By Dr. Eliud Mwangi
As the globe marks World Tuberculosis (TB) Day on March 24, 2024, rallying around the conviction that we can indeed End TB, it becomes imperative to focus on the intertwined challenges of pediatric TB and its twin epidemic, HIV, especially within Kenya. Despite significant progress in global TB control efforts, children, particularly those living with HIV, continue to disproportionately suffer from these dual epidemics.
The 2022 Kenya’s TB program report shed light on the severe reality of pediatric TB and its connection to HIV. In 2022, the HIV coinfection rate for childhood TB was recorded at 10.4percent, with 926 cases reported, alongside a Multi-Drug Resistance TB notification of 3.4percent among children aged below 15 years. Despite efforts to intensify case finding gaining traction, there remains much more to be done, especially considering that data reveals 23percent of individuals diagnosed with TB in 2022 were coinfected with HIV. This underscores the critical need to ensure optimal HIV and TB treatment, particularly as people living with HIV (PLHIV) face a higher risk of mortality from TB.
Addressing pediatric TB and HIV concurrently is crucial due to their synergistic relationship. HIV compromises the immune system, making children more susceptible to TB, while TB accelerates the progression of HIV, creating a deadly cycle. Moreover, the diagnosis of TB in children, especially those co-infected with HIV, is challenging, leading to underdiagnosis or misdiagnosis, and consequently, linkage to treatment and management. By targeting both diseases together, we can save lives and prevent further spread, emphasizing the urgent need for integrated healthcare solutions.
On World TB Day 2024, Kenya must strengthen its resolve to tackle this syndemic by:
1.Enhancing Screening and Diagnostic Services: Early detection through improved TB and HIV screening in pediatric care settings is vital. Routine screening, especially in HIV care facilities, and the use of point-of-care diagnostic technologies can speed up case identification and the initiation of treatment.
2.Optimizing Case Identification and Treatment Regimens: Better screening and identification of TB cases among children, including those with TB/HIV co-infections, are crucial for improving clinical outcomes. Coupled with appropriate treatment and management, these efforts can significantly enhance recovery rates.
3.Addressing Social Determinants: Understanding the impact of social determinants is key in tackling the pediatric TB-HIV syndemic. Poverty, inadequate housing, malnutrition, and limited healthcare access increase children’s susceptibility. Socio-economic support programs that aim to reduce poverty, improve nutrition, and access to education and healthcare are necessary to mitigate these risks.
4.Fostering Multi-Sectoral Collaboration: The fight against these interconnected epidemics requires the cooperation of government agencies, NGOs, healthcare providers, and communities. Utilizing existing health infrastructure and resources for integrated TB-HIV programs can amplify Kenya’s efforts.
5.Incorporating AI in the battle against pediatric TB: represents an innovative method to address this public health challenge. AI-driven diagnostics and predictive analytics can drastically improve early detection and treatment outcomes, enhancing both the precision and speed of intervention strategies. By integrating AI into healthcare systems, Kenya can advance toward eradicating pediatric TB and setting a global standard in the process.
This World TB Day, let’s rally together to combat pediatric TB and HIV. By joining forces, we can indeed end TB by disrupting transmission chains, alleviate children’s suffering, and forge a path to a healthier, TB-free future for all.
