TB patients held in police cells for defaulting on treatment

Kenyan government officials have defended the arrest and incarceration of two men infected with multi-drug resistant tuberculosis (MDR-TB), who failed to adhere to their treatment.



For more than a week, the two men have been held in police remand in Kapsabet town in Rift Valley Province for “posing a risk to the health of the wider community”. Under the Public Health Act, they can be held until the district medical officer who ordered their arrest decides they are no longer a public health threat.



"Safeguarding public health supersedes an individual's right to comfort and these two not only had an infectious disease but were also failing to take their drugs as prescribed," said Joseph Sitienei, head of the National Leprosy and TB Control Programme. "They were not only endangering their lives but also those of other people."



He added that the law was very clear on what a public health officer should do in such cases.



The Public Health Act authorizes public health officers to take whatever action they deem necessary - including detaining infectious patients - to prevent the spread of diseases.



Infectious TB patients are often placed in isolation wards in government hospitals, but Sitienei noted that not all hospitals had isolation wards.



Raising concerns



However, some HIV/AIDS activists have expressed concern about the men's arrest.



"Quarantine for tuberculosis [TB] patients is allowed, but to put these people in a police remand cell is bad for them considering the deplorable conditions in these cells and the health of the two," said Nelson Juma Otwoma, the national coordinator of the Network of People Living with HIV/AIDS in Kenya (NEPHAK).



NEPHAK is calling for the two men to be released and placed in a medical facility.



"What is important is that they are isolated from the public; whether this is done in a health facility or in police remand, they will continue to receive their treatment and they will be monitored," Sitienei said.

More on TB

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XDR-TB: Is forced isolation the cure?

Turning the tide against drug resistant TB

Stigma holding back the fight against TB

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Local health officials are supposed to notify higher level authorities when patients are diagnosed with MDR-TB so that their movements can be monitored and cases of transmission minimized.



Kenya ranks 13th on the UN World Health Organization's list of high-burden TB countries; an estimated 40 percent of HIV-positive Kenyans are also infected with TB. According to Sitienei, while more than 500 Kenyans have been diagnosed with MDR-TB, fewer than half are receiving treatment.



Each MDR-TB case costs the Kenyan government an estimated US$21,000 to treat compared with $80 for patients with non-resistant TB. MDR-TB often develops as a result of patients on first-line TB drugs not completing their six-month course of treatment.



"It is now clear that there is a reason to create more awareness among the public on the need to adhere to treatment, especially for infectious diseases like TB," said Sitienei.



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