TB ARC

Background

The burden of tuberculosis (TB) in Kenya is among the highest in the world and the 4th cause of death among infectious diseases. Kenya has an incidence rate of 233 cases per 100,000 and a high mortality rate of 16 deaths per 100,000. In 2015, 81,518 TB cases were notified and it is estimated that there are a missing 28,000 cases.

High poverty levels in Kenya, estimated at 46%, have contributed to the burden of TB, through poor housing, poor nutrition, overcrowding in homes and at workplaces, alcohol and substance abuse and poor access to health care services.

In 2015, the burden of TB among children under 14 years of age is estimated at 9% of the total TB burden in Kenya. The emergence of MDR-TB has rendered children victims of contacts and poor case control of adults with TB. Children can present with TB at any age, with the most common age being 1-4 years. Risk of progression to disease and development of disseminated TB is increased among the very young (0-4 years), immune compromised and malnourished children. HIV infected children have a lifelong risk of TB.

TB Hotspots in Kenya

In 2015, 10 counties had higher TB case notification accounting for 48% of the total notified cases. These counties include: Nairobi (12,425), Mombasa (4,225), Kiambu (3,702), Nakuru (3,636), Meru (3,420), Kisumu (2,933), Turkana (2,250), Machakos (2,223), Kakamega (2,184), Homabay (2,143). Source TIBU May 20, 2016.

The leadership role of the Government of Kenya’s National Tuberculosis Leprosy and Lung Disease Program (NTLD-Program) in collaboration with development partners has seen Kenya recognized as the first country in Africa to achieve WHO global targets of detecting 70% and treating 85% of these TB cases successfully.

In spite of these gains, more remains to be done to increase case notification, respond to drug-resistant TB, scale up TB-HIV collaboration, promote research and development to accelerate progress in point-of-care diagnostics, treatment regimens, effective vaccines to prevent TB in adults and avail adequate financing for TB care and control.

USAID - TB ARC LOGOS

Goal: To reduce Kenya’s TB burden

The USAID funded Tuberculosis Accelerated Response and Care seeks to expand access to quality-assured TB services in all Counties and for all forms of TB, through the identification and implementation of evidence-based interventions that support and/or complement the activities of the NTLD-Program and increase the proportion of TB cases identified and treated over a period of five years.

The United States Government has invested 40 Million Dollars though the Tuberculosis Accelerated Response and Care (TB ARC) Activity to support strategic TB program coordination efforts and stewardship; as well as support TB diagnostic services including GeneXpert machines. This investment will also be used to implement innovative approaches towards TB Control and improve ICT for data management

TB ARC works closely with the NTLD-Program and other implementing partners to increase the proportion of all TB cases identified and treated to over 95% and treatment success rate to over 85% in all counties.

Country Progress to Date

The leadership role of Kenya’s National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program) in collaboration with her partners has seen Kenya recognized as the first country in Africa to achieve WHO global targets of detecting 70% and treating 85% of these TB cases successfully. Kenya surpassed the target on TB case detection rate of 75%, treatment success rate of 86% for new and relapse cases. Other achievements include:

  1. Launch of the National Strategic Plan (NSP 2015-2018), providing a roadmap for TB, Leprosy and Lung Health activities in Kenya
  2. Kenya conducted it’s first post-independence prevalence survey from July 2015 to August 2016. The analysis and report writing is underway – Final report to be released in March 2017
  3. The Drug Resistant Survey (DRS) was successfully carried out in 2015
  4. Rollout of Isoniazid Preventive Therapy (IPT) across the country to protect people living with HIV and children under five years of age in contact with persons with TB from getting TB. The target is to initiate about 900,000 by December 2016
  5. From July 2016, GeneXpert was commissioned as first test for presumptive TB cases in all facilities where the machine is available
  6. Kenya was the first country to nationally roll out the new child-friendly tuberculosis (TB) medicines in October 2016
  7. Use of TIBU an electronic patient management and payment system
  8. Rolled out Extension for Community Healthcare Outcomes (ECHO), a collaborative model of medical education and care management to improve quality of care

Tuberculosis Accelerated Response and Care is implemented through a consortium led by Centre for Health Solutions – Kenya (CHS) with support from PATH and technology partners SAFARICOM and Tangazo Letu, working in collaboration with the NTLD-Program.

Result Areas

  1. Support Kenya’s national TB program to reduce the burden of TB in Kenya
  2. Support development, implementation and scale-up of new program areas/interventions
  3. Provide technical assistance for the local adaptation and scale-up of globally proven interventions
  4. Support monitoring and evaluation of the National TB Program (NTLD-Program)

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