A closer look at Tuberculosis, Kenya's leading health threat

According to the World Health Organization (WHO), lower respiratory diseases rank as the fourth leading cause of death globally.

With tuberculosis (TB) and pneumonia leading, these maladies, are the number one cause of death in Kenya as indicated in the 2024 Economic Survey.

With around 130,000 new cases each year, Tuberculosis remains a significant health concern in Kenya. Among these, 50,000 are also HIV-positive, making the disease even more fatal.

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TB alone accounts for 4 per cent of all deaths in the country, cementing its status as a public health crisis.

Dr Andrew Owuor, a specialist pulmonologist, explains that TB is caused by the bacterium Mycobacterium Tuberculosis.

“This bacterium primarily targets the lungs, but can affect nearly any part of the body except the nails, hair and teeth,” he says.

TB is categorised into two main types: Pulmonary TB (affecting the lungs) and Extra-pulmonary TB (affecting other parts of the body).

“Pulmonary TB, which accounts for 90 per cent of cases, is highly contagious and spreads through airborne droplets when an infected person coughs or sneezes,” Dr Owuor says.

Pulmonary TB is the most common form, leading to symptoms like a persistent cough, chest pain and coughing up blood. Extra-pulmonary TB occurs outside the lungs, involving other organs and tissues.

Types of Extra-pulmonary TB include TB Meningitis, which affects the brain and spinal cord; Skeletal TB, which targets the bones and joints; Genitourinary TB, impacting the kidneys, bladder and reproductive organs; Gastrointestinal TB, affecting the digestive system; Cutaneous TB, which manifests on the skin; and Ocular TB, which can lead to vision problems by affecting the eyes.

While Pulmonary TB is more prevalent, Extra-pulmonary TB requires equally urgent attention due to the diverse and severe symptoms it can produce depending on the organ system involved.

The symptoms of TB vary depending on whether it is Pulmonary or Extra-pulmonary. Common symptoms include a persistent cough, fever, chest pains, weakness, night sweats and weight loss. A chronic cough with sputum production is a key indicator of Pulmonary TB.

Diagnosing TB involves several tests.

 “TB diagnosis often starts with sputum analysis, where the patient's sputum is examined under a microscope or through sophisticated tests like the GeneXpert test. Imaging tests such as chest X-rays can suggest TB, but confirmation requires microbiological evidence,” explains Dr Owuor.

Preventing TB involves several strategies.  “Vaccination is a critical preventive measure. In Kenya, children receive BCG vaccine at birth, which helps prevent severe forms of TB,” says Dr Owuor. Additionally, measures like wearing masks, ensuring well-ventilated living spaces and maintaining a balanced diet can significantly reduce the risk of TB.