Tuberculosis (TB) still remains a global health emergency. It is estimated that about 9 million people were infected with TB worldwide, and 2 million people died of TB in 2009 . According to the global plan to stop TB, Asia and Sub-Saharan Africa accounts to 84% of such cases from the high burdened nations. Kenya ranks 13th on the list of 22 high-burden TB countries in the world collectively contribute to the global TB disease burden, and have the fifth highest burden in Africa. According to the World Health Organization’s (WHO’s) Global TB Report 2009, Kenya had approximately more than 132,000 new TB cases and an incidence rate of 142 new sputum smear-positive (SS+) cases per 100,000 population.
However, lack of or limited amount of correct information about TB in the general population and the fear and stigma attached to TB, especially due to the association between TB and HIV/AIDS has led to low TB case detection in resource constrained settings such as Korogocho. HIV epidemic, congestion in prison, limited access to general health care services, poverty and social deprivation leading to overcrowded informal settlements has exacerbated the situation. In order to address challenges posed by TB, early case detection and treatment of the detected cases as a key strategy in TB control has been identified by the Ministry of Health (MOH) of Kenya, through the National Leprosy and Tuberculosis Program (NLTP). The intention of case finding is to diagnose and treat TB cases as early as possible, mainly through passive case finding, timely treatment and contact tracing. The NLTP strategy also encourages the decentralization of diagnostic or treatment centers to increase access to TB services, TB/HIV collaboration, better coordination with the private health sector and increased awareness of TB control among health workers and the communities. However, the actual implementation of this strategy has been limited in scope and scale.
Korogocho being the third largest slum in Kenya does not have government supported health facility. There is also no TB specific awareness creation in the area. Stigmatization of TB patients is very high. This leads to low level of TB health services utilization, late identification of TB suspects and high rate of defaults in taking drugs by TB patients in Korogocho. The health facility(MAKWK) initiated by Korogocho residents does not have diagnostic equipments. Those suspected to have TB have to travel to other places for screening purposes. In most cases, they do so when it is very late. As a result, TB continues to thrive in Korogocho. Pambazuko Mashinani in collaboration with MAKWK intends to mobilize strategic stakeholders in building the capacity of community health workers to help in identification and referral of potential TB patients while at the same time tracking defaulters.
By the end of the 12 month project period, we expect:
a) To build the capacity & support the work of community health workers to trace and support at least 100 TB defaulters in Korogocho
b) To build the diagnostic capacity of MAKWK in order to carry out TB tests to at least 3000 Korogocho residents
c) To initiate & support a coalition of individuals and groups in Korogocho to embark on community based TB advocacy targeting Korogocho residents
Stay tuned!
Dr. Aggrey Willis Otieno 
Good Project!!!!! You continue to be an inspiration, and I can’t wait to have my students listen and be inspired by you….Go Go Go!
Thanks Esther. It will be my pleasure to talk to them.