By Eric Akasa
The Kenya Ministry of Health together with TB Alliance and other partners Tuesday announced the launch of appropriately dosed, child-friendly tuberculosis (TB) medicines, making Kenya the first country in the world to roll out these products nationally.
The improved medicines are easier for caregivers to give and for children to take, and are expected to help improve treatment and child survival from TB.
“Kenya is playing a leading role in the fight against childhood TB by being the first to introduce improved TB medicines for children,” said Dr Cleopa Mailu Kenya’s Cabinet Secretary for Health.
“Now, with the appropriate treatments, we can make rapid progress in finding and treating children with TB so we can achieve a TB free generation,” he added.
Tuberculosis still remains a major killer of children. According to the World Health Organization (WHO), at least 1 million children suffer from TB each year and 140,000 children die of this preventable, treatable and curable disease. In 2015, Kenya reported nearly 7,000 cases of TB in infants and children, with those under age five at greatest risk of having severe forms of TB and dying from the disease.
Previously, caregivers had to cut or crush multiple, bitter-tasting pills in an attempt to achieve the right doses for children. This made the six-month treatment journey difficult for children and their families, contributing to treatment failure and death from the disease.
Jimmy Nyaga a healthcare worker at Pumwani health facility in Majengo Nairobi says that, previously the greatest challenge was the burden of pills an average child took was about nine tablets per day but with the new formulation, in the first phase the children will take three tablets per day in the first phase of treatment and two tablets per day in the second phase.
“Previously, during the first two weeks of administering drugs to TB diagnosed patients was challenging since caregivers overdosed or under dosed children because some drugs were given in halves,.” Said Nyaga.
The treatments now being introduced are the first to meet the WHO’s guidelines for childhood TB treatment. They are not new drugs, but improved formulations that come in the correct doses, require fewer pills, are flavoured and dissolve in water.
According to Robert Matiru, Director Operations, UNITAID, the new formulation will see children take three tablets for the first phase of two months, then two tablets for the second phase of four months as compared to the previous nine tablets for the six months.
“No child should die of TB, yet for too long, we have not had the medicines to mount a sustainable response against childhood TB,” said Mr Robert Matiru, Director of Operations for UNITAID. “UNITAID’s investment in addressing this problem should help equip countries, healthcare workers, and families with the tools they need to rise to the challenge.”
The development of the medicines was overseen by TB Alliance, an international not-for-profit organization, and was funded by UNITAID and other partners.
“These new treatments won’t have an impact until they reach the children that need them,” said Dr Cherise Scott, Director Pediatric Programs, TB Alliance.
“We are proud to partner with the Government of Kenya, the first of many countries, as they work to translate the potential of these medicines into lives saved,” she said.
Starting October 1, 2016, all children in Kenya who will be initiated on TB treatment will be given the improved formulation. “Childhood TB is a problem that can be solved when we choose to act,” said Dr Enos Masini, Head of Kenya’s National Tuberculosis, Leprosy and Lung Disease Program.
Children often get TB from infected persons in their environment. This can be at home, at school or in any other place where children spend their time. Children should be taken to the nearest health facility to receive a TB diagnosis if they have a cough, fever, night sweats, reduced playfulness, or if they fail to gain weight. If any member of the household is diagnosed with TB, all other household members should be tested for TB, especially children. TB testing and treatment is free at all public health facilities in Kenya.
According to Francisca Kageha a mother who has TB infected five year child, It is hard to know if your child is infected with TB, “I didn’t know my child had TB it started with headaches, stomachaches then I took him to private clinics where he was given pain killers in February 2016 but there was no improvement,” says Kageha.
This prompted her to take the child To Kangemi County Council health facility where a heads scan for the child was done but there was nothing after which the child was referred to Kenyatta National Hospital (KNH). “At KNH, the child was admitted several tests done but the doctors could not tell what was ailing my son,” says Kageha.
“Finally after six months in August my son was diagnosed with Tuberculosis in August 2016 at KNH and he is now on treatmen,”she adds.
According to Dr Immaculate Kathure of National TB Programme, diagnosing children with TB in good time was initially the greatest challenge since most healthcare workers looked for TB as a second option after trying all other diseases. “That is in the past now since Kenya adopted the use of gene expert machine compared to the previous sputum tests which was difficult to get in children, she said.