By James Ratemo
Have been coughing persistently for two weeks? If yes, then you have cause to worry. Just go see the doctor to be sure that your lungs are insured.
It now emerges that many people risk contracting the dreaded Multi Drug Resistant TB disease.
Kenyatta National Hospital CEO, Jotham Micheni attributes this to many infected people who are not under treatment but roaming freely with the disease in the society.
“Out of the 500 people infected, only 80 are currently on treatment with 332 on the waiting list,” he said during the institutions open Day on Thursday.
Each patient suffering from the dreaded multi Resistant TB requires up to Sh1.5 million for treatment with major support coming from the Global Health Fund.
He said the national hospital is grossly under funded to handle all the deserving MDR TB patients with the isolation wing, which is due to competition next month only able to accommodate 15 patients.
According to Dr Henderson Irimi, KNH Head of Respiratory and Infectious Diseases, out of the 80 MDR TB patients on drugs, the national hospital has 39, Moi Referral six and others at Medicines Sans Frontiers centre in Homabay.
This means a lot more patients with the dreaded infection could be out there infecting others and having the disease grow in their systems without knowing.
This strain of TB is highly contagious and is wind borne. This means a cough or sneeze from an infected person could transmit the virus to the surrounding healthy individuals.
“To prevent contracting or spreading MDR TB, live in well-aerated houses.If you cough two weeks consistently seek medical check up just to be sure. Observe coughing etiquette, cover your mouth whenever you cough or sneeze,” advices Irimi.
Patients with MDR TB strain are usually treated under isolation to prevent them from infectiong others thus complicate prevention of the disease.
Unfortunately isolation facilities for such patients is quite expensive and unreachable to many.
KNH for instance, can comfortably acommodate 15 patients in its sh50 million-worth isolation wing due to competition next month.
This is despite the large influx of patients requiring isolation and treatment.
The more one delays to start treatment the more difficult and expensive it becomes to control the disease.
With the current burden on the national hospital and other referral centres in the country, it means the ‘freely roaming’ patients pose danger to themselves and those they live and interact with.
To relieve burden on KNH, Micheni said plans are underway to install centres of excellence across the country;
“Hospitals should not unnecessarily duplicate services. We will set up centres of excellence depending o the disease pattern across the country,” he explained.
For instance, he said, trauma centres will be located along the highways where road carnage is common. This will see number of accident victims admitted at KNH reducing thus giving the hospital staff space to deal with more complicated diseases and cases.
Introducing referral hospitals or centres of excellence across the country will also relieve burden on the national hospital.
Research indicates that a majority of patients who visit KNH could as well be handled at district and other health centres but only choose KNH because they belive that’s where they can get better treatment.
Currently, said Michemi, 90 per cent of patients who flock the referral hospital are self- referred piling unnecessary pressure on KNH staff.
Over 80 per cent of patients who seek treatment at KNH are also not under any medical scheme cover and are jobless hence leaving the burden to pay on the hospital.
The hospital receives less than 20 official referrals everyday but handles between 200 and 300 self-referred patients every day.
The hospital receives Sh3.2 bilion from the Exchequer and collects Sh1.8 billion from cost sharing. This is against its Sh6 to Sh8 billion of its annual budget.
Though with capacity of 1800 beds, the hospital has daily bed occupancy of over 2500 patients and almost 3000 patients are seen daily at the outpatient clinics.
This translates to a workload of about 80,000 inpatients annually and about 600,000 outpatients on annual basis.
The hospital has initiated Information Management as a strategy through the computerization and Internet linkages to provide telemedicine.
“This will provide health care services providers and consumers with timely access to medical data, disease information and the clinical expertise,” said Micheni.
