AIDS, poverty worsen Africa's tuberculosis crisis

Fri Mar 24, 2006

By Jack Kimball

NAIROBI (Reuters) - Five-year-old Unis Nyambura waves her yellow lollipop while waiting for treatment in a tuberculosis clinic in Nairobi's sprawling Kibera slum.

Wearing starred pajama bottoms under her green-and-white dress, she grimaces as she waits for an injection. Like many in Africa, Nyambura's TB status is complicated by an HIV infection.

"All the patients who've died here from TB were also infected with HIV," said Winfred Nzioka, a nurse at the African Medical and Research Foundation (AMREF) clinic in the Kenyan slum which is home to one million people.

Africa's TB crisis -- linked to HIV/AIDS, weak health systems and poverty -- is the main reason behind a rise in worldwide infection rates, the World Health Organization (WHO) said this week ahead of Friday's World Tuberculosis Day.

Of the two million people who die from TB every year, 1.5 million are Africans.

Nzioka said about two thirds of TB patients she treats have HIV. The virus attacks the immune system, leaving people far more susceptible to TB.

"Tuberculosis is coming in as an opportunistic infection," she said. "Our patients with TB/HIV normally deteriorate very fast."

AMREF estimates that more than two-thirds of people living with dual HIV/AIDS and TB infections are African.

Tuberculosis is caused by bacteria, which attack the lungs, but can also infect any part of the body. Left untreated, an infected person will pass it on to an estimated 10-15 people.

The disease is airborne, but sunlight and good ventilation can drastically decrease infection rates, health workers say.

BREEDING GROUND

At Kibera's AMREF clinic, the shelves are filled with rectangular medicine boxes labeled in black marker with patients' names.

Barring complications, treatment for TB is an eight-month ordeal. But not all follow through with the entire treatment and scientists warn that drug resistant TB is emerging as a global health problem.

"We are doing all we can to make sure drugs don't develop resistance," Joel Kangangi, head of the WHO's TB program in Kenya said, adding that surveys in the east African country showed resistance was very low.

The WHO says Kenya, which gives out free TB drugs, is making strides in the fight against TB.

But slums like Kibera, where the majority live in cramped and dire conditions, are at great risk of infection. "Poverty has really contributed to the TB spread," Nzioka said.

The canvas bags forming a roof above John Adava allow narrow shafts of light to pour into his small mud-wall house. Adava, who has TB and HIV, lives there with nine other people.

The day before World Tuberculosis Day, Adava said the free drugs from the clinic saved his life, pointing to a picture of his emaciated body nine months before he came to the clinic.

"Were it not for the drugs, we would not be able to celebrate this day alive," he said.

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