The Ministry of Health on Tuesday, September 27 announced the launch of appropriately dosed, child-friendly tuberculosis (TB) medicines, making Kenya the first country in the world to roll out these products nationally. The launch organised under the theme ‘A TB Free Generation’ attracted health and TB control partners including County Executives Committee Members for Health (CECs) from various counties in the country. The improved medicines are easier for caregivers to give and for children to take, and are expected to help improve treatment and child survival from TB.
“Kenya is playing a leading role in the fight against childhood TB by being the first in the world to introduce the improved child-friendly TB medicines,” affirmed Dr Jackson Kioko, Director Medical Services at the Ministry of Health. Speaking during the launch Dr Kioko indicated that Kenya is honoured to celebrate what it has advocated for and looked forward to for the last four years – having friendly TB drug formulations for children. “With these appropriate treatments, Kenya is expected to make rapid progress in finding and treating children with TB to achieve a TB free generation,” he said.
Previously, caregivers had to cut or crush multiple, bitter-tasting pills in an attempt to achieve the right doses for children. This made the six-month treatment journey difficult for children and their families, contributing to treatment failure and death from the disease. “The TB treatment regimen for children comprised of multiple pills of different formulations. This was a very complex regimen for health care workers and care givers, leading to poor adherence and poor health outcomes,” said Dr Kioko.
Tuberculosis still remains a major killer of children. According to the World Health Organisation (WHO), at least 1 million children suffer from TB each year and 140,000 children die of this preventable, treatable and curable disease. In 2015, Kenya reported nearly 7,000 cases of TB in infants and children, with those under age five facing the greatest risk of having severe forms and often fatal forms of the disease.
“There is a higher risk and more rapid progression to active TB among children, thus leading to higher mortality,” said Dr Joseph Sitienei, Head of Strategic Health Programs at the Ministry of Health. “There exists a gap in case detection among children, with 29% of children with TB being missed each year,” he added. He further noted that increased use of the GeneXpert machine will enhance case detection and identification of drug resistance among children.
The treatment being introduced is the first to meet WHO guidelines for childhood TB treatment. These are not new drugs but improved formulations that come in the correct doses, require fewer pills, are flavoured and dissolve in water. The development of the medicines was overseen by TB Alliance, an international not-for- profit organisation, and funded by UNITAID and other partners.
“These new treatments will not have an impact until they reach the children that need them,” said Dr Cherise Scott, Director of Paediatric Programs at TB Alliance. She also reaffirmed that TB Alliance is proud to partner with the Government of Kenya, the first of many countries, as they work to translate the potential of these medicines into lives saved.
Mr Robert Matiru, Director of Operations at UNITAID emphasised that children’s lives are precious and need to always be taken care of. “No child should die of TB, yet for too long, we have not had the medicines to mount a sustainable response against childhood TB,” he said. UNITAID’s investment in addressing this problem aims to help in equipping countries, health care workers, and families with the tools they need to rise to the challenge.”
Starting October 1, 2016, all children in Kenya initiated on TB treatment will be given the improved formulation. “Childhood TB is a problem that can be solved when we choose to act,” said Dr Enos Masini, Head of Kenya’s National Tuberculosis, Leprosy and Lung Disease Program. This calls for active diagnosis and case finding to ensure that all children are treated. He further noted that children often get TB from infected persons in their environment. “One single adult TB source presents the possibility of spreading TB infection to 60 children,” he emphasized. This can be at home, at school or in any other place where children spend their time.
The launch was also graced by Hon Stephen Mule, the chairman of the African Parliamentarians TB Caucus who noted that there is need for the Ministry through the TB Program to increase the capacity of diagnosing TB at the earliest date possible, at the lowest level of the health sector in Kenya.
The take home message was that children should be presented to the nearest health facility to receive a TB diagnosis if they have a cough, fever, night sweats, reduced playfulness, or if they fail to gain weight. Further, it was made clear that if any member of the household is diagnosed with TB, all other household members should be tested for TB, especially children. TB testing and treatment is free at all public health facilities in Kenya.