Poor health-seeking habits, alcohol use, and substance abuse also identified as key drivers of infection among 15–24-year-olds in Kenya.
Health officials have urged Kenyans to reconsider attending political rallies and other large gatherings to reduce new tuberculosis infections, warning that crowded spaces are driving a disease that kills between 10,000 and 20,000 people in the country every year.
Dr Immaculate Kathure, National TB Programme Manager at the Ministry of Health (MoH), issued the caution during the dissemination of findings from four recent studies on TB in Kenya.
“Tuberculosis spreads through aerosolised droplets (fine spray of bacterial droplets). Its transmission is very high, not just election crowds but every situation of crowds,” she said.
Kenya records over 120,000 new TB infections annually. Cabinet Secretary Aden Duale confirmed that 90,900 Kenyans were diagnosed and initiated on treatment in 2025, representing 81 per cent of Kenya’s TB burden. The remaining 19 per cent reflects people living with undetected TB who continue to infect others.
Dr Kathure acknowledged that political campaigns cannot simply be called off, but said the government had a duty to act. “Campaigns are inevitable, but we have a responsibility to minimise the risk. Research has established that those infected with TB stop being infectious after two weeks of treatment,” she said.
TB among Kenyans aged 15 – 24 years accounted for 15% of about 95,000 new TB cases annually
Findings from the Light Consortium, a six-year cross-disciplinary global health programme funded by UKAID and the Liverpool School of Tropical Medicine in collaboration with Kenyan partners from 2020 to 2026, highlighted a worrying concentration of TB cases among Kenyans aged between 15 and 24 years, who accounted for 15 per cent of at least 95,000 new TB cases annually.
The four studies, carried out with the National Tuberculosis, Leprosy and Lung Disease Programme and research and implementing partners, examined barriers to TB care among adolescents and young adults, TB-related stigma, how social, legal and gender-related issues affected access to services, and what young Kenyans knew and believed about the disease.
What they found was a generation that knows TB exists but holds deeply wrong beliefs about it. Stigma, poor health-seeking habits, alcohol use, and drug and substance abuse were identified as key drivers of infection in this age group.
Eunice, 22, who asked to be identified by one name, described how her TB diagnosis was delayed by three months. She first visited a pharmacy in her Eastlands neighbourhood and was given cough syrup. When the cough persisted, a health centre diagnosed her with tonsillitis and pneumonia and put her on antibiotics. It took two more months and three facility visits before she was finally diagnosed with TB. By then, she had unknowingly exposed her family, schoolmates and community.
Her story was not unusual. The studies found that 73 per cent of people with TB symptoms did not undergo tests, missing the opportunity for early diagnosis and treatment.
TB is a disease like any other. It does not necessarily mean everyone who has TB has HIV
One study used national data from TIBU, Kenya’s TB digital reporting platform, spanning 2017 to 2022. Another constituted Kenya’s first-ever national TB stigma survey, conducted in 2023. Together, they pointed to system failures and negative attitudes as the main obstacles standing between sick young people and the care they need.
“There is so much stigma, and the young people don’t want to be associated with a disease like tuberculosis. They need to normalise conversations around TB because it’s not something to be ashamed of. It’s a disease like any other and does not necessarily mean that everyone who has TB has HIV,” Dr Kathure said.
The studies confirmed that TB and HIV co-infection is far from universal. Recent data from TIBU showed that 75 per cent of TB cases were not co-infections with HIV. Yet the association persists in public perception, compounding reluctance to seek testing.
Prof Jeremiah Chakaya, a globally recognised TB and lung disease researcher at the Centre for Respiratory Diseases Research at the Kenya Medical Research Institute, reinforced the call to normalise TB. “We must destigmatise TB. It’s an airborne disease, and anyone can get it. When we normalise conversations about TB like malaria, hypertension and diabetes, people will easily seek treatment in time,” he said.
Greatest drivers of TB deaths are malnutrition and co-infection with HIV, alcoholism
Alcohol was identified as a particularly serious compounding factor. Dorcas Kiptui, Head of the Tobacco and Alcohol Control Unit at the Ministry of Health, was explicit about its role. “This group engages in high-risk behaviours like alcoholism and substance abuse. The greatest drivers of TB deaths are malnutrition and co-infection with HIV, but alcoholism contributes to a lot of deaths,” she said.
According to the National Institute of Health and Centre for Health Solutions Kenya, alcohol weakens the immune system by impairing the cells vital for fighting TB bacteria, damages organs including the liver, causes poor nutrition, and reduces treatment adherence, in turn raising the risk of drug-resistant infections.
Despite the barriers to reaching care, treatment outcomes among those who did complete it were strong. The studies reported a treatment success rate of 92 per cent among those aged 15 to 19 and 89 per cent among those aged 20 to 24. However, the studies also found that 42 per cent of presumptive TB cases were not tested at all, representing a large pool of people who never entered the care pathway.
Dr Kathure urged young Kenyans to visit hospitals when they experience symptoms and reassured them that they would be treated respectfully. “People need to go for free checkups and early treatment available in our public facilities,” she said.
In Indonesia, all ministers give monthly reports on efforts to reduce TB infections and deaths
To reach young people where they are, health officials proposed using social media platforms such as TikTok. Dr Kathure was characteristically direct about the strategy. “When TB is integrated in the school curriculum, the learners will remind their older relatives that the teacher told them people who cough for over two weeks need to go for TB tests in hospitals. For the young people, if it means me having a TB dance on Tik-Tok I am ready. We’ll get them where they are,” she said.
Partners at the dissemination event, held on March 16, at a hotel in Nairobi, called on county governments and corporate entities to invest in TB control to complement the 70 per cent currently financed by the national government. The stakeholders also called for plans to leverage school children’s advocacy and social media outreach.
There was a call for Kenyan legislators and the executive to treat TB reduction as a top health priority, pointing to Indonesia as a model of political accountability. In Indonesia, all ministers give monthly reports on efforts to reduce TB infections and deaths.
Indonesia ranks second globally for TB cases after India. The WHO Global Tuberculosis Report 2025 estimated that 10.7 million people worldwide fell ill with TB, with Indonesia accounting for 10 per cent of those cases.
Kenya’s own burden, while large, is not static. Treatment is free, facilities are expanding, and the evidence base is growing. What is now needed, researchers and officials agreed, is the political commitment and sustained public investment to act on it.
