20171201

WORLD AIDS DAY
Today, December 1, marks the World Aids Day. With that in mind, we appreciate the fact that most of theAids patients stand a greater chance of co-infection if predisposed to condition for TB spread. We note,
especially to the CHVs who will be attending the World Aids Day celebrations, to communicate themessages to them, especially when they speak to them at various tents in the stadium. I had written a shortmessage to be given to the HIV patients, on how to prevent themselves from the infection of TB.
TB, when in the body of a patient with HIV, can easily kill the patient. It is, therefore, better to have
prevention than taking medicine for too long to be cured of TB.
We have noted again that the introduction of the bicycles has increased the number of patients referred to
the laboratory. However, we have detected a worrying trend, which I informed Mr. Shikanda about. Mostof the patients take too long to be served, and their results are late. It is ideal that the lab technicians beinformed of their work, very strictly. The quality of the bicycles has been praised, and it has encouraged
access to many places. Over the last two months, the numbers have increased by 67 per month.

HIGH MORTALITY AMONG TB-HIV CO-INFECTED PATIENTSIn the CHV meeting today, we have learned that four patients who had both HIV and TB have passedaway.This information comes at a time when the Kenya government has released statistics for 2016
which portray a very low survival rate for patients with co-infection.
Out of the 53,000 co-infected patients discovered last year, 24,000 died in what the MoH says was as aresult of late diagnosis and treatment. In Kangemi alone, a total of nine co-infected patients have died insince 2016, a fact that confirms the high mortality rate among such patients. It has been advised that HIV
programmes and TB programmes be held together, to facilitate the speedy diagnosis and treatment, hence
reduce the worrying mortality rates.
In the meeting, I have informed Mr. Shikanda, the head of the Kangemi Health centre, to address thematter, as regards HIV and TB infection. Partners working around HIV should be ready to cooperate andrefer the patients for TB testing, as a measure to improve early diagnosis.

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CHV TRAINING CONTENT REVISED
In line with efforts to give better training, to tackle emerging issues, we have revised the content oftraining of CHVs. In this year's training, we shall include a number of lessons which were not covered
previously. We shall pay particular attention to the elimination ofstigma, prompt action towards TB patients, accelerated access to
TB information, and sustained community CHV partnerships.
Much as Kangemi currently leads in the TB statistics in thelaboratory, and the number of patients being treated, we are awarethat there are many more not discovered. It would be pointless totreat people, and when they go home, they stand a risk ofreinfection from patients who have not come for medication.

This focus shall be critical in this training. We shall ensure that the new CHVs work towards zerotolerance to TB. They shall make sure that they go to every hose, and ensure no TB patients has not been
attended to. Further, the CHVs must be at the forefront at eliminating stigma. This is the major reason
why many people with Tb have not come out to be treated. It is our sincere dedication to this project thatwill bear fruit. Together with the Kenya team, I shall be at the forefront in working hard to ensure thishappens, and we kick TB out of Kangemi.

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In a `bid to bring a much more focused team, it is imperative that we have lessons that focus on such facts.
Together with Dr. Asma, I am in the process of preparing lessons that will be incorporated into thetraining, and have the CHV know exactly the roles required of them.
The new lessons will cover the following aspects of their work:
1. The TB-HIV correlation, treatment, and care
2. Stigma and discrimination
3. Infection control and prevention
4.Role of CHVs in a community health system
5.Tracing of defaulters
6.Recording, monitoring, and reporting
7. Epidemiology and Nutrition of patients with TB
With the support of the experienced medical personnel, it is my hope that these will be beneficial, andwill encourage us to have a more vibrant, and knowledgeable CHV group for the anti-TB campaigns.

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ONE CHV SUCCUNBS TO HIGH BLOOD PRESSURE
The CHV community is saddened to reveal the death of one of theirmembers, Elizabeth Waigwa Waweru.
She dies today, 19th December 2017, after ailing for a long time fromHigh Blood Pressure.Ms. Elizabeth was one of the mature CHV
who was from Kangemi central, and has been involved in a numberof Cmmunity volunteer work for the last 15 years.She is survived bya five children, and her husband.
Communication on burial arrangements will be done later since thepreparations are underway.
May she rest in peace.

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TRAINED CHVs TO BEGIN WORK IMMEDIATELY
The first batch of trained CHVs will commence their work immediately after the short break for theChristmas Holidays. Effectively, they will be working in the community from January. Lilian Nyokabi
will be in charge of their supervision, and in that line, she will demand a monthly report from them togauge their performance. Further, we noted that the work they do must be reflected in the statistics in thelaboratory, the drug intake, as well as the discovery of patients from the villages in Kangemi, andreferring them to the facility for testing and treatment. The rest of the training will be carried out nextyear.

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