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Tuberculosis Surveillance in Kenya: Challenges and Progress

This presentation by Amos Kutwa provides an overview of TB surveillance in Kenya, including case finding, holding, and constraints. It details the country's TB control efforts, regional zones, case detection rates, and treatment outcomes. The data highlights the challenges faced in surveillance, such as manual data entry and lack of analytical capacity. Despite these constraints, the presentation shows the significant increase in TB case findings and outlines the treatment outcomes for different types of TB cases in various cohorts from 1993 to 2002.

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Tuberculosis Surveillance in Kenya: Challenges and Progress

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  1. TUBERCULOSIS SURVEILLENCE KENYA AFRICAN TB SURVEILENCE WORKSHOP, HARARE:ZIMBABWE Presented by: Amos Kutwa Head National Leprosy &Tuberculosis Program Kenya

  2. Outline of the Presentation: • Introduction • Case finding report • Case holding • Constraints Kutwa2003

  3. Introduction • Pop: App 32 million people • TB control: MoH/ NGOs/ Private • Central unit within NLTP/ NASCOP Division • 10 Regional control zones/74 District zones manned by Technical officers • TB-ICC since 2002: USAID,CDC,WHO, KNCV, WB,CIDA,KAPTLD Kutwa2003

  4. Health units implementing NLTP activities Kutwa2003

  5. TB Case finding report 2002 • TB case finding: 82,114 all types 34,337 PTB + • 7-fold increase since early nineties • Average annual increase (5 yrs): 16% • 50-55% of estimated incidence • 40 % HIV + in SM+ (1994) Kutwa2003

  6. 2002 Notification rates in Kenya Kutwa2003

  7. Case Notification Rates Smear positive PTB and all Types TB Kenya 1990-2002 Kutwa2003

  8. Trend of case detection rates (WHO reports) Kutwa2003

  9. Distribution of TB cases by type: 2002 Kutwa2003

  10. Age -sex Segregation:2002 Kutwa2003

  11. Trend of Treatment outcomes of New Smear Positive PTB on SCC :1993-2001 Kutwa2003

  12. SCC Treatment results 2001 cohort Sm.+PTB Sm.-PTB EPTBRelapse Rx success rate 80% 74% 74% 77% Failure rate 0.3% - - 1% Death rate 5% 7% 7% 10% Defaulter rate 9% 12% 10% 7% Transfer 7% 7% 8% 6% Kutwa2003

  13. Nomadic Treatment results 2001 cohort Sm.+PTB Sm.-PTB EPTB Relapse Rx success rate 89% 87% 74% 82% Failure rate 1% - - 1% Death rate 4% 6% 6% 12% Defaulter rate 4% 5% 7% 4% Transfer 2% 2% 3% 1% Kutwa2003

  14. Constraints to Surveillance • Manual data entry at facility/district level • Lack of capacity to analyze data at district level • Lack of capacity to determine the TB prevalence Kutwa2003

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