Cross-border TB fight hampered by patient mobility, family secrecy and bureaucratic barriers

Health officials from Kenya and Tanzania have raised an alarm over the daunting challenges in managing tuberculosis cases along their shared border.

The medics say patients’ disappearances, family interventions and administrative red tape are undermining treatment efforts and fuelling complications, including deaths.

The concerns emerged during a cross-border meeting held in Mabera, Migori county, which brought together key stakeholders including immigration authorities, local government administrators, health officials, community health promoters, clinicians and doctors from both countries.

The forum aimed to forge collaborative strategies to curb the spread of TB, a chronic disease requiring prolonged treatment of at least six months and in some cases over a year, amid rising co-infections with HIV.

John Alila, the clinical officer coordinating TB cross-border activities in Nyatike subcounty, painted a grim picture of patient tracking woes.

He said that individuals often seek medical services in neighbouring Uganda or Tanzania, only to quit treatment midway.

 "We need a follow-up, but we lose them as they disappear across the border, while some come back with complications and even die," Alila said.

He explained additional hurdles, including instances where relatives hide patients to avoid stigma due to cultural beliefs, complicate efforts to locate and monitor them.

Patients also frequently use different names when crossing borders, further muddying records and making traceability nearly impossible.

Immigration hurdles, such as restrictive border policies and lack of shared health data systems, exacerbate the problem, delaying or preventing follow-ups altogether.

To address these gaps, Alila called for innovative modalities to ensure seamless care.

"We come up with modalities to provide care; they are supported to receive it," he said, while pointing to occupational risks like small-scale businesses and tobacco consumption that heighten vulnerability.

 He also flagged emerging trends in HIV-TB co-infections, where lowered immunity leaves individuals at greater risk.

"We have those with TB where stigma is not like HIV, but we put them on antiretroviral therapy and medicine to protect the patient from opportunistic diseases if they are at risk," he added.

Oluoch Odoro, who oversees TB and HIV clinics in Kuria East subcounty, commended authorities in Migori and Tanzania for improving access to medical materials but warned of the dangers posed by mobile populations.

Community health volunteer Joseph Chacha highlighted treatment defaulting as a critical issue, often tied to bureaucratic obstacles.

He called for streamlined processes to overcome immigration and administrative barriers that deter patients from completing treatment regimens.

The meeting also proposed commitments to enhanced protocols, including joint patient registries and awareness campaigns to tackle stigma and family secrecy.