My name is Dr Neimah Barasa, the County TB, Leprosy and Lung Disease Coordinator, Nakuru County. I am in charge of our county efforts to battle Tuberculosis (TB). Since the COVID-19 outbreak, we have witnessed a considerable increase in TB cases in the county. The numbers have risen, but so has our will to address the health crisis.
To strengthen our fight against TB, we have taken a multifaceted approach, with community-based activities playing a critical role. Our devoted community health promoters hold regular community health talks to raise TB awareness, create demand for its services at the facility level and promote TB treatment adherence. We also work together with the Ministry of Education, conducting similar health talks, and screening students for TB in schools.
We work with local radio stations and use social media platforms to reach a larger audience with TB information. Within the Nakuru County health department, our communications staff works tirelessly to design posters and materials to ensure proper TB information dissemination.
Stigmatisation has historically been a problem, but our community health promoters have made tremendous progress in eliminating it.
Nakuru County is lucky to have significant assistance from our partners and the local Department of Health at the facility level. We constantly train our healthcare team, bringing them up to date on the most recent tuberculosis recommendations and methods.
We’ve also realised the value of incorporating the private sector, because tuberculosis may impact everyone, regardless of socioeconomic level. In fact, the private sector accounts for over 48% of our patients. This insight has prompted to rollout the TB workplace model in the county. With the support of the National TB Program and USAID TB ARC II activity, we are engaging workplaces like flower farms and manufacturing companies in TB active case finding interventions by conducting regular sensitisation and screening exercises. We have also partnered with chemists and radiology centers, allowing us to widen our reach and increase case identification.
To track our performance, we have also joined the National TB Program Quality Efficiency (PQE) initiative, a pilot program that examines the quality of our work. It guarantees that we make correct diagnoses, avoid missing cases, and keep accurate patient records. This program provides essential direction and holds us accountable for providing excellent care. PQE is now being implemented in five of our sub-counties, with plans to expand it to all eleven sub-counties soon. We expect that this program will result in an increase in the number of TB cases diagnosed and treated.
However, our success is not solely due to our tactics; it is also due to the dedication of our employees. Their enthusiasm and dedication are the bedrocks of our patients’ recovery journeys. When a patient is in our care for six months or more, the staff’s approach and attitude can make or break the situation.
On treatment success rate, we do have defaulters, like in many other areas, though Nakuru County has managed to keep their numbers reasonably low. We trace patients who miss appointments and ensure they return to care with the support of community health promoters. When patients leave the county, we work with other hospitals to keep their therapy going. We also sensitise our patients on the importance of adhering to treatment before initiating them on treatment. The same is repeated when they come for clinic review and drug refills.
Our effort have resulted in an improvement of quality TB services and indicators. According to the 2023 first-quarter data, we had 1,017 patients under care, and by the mid of the second quarter, we had approximately 936 individuals. We believe that our numbers will continue to grow as we expand our outreach efforts.
In the previous year, our cure rate was roughly 79%, with a 88% treatment success rate. We are certain that our cure rates will improve in the next years as a result of the ongoing efforts and enhanced diagnostics. As Nakuru County, we’re committed to lowering the TB burden and providing high-quality of care to our patients.
