ENYA— A new study by the Kenya Medical Research Institute (KEMRI), Ministry of Health, and Amref Health Africa has revealed severe stigma against tuberculosis (TB) patients in Kenya, identifying it as a primary reason many patients default on their medication. 

The details emerged from a KEMRI study titled “Mental health issues associated with the management of tuberculosis in Homa Bay, Busia, and Kakamega counties, Kenya,” published in April by the PLOS ONE journal. 

The study elaborated, “Negative societal beliefs about TB and HIV co-morbidities appear to contribute to TB stigmatisation in society.” 

Such beliefs lead to social exclusion and self-stigmatisation among TB patients, reducing their self-esteem and increasing the likelihood that they will hide their TB status out of shame or guilt. This, in turn, raises the risk of TB transmission within communities 

The study investigated the prevalence and impact of mental health issues in TB patients in Kenya.  

It involved 127 TB patients and 30 healthcare workers (HCWs), revealing that 66 percent of TB patients experience anxiety and 55 percent suffer from depression, particularly during the presumptive stage of TB.  

The researchers identified stigma as the biggest source of mental health problems for patients. 

One patient reported avoiding disclosing their TB status due to fear of being assumed to have HIV as well. “It was easier to suffer in silence than to face the shame and isolation,” the patient remarked. 

The psychological toll of TB is compounded by the lack of mental health support integrated into TB care programs.  

The authors noted that healthcare workers were not adequately trained to handle the mental health issues associated with TB.

This lack of training makes healthcare workers focus primarily on the physical treatment of TB, sometimes overlooking the emotional and mental needs of their patients.  

This gap in training and resources often leads to missed signs of depression and anxiety, resulting in substandard patient care. 

Kenya reports at least 90,000 tuberculosis cases annually, with 18,000 deaths each year, according to the Ministry of Health.  

In 2022, the country reported 97,000 cases, as per the National TB Programme Annual Report, 2023. 

Despite these challenges, the KEMRI study also highlighted the positive impact of support structures on TB management.  

Patients reported that encouragement, reminders to take medication, accompaniment to clinics, and financial support were crucial in their treatment journey. 

The study calls for integrating mental health care into TB programs, stressing that a holistic approach is essential for improving treatment outcomes.  

As a result, the researchers recommended that healthcare systems prioritize training healthcare workers to identify and manage mental health issues in TB patients. 

 This includes providing psychosocial support packages and raising community awareness to reduce stigma.  

The authors emphasized that addressing the dual stigma and mental health challenges faced by TB patients is vital not only for their well-being but also for controlling the spread of the disease. 

The study concluded by noting that integrating mental health care into TB programmes and fostering supportive communities can significantly enhance the quality of life for TB patients and improve treatment adherence. 

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