UPTAKE OF NEW TUBERCULOSIS DIAGNOSTICS IN KENYA Back

UPTAKE OF NEW TUBERCULOSIS DIAGNOSTICS IN KENYA

Back ground • Tuberculosis is a disease of public health importance: – its mode of transmission. – The upsurge of drug resistance especially MDR and XDR

WHO TB report 2016 • Estimated MDR/RR-TB cases among 1 300 notified pulmonary TB cases. • MDR/RR-TB cases tested for resistance to second-line drugs 204 • Laboratory-confirmed cases MDR/RR-TB: 326, XDR-TB: 9

Objective • To determine the uptake of tuberculosis diagnostics and uncover the impediments for their implementation

Methodology • Online Survey in - 32 counties • Laboratory Facility questionnaire - 32 counties • In-depth interviews – 8 previous administrative regions (Provinces)

Key findings Ø Preferential coverage of culture and molecular diagnostics o o o Xpert MTB/RIF - 90. 625 % (29/32) Culture -6. 25% (2/32) Line Probe Assay – 0%

Barrier to utilization I • Heath system issues – Human resources issues: Under staffing, – Limited awareness, utilization knowhow and perception to new TB diagnostics – Pathway to care by affected people: patients die before diagnosis is done – Distance from services providing TB diagnosis and treatment

Barrier to utilization II • Prioritization and profits – Low coverage of TB diagnosis and treatment services - tuberculosis care is free and centralized. – Disease suspicion index is low among clinician. • Decision making – Limited stakeholder (Public and staff) involvement in decision making

Solutions to improve the uptake • Knowledge empowerment through public awareness campaigns on equipment availability and training of staff both to improve disease suspicion index and equipment utilization to increase demand. • Infrastructure improvement to accommodate additional diagnostic tools and maintenance program • Increase budget allocation – National and County for tuberculosis management and research • Research to explore the perception of stakeholders that will encourage buy-in