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

Outline of the Presentation: Introduction Case finding report Case holding Constraints 12/3/2018 Kutwa2003

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 12/3/2018 Kutwa2003

Health units implementing NLTP activities GOK NGO Private Total Hospitals 129 67 15 211 Health Centers 467 53 12 532 Dispensaries 550 73 7 630 Others 8 24 32 1146 201 58 1405 Laboratories 528 150 42 720 AFB microscopy 381 126 35 542 12/3/2018 Kutwa2003

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) 12/3/2018 Kutwa2003

2002 Notification rates in Kenya 12/3/2018 Kutwa2003

Case Notification Rates Smear positive PTB and all Types TB Kenya 1990-2002 12/3/2018 Kutwa2003

Trend of case detection rates (WHO reports) 12/3/2018 Kutwa2003

Distribution of TB cases by type: 2002 12/3/2018 Kutwa2003

Age -sex Segregation:2002 12/3/2018 Kutwa2003

Trend of Treatment outcomes of New Smear Positive PTB on SCC :1993-2001 12/3/2018 Kutwa2003

SCC Treatment results 2001 cohort Sm.+PTB Sm.-PTB EPTB Relapse 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% 12/3/2018 Kutwa2003

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% 12/3/2018 Kutwa2003

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 12/3/2018 Kutwa2003