1. Introduction
Respiratory illnesses are among the leading causes of morbidity and mortality worldwide, with a particularly significant burden in low- and middle-income countries (LMICs) such as Kenya. Respiratory diseases such as tuberculosis (TB) and pneumonia remain major public health concerns, disproportionately affecting vulnerable populations, including children, the elderly, individuals with compromised immune systems, and people living in poverty.
Despite advancements in treatment and prevention strategies, high transmission rates, delayed diagnosis, and antibiotic resistance continue to pose significant challenges in combating respiratory infections.
This lecture will provide an in-depth analysis of respiratory illnesses in Kenya, focusing on:
- Tuberculosis (TB): Causes, symptoms, transmission, and treatment
- Pneumonia: Causes, symptoms, transmission, and treatment
- Risk factors and prevalence of respiratory illnesses in Kenya
- Control and prevention strategies
- Challenges in managing respiratory diseases
2. Understanding Tuberculosis (TB)
2.1 What is Tuberculosis?
Tuberculosis (TB) is a contagious bacterial infection caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also infect other body parts, including the kidneys, spine, and brain (extrapulmonary TB).
TB is a major global health problem, particularly in Kenya, which is among the 30 high-TB burden countries identified by the World Health Organization (WHO).
2.2 How TB Spreads
TB is an airborne disease, meaning it spreads when an infected person coughs, sneezes, speaks, or sings, releasing TB bacteria (droplet nuclei) into the air. People who breathe in these bacteria may become infected.
2.3 Types of Tuberculosis
There are two main forms of TB:
-
Latent TB Infection (LTBI)
- The bacteria remain inactive in the body.
- The infected person does not show symptoms and cannot spread the disease.
- However, latent TB can become active if the immune system weakens.
-
Active TB Disease
- The bacteria multiply, causing symptoms.
- The person can spread TB to others.
- Requires immediate medical treatment.
2.4 Symptoms of TB
- Persistent cough (lasting more than 3 weeks)
- Coughing up blood or sputum
- Unexplained weight loss
- Night sweats
- Fever and chills
- Chest pain and difficulty breathing
2.5 Diagnosing TB
TB is diagnosed using:
- Sputum microscopy and culture – Examining a sputum sample for TB bacteria.
- Tuberculin Skin Test (TST) – A small amount of TB protein is injected into the skin; a reaction indicates infection.
- Chest X-ray – Helps detect lung damage.
- GeneXpert Test – A rapid molecular test that detects TB bacteria and drug resistance.
2.6 Treatment of TB
TB is treated with a standard six-month antibiotic regimen consisting of:
- Isoniazid (INH)
- Rifampicin (RIF)
- Ethambutol (EMB)
- Pyrazinamide (PZA)
Failure to complete TB treatment can lead to drug-resistant TB (MDR-TB), which is harder to treat.
3. Understanding Pneumonia
3.1 What is Pneumonia?
Pneumonia is an acute respiratory infection that causes inflammation of the air sacs (alveoli) in the lungs, which may fill with pus or fluid, leading to difficulty breathing.
Pneumonia is a leading cause of death in children under five years in Kenya and worldwide.
3.2 Causes of Pneumonia
Pneumonia can be caused by bacteria, viruses, or fungi:
- Bacterial pneumonia – Caused by Streptococcus pneumoniae, Haemophilus influenzae, or Staphylococcus aureus.
- Viral pneumonia – Caused by influenza, respiratory syncytial virus (RSV), or coronaviruses.
- Fungal pneumonia – More common in people with weakened immune systems (e.g., HIV/AIDS patients).
3.3 Symptoms of Pneumonia
- High fever and chills
- Cough with yellow, green, or bloody mucus
- Shortness of breath and chest pain
- Fatigue and muscle pain
- Rapid breathing (tachypnea)
3.4 Diagnosing Pneumonia
- Chest X-ray – Detects lung infection.
- Sputum test – Identifies the causative organism.
- Blood tests – Detects infection levels.
3.5 Treatment of Pneumonia
- Antibiotics for bacterial pneumonia (e.g., Amoxicillin).
- Antiviral medications for viral pneumonia (e.g., Oseltamivir for influenza).
- Supportive care – Oxygen therapy, hydration, and fever-reducing medications.
4. Respiratory Illnesses in Kenya: Prevalence and Risk Factors
4.1 Prevalence of Respiratory Diseases in Kenya
- Kenya has a high burden of TB, with over 120,000 cases reported annually.
- Pneumonia is the leading infectious cause of death among children under five.
- High-risk regions include urban slums and rural areas with poor healthcare access.
4.2 Risk Factors for Respiratory Illnesses
- Poor air quality (indoor and outdoor pollution)
- HIV/AIDS (weakens immunity, increasing TB risk)
- Malnutrition (reduces the body’s ability to fight infections)
- Overcrowding and poor sanitation
- Limited access to vaccines and healthcare
5. Control and Prevention Strategies
5.1 Preventing Tuberculosis
- BCG vaccination (given at birth in Kenya).
- Early detection and treatment to prevent transmission.
- Improved ventilation to reduce airborne spread.
5.2 Preventing Pneumonia
- Vaccination (Pneumococcal Conjugate Vaccine – PCV).
- Good hygiene and handwashing.
- Proper nutrition to boost immunity.
6. Challenges in Managing Respiratory Diseases
- Delayed diagnosis (TB symptoms often mistaken for common colds).
- Drug-resistant TB (MDR-TB and XDR-TB).
- Inadequate healthcare infrastructure in rural areas.
- High costs of pneumonia treatment in low-income households.
End of Lecture Quiz
-
Which bacterium causes tuberculosis?
A) Streptococcus pneumoniae
B) Mycobacterium tuberculosis ✅
C) Haemophilus influenzae
D) Staphylococcus aureus -
How is TB transmitted?
A) Contaminated food
B) Airborne droplets from an infected person ✅
C) Mosquito bites
D) Blood transfusion
Online Resources for Further Learning
- WHO – Tuberculosis: https://www.who.int/health-topics/tuberculosis
- CDC – Pneumonia: https://www.cdc.gov/pneumonia
- Kenya Ministry of Health – Respiratory Diseases: https://www.health.go.ke
Key Takeaways
- TB and pneumonia are leading causes of respiratory illness in Kenya.
- TB is caused by Mycobacterium tuberculosis and spreads through airborne droplets.
- Pneumonia can be bacterial, viral, or fungal and is a leading cause of child mortality.
- Prevention includes vaccination, early detection, and good hygiene.
- Challenges include drug resistance, poor healthcare access, and delayed diagnosis.
