioned by job searches deepened Mwangi’s frustration, triggering a default on his medication regime. “I couldn’t see myself swallowing medicine on an empty stomach. I took the easy way out by stopping whenever I pleased,” said Mwangi.

In 2020, he was diagnosed with TB, a misfortune he attributes to failure to adhere to HIV treatment.

“I almost died. Luckily, help came right on time. I was put on TB medication for six months and I recovered totally. I have now gone back to my ARV’s which I take religiously to avoid recurrence of a similar scare.”

Impressive results

The success rate on TB treatment in Kenya is largely attributed to a vibrant TB response program. Ms. Evaline Kibuchi, Chief National Coordinator, Stop TB Partnership – Kenya has been in the TB field since 2007. Kibuchi reckons that some areas in TB response steadily recorded impressive results including treatment success rate, incidence, and TB mortality rate reduction. The country recorded a significant decline of 44 per cent in TB mortality rate between 2016 and 2022.

Kenya suffers from dual HIV and TB epidemics.  The country is ranked sixth globally in HIV disease burden. However, WHO indicates a 15 per cent reduction in HIV/ TB co-infection from 40 per cent to 25 per cent between 2007 to 2020.

 

 

 

 

 

 

 

 

 

Improved technologies  

Two interventions in HIV response have catapulted a reduction in TB / HIV infection. Notable treatment improvements include: the isoniazid preventive therapy (IPT), a technology that reduces chances of people with HIV from getting infected with TB. There’s also the TB prevention therapy, which is an improved IPT, friendlier and very helpful in preventing TB infections.

 

Ms. Kibuchi notes that progress in awareness and community involvement is yielding favorable results in TB response.

“In 2007, there was barely a civil society working in TB response, non-existence of TB communities, and minimal political good will. We now have TB communities that are recognized as stakeholders. The communities are involved in activities like creating awareness, contact tracing, supporting people on treatment and advocacy. This has caused a huge positive impact,” she says.

 

Strategies and intervention  

With a vibrant civil society, Ms. Kibuchi notes that most organisations working in HIV response begun to integrate TB into their work. Advocacy for TB was really amplified.

 

To augment the gains and progress, in 2015, there was a shift in political support toward TB eradication, with the formation of global parliamentary TB caucus, and later the establishment of an Africa parliamentary TB caucus.  Today, Africa boasts of about 18 countries with National TB parliamentary caucus.

Further, the united high-level meeting on TB of 2018 in a huge way improved political commitment to TB both at the country and global level.

 

Screening 

Ms. Kibichu contends that to clear any doubt of TB infection, it is important for people living with HIV to undergo regular screening every time they go for routine checks to arrest TB before it advances. Additionally, she calls on everybody visiting a health facility to screen for both HIV and TB to allay fears as well as get early intervention if necessary.

 

Mwangi’s story is a reminder that we need to adhere to treatment and regular screening. Additionally, pregnant and prospective mothers should screen for HIV to protect their babies from infection.  TB is curable if only we screen regularly and adhere to treatment.  Let’s avoid crowded places and always open windows to allow air circulation. These will reduce the risk of TB infection.