Health volunteers changing narrative in the war against TB

For five months, Mzee Ekai, 83, a resident of Soweto village on the outskirts of Lodwar town, Turkana County, had a persistent cough and chest pains. He was also experiencing difficulty in breathing. 

But on March 23, he realised that he had TB symptoms. This was during a sensitisation campaign on prevention and treatment of tuberculosis, which was being spearheaded by community health volunteers  (CHVs) in the village.  “I was diagnosed with TB during a free TB screening exercise and I am now on medication,” says Ekai. 

Ekai was among the more than 1,000 residents of California and Soweto villages who turned up for the three-day TB awareness and screening exercise. 

County TB, Leprosy and Lung Diseases Coordinator Job Okemwa said a total of 444 residents were screened using a digital chest X-ray computer-aided detection technology that uses lung shape and texture analysis to determine the likelihood of TB. “Out of the 95 sputum samples that were processed, 19 were positive, presenting a 20 per cent positivity rate,” he added.

Dr Okemwa noted that the devolved unit’s Department of Health and Sanitation in partnership with various partners targeted low-income neighbourhoods of California and Soweto in line with the county’s strategy to eradicate fatal infectious disease. 

“The two villages are congested , with living conditions contributing to increasing number of TB cases. That is why even private hospitals have not been left behind in efforts to reduce TB burden in the county through supporting community screening initiatives. Banking on community health volunteers has been proven to be effective because the 20 per cent positivity rate was established in just three days,” said Richard Kariuki, Lodwar Hills Hospital administrator.

The county has partnered with World Relief Kenya, Save the Children Kenya, Kenya Red Cross Society, Centre for Health Solutions - Kenya, the United States Agency for International Development, International Rescue Committee and Lodwar Hills Hospital.

The CHVs have been sensitising locals on preventive measures and treatment of TB. The move has helped reduce the spread of the disease in the community hence saving the lives.

According to a report from the county’s Health department, Turkana recorded 3,062 TB cases in 2022 up from 2,632 in 2021. The county is one of the top 10 high burden counties for TB in Kenya, with a TB case notification rate above 164 per 100,000 people. 

“Despite the challenges, we are making progress in the fight against the disease. The microscopy diagnostic sites have increased from 40 in 2021 to 43 in 2023, while the treatment sites have increased from 60 in 2021 to 80 in 2022. As a result, the county has achieved an 86 per cent treatment success rate,” the report indicated.

Dennis Erot, project coordinator for World Relief International,  said CHVs have been trained on TB management.

Turkana South TB Coordinator John Lukado is also, with support from community health volunteers, conducting free TB screening in secondary schools such as Uhuru and AGC High in Lokichar following requests from teachers after several cases were reported.

Turkana Central Sub-county TB Coordinator Jonah Ngasike said the sustained free screening exercises are playing a big role in the fight against TB.

Dennis Erot, project coordinator for World Relief International, pointed out that such TB screenings are an indicator of positive community engagement. 

“Through collaboration and meaningful partnership with health partners, integration of TB active case finding in other community health outreaches will improve early detection,” he said. 

He said CHVs have been trained on TB management after screening that is done through digital chest x-ray and sputum examination.

Turkana South TB Coordinator John Lukado is also with support from community health volunteers conducting free TB screening in secondary schools such as Uhuru and AGC High in Lokichar following requests from teachers after several cases were reported.

“TB is preventable and curable - that is the consistent message the health volunteers are passing across,” he said.

This comes even as health officials from Kenya (Turkana) and South Sudan (Kapoeta) seek to strengthen TB screening and referrals for highly mobile cross border populations to prevent spread of the disease on both sides of the border. Kenya is on the list of the countries with a high TB burden globally and among the 30 countries that contribute to 80 per cent of the global TB burden.

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