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Mycobacterium Tuberculosis (TB) is a major public health concern causing over a billion deaths in the last 200 years. Several countries have been affected, with the incidence projected to increase due to COVID-19. The WHO's global strategy to End TB recommends several strategies to support global efforts, including engaging private facilities to diagnose and treat TB.TB reporting and documentation remain a challenge, with gaps between the number of new cases and the number reported/under-reported due to a mixture of underreporting and underdiagnoses. In Kenya, patient pathway analysis reveals that patients sought care in formal and informal private hospitals. However, underreporting TB notification among private facilities has not yet been systemically evaluated.This study targeted private facilities in Meru, Mombasa, Kilifi, Nyeri, and Kirinyaga counties to assess actual levels of TB underreporting, improvement in TB yield with strategic support, and patient characteristics.Study findings show low screening for TB. However, the strategic management of private facilities resulted in increased case notification, especially among children and men.The researcher recommends the need to strengthen reporting of data by age and gender. The author also proposes prospective research while collecting age and gender data to inform the actual situation based on identified gaps.

This study compares client volume, demographics, testing results, and costs of 3 ‘‘mobile’’ HIV counseling and testing (HCT) approaches with existing ‘‘stand-alone’’ HCT in Kenya. A retrospective cohort of 62,173 individuals receiving HCT between May 2005 and April 2006 was analyzed. Mobile HCT approaches assessed were community-site mobile HCT, semimobile container HCT, and fully mobile truck HCT. Data were obtained from project monitoring data, project accounts, and personnel interviews. Results: Mobile HCT reported a higher proportion of clients with no prior HIV test than stand-alone (88% vs. 58%). Stand-alone HCT reported a higher proportion of couples than mobile HCT (18% vs. 2%) and a higher proportion of discordant couples (12% vs. 4%). The incremental cost-effectiveness of adding mobile HCT to stand-alone services was $14.91 per client tested (vs. $26.75 for stand-alone HCT); $16.58 per previously untested client (vs. $43.69 for standalone HCT); and $157.21 per HIV-positive individual identified (vs. $189.14 for stand-alone HCT). Conclusions: Adding mobile HCT to existing stand-alone HCT seems to be a cost-effective approach for expanding HCT coverage for reaching different target populations, including women and young people, and for identifying persons with newly diagnosed HIV infection for referral to treatment and care.

To describe and evaluate the establishment of the first VCT services for the Deaf in Africa.Operational research methods were used to document programme establishment. The demographics of deaf VCT clients were compared with hearing clients at the same sites as well as where clients had learned of the service, HIV risks, and HIV test results. Univariate and multivariate analyses were used.During the two year period (January 2004 to December 2005) 1709 Deaf and 1649 hearing clients were seen at three Deaf VCT sites. The majority of Deaf clients in this sample learned of the services through the peer education programme. Data indicate that Deaf VCT clients are as much at risk of HIV from sexual transmission as their hearing counterparts and that Deaf persons seeking VCT services have an HIV prevalence of 7%, similar to the national rate of 6.7%.The Deaf in Kenya are at risk of HIV and there is an urgent need for Deaf-friendly HIV services, supplemented by peer education programmes. This is the first published report describing HIV services run by the Deaf for the Deaf in the developing world.