Why TB still kills many Kenyans

Mortality 15% is more than double the national average of 6.4 %, most deaths occur during intensive treatment

In Summary
  • Major mortality predictors: comorbidities, severe illness, malnutrition HIV and smoking are risk factors.
  • Last month, Kenya joined the phase three trial for what could become the world's first TB vaccine in more than 100 years.
Health stakeholders sensitise residents on the importance of going for TB screening and treatment
Health stakeholders sensitise residents on the importance of going for TB screening and treatment
Image: FILE

TB is curable and there are effective drugs for that. But it is still a death sentence for about 16,000 Kenyans every year.

Experts are now working to understand why this ancient killer is still taking many Kenyans to the grave.

Recently, they sought to identify predictors, causes and conditions contributing to mortality among TB patients.

Four researchers followed 291 patients from 20 purposively selected health facilities in Vihiga, employing questionnaires and face-to-face interviews to gather data.

They reveal that 15 per cent of these TB patients succumbed to the disease, with a majority of deaths occurring during the intensive phase of treatment.

This mortality rate of 15 per cent is more than double the national average of 6.4 per cent.

Further analysis uncovered several significant predictors of TB mortality. Comorbidities, severe illness, HIV and smoking emerged as independent risk factors associated with higher mortality rates among TB patients.

HIV-positive individuals faced a substantially higher risk of mortality, with 27 per cent succumbing to TB compared to nine per cent among HIV-negative patients.

“TB and HIV co-infected patients were two and a half times more likely to die compared to the HIV negative patients,” researchers said.

They were led by Paul Waliaula of the Vihiga county government.

Their analysis titled "Predictors of mortality and survival probability distribution among patients on tuberculosis treatment in Vihiga county, Kenya" is published in the Africa Health Sciences journal.

“Those who smoked were almost three times more likely to die compared to non-smokers,” the researchers said.

For HIV-negative patients, comorbidities and clinical diagnosis were identified as significant contributors to mortality, while for HIV-positive patients, smoking, severe illness, severe malnutrition and comorbidities were key factors.

“Among HIV negative TB patients, significantly lower survival probability was observed among those who consume alcohol, smokers, the severely malnourished, overweight and severely ill,” the researchers said.

“Results of the current study have shown that smoking independently increase the risk of death and significantly reduce survival probability among patients on TB treatment.”

They said their study serves as a wake-up call, highlighting the urgent need for targeted strategies to curb TB-related mortality.

The study comes as Kenya ramps up efforts to combat the ancient killer.

Last month, Kenya joined a trial for what could become the world's first TB vaccine in more than 100 years.

The phase three trial will assess the vaccine candidate's efficacy and safety.

If shown to be well-tolerated and effective, the candidate, known as M72/AS01E, could potentially become the first vaccine to help prevent pulmonary TB in adolescents and adults and the first new TB vaccine in over a century, donors said.

The announcement was made by trial sponsor the Bill & Melinda Gates Medical Research Institute (Gates MRI).

At full capacity, the trial will include up to 20,000 participants, including people living with HIV, at up to 60 trial sites in Kenya, South Africa, Zambia, Malawi, Mozambique, Indonesia and Vietnam.

Kenya on average reports more than 90,000 tuberculosis cases annually, and 18,000 deaths every year, according to the Ministry of Health.

Last year, the country reported 97,000 cases, national TB programme manager Dr Kathura Immaculate said, referring to statistics from the National TB Programme Annual Report, 2023.

While TB is one of the world’s deadliest infectious diseases–and the leading cause of death amongst people living with HIV– the only available TB vaccine, BCG, dates back to 1921.

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