Trends in TB and HIV care and treatment cascade, Kenya, 2008–2018
METHODS: Using Microsoft Excel (2016) and Epi-Info 7, we analysed Kenya Ministry of Health TB surveillance data from 2008 to 2018 to determine trends in TB notifications, TB classification, HIV and ART status, and TB treatment outcomes.
RESULTS: Among the 1,047,406 people reported with TB, 93% knew their HIV status, and 37% of these were HIV-positive. Among persons with TB and HIV, 69% received ART. Between 2008 and 2018, annual TB notifications declined from 110,252 to 96,562, and HIV-coinfection declined from 45% to 27%. HIV testing and ART uptake increased from 83% to 98% and from 30% to 97%, respectively. TB case fatality rose from 3.5% to 3.9% (P <0.018) among HIV-negative people and from 5.1% to 11.2% (P <0.001) among PLHIV on ART.
CONCLUSION: TB notifications decreased in settings with suboptimal case detection. Although HIV-TB services were scaled-up, HIV-TB case fatality rose significantly. Concerted efforts are needed to address case detection and gaps in quality of TB care.
Document Type: Research Article
Affiliations: 1: Division of Global HIV&TB, US Centers for Disease Control and Prevention, Nairobi, Kenya, National Tuberculosis, Leprosy, and Lung Disease Program, Ministry of Health, Nairobi, Kenya 2: National Tuberculosis, Leprosy, and Lung Disease Program, Ministry of Health, Nairobi, Kenya 3: Division of Global HIV&TB, US Centers for Disease Control and Prevention, Nairobi, Kenya 4: Division of Global HIV&TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA 5: College of Health Sciences, University of Nairobi, Nairobi, Kenya
Publication date: July 1, 2022
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