A Cough That Won't Go Away: When to Test for TB
A cough lasting two weeks or more could be TB. Learn the signs, how TB testing works, why treatment is free in Kenya, and where to get assessed in Nakuru North.
- Written by
- Primegala Clinical Team
- Published
- Reading time
- 5 min read
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Short answer: A cough that lasts two weeks or more, especially with fever, night sweats or weight loss, should be checked for tuberculosis (TB). Testing usually starts with a sputum (phlegm) sample, and TB testing and treatment are free under Kenya's national TB programme. TB can be cured when the full course of medicine is taken, usually for six months.
It starts as "just a cold" after a chilly morning on the shamba or a long matatu ride. A week later the cough is still there. By the third week there have been cough syrups from the chemist, ginger and lemon tea, and a household that has grown used to the sound at night. Many people wait far too long before asking whether it could be something more.
What are the signs of TB?
TB is caused by bacteria that most often affect the lungs, although it can affect other parts of the body too.
| Sign | What to look for |
|---|---|
| Cough | Lasting two weeks or more, with or without phlegm |
| Coughing blood | Any blood or blood-stained phlegm |
| Fever | Often in the evenings, coming and going |
| Night sweats | Waking up with damp clothes or bedding |
| Weight loss | Clothes becoming loose without trying |
| Tiredness | Feeling weak and losing your appetite for weeks |
| Chest pain | Pain when breathing in or coughing |
In children, TB may show as a long-lasting cough or fever, poor weight gain, or being less playful than usual. People living with HIV should have any cough, fever, night sweats or weight loss checked, however long it has lasted.
Who is more at risk?
- People living with HIV
- Anyone who lives or works closely with someone who has TB
- People with diabetes or poor nutrition
- People who smoke or drink alcohol heavily
- Young children and older adults
- People in crowded homes or workplaces with little fresh air
How does TB testing work?
- A clinician asks about your symptoms and examines you.
- You may be asked for a sputum sample: phlegm coughed up from deep in your chest, not saliva, into a clean container.
- The sample is tested in a laboratory. In Kenya, a rapid molecular test is widely used that can also show whether the TB is resistant to a key medicine.
- A chest X-ray or other tests may be needed, especially for children and people living with HIV.
- An HIV test is offered to everyone diagnosed with TB, because the two infections are closely linked.
How long does TB treatment take?
Most people take treatment for six months. Many feel better within a few weeks, but the bacteria are still there.
- Take every dose, every day, even after you feel well.
- Don't stop early. Stopping can bring TB back and lead to drug-resistant TB, which is harder and longer to treat.
- Keep every follow-up appointment so your progress can be checked.
- Report side effects such as yellow eyes, a rash or vomiting to your health worker instead of stopping on your own.
- Eat well and rest. Good nutrition supports recovery.
Once you are on the right treatment, the risk of passing TB to others usually falls within a few weeks. Your health worker will advise you.
How to protect your family
- Get household contacts screened, even if they feel well. Young children and people living with HIV may be offered medicine to prevent TB.
- Cover your mouth and nose with a tissue or your elbow when you cough or sneeze.
- Let fresh air in. Open windows and doors at home, and in vehicles where you can.
- Wear a mask around others if your health worker advises it, especially in the early weeks of treatment.
- Don't spit on the ground. Use a tissue or a container and dispose of it safely.
- Make sure babies get the BCG vaccine at birth, as part of Kenya's routine immunisation schedule.
TB and HIV
HIV weakens the body's defences, which makes TB more likely to develop and more serious. TB is one of the most common serious illnesses in people living with HIV. If you are living with HIV, regular TB screening and taking your HIV treatment every day help protect you. If you don't know your HIV status, read what to expect at an HIV test.
When to seek care urgently
Come in immediately, at any hour, or call 999 or 112, if someone:
- Coughs up more than a small streak of blood
- Has severe difficulty breathing or chest pain
- Is confused, very weak or unable to eat or drink
- Is a young child with a cough and fast breathing, or skin sucking in under the ribs
How Primegala can help
If you have had a cough for two weeks or more, don't wait for it to clear on its own. Our clinicians at Maili Sita, opposite Kiamaina Primary School, can assess you and arrange testing or referral, and help link you to free treatment through the national TB programme if TB is confirmed. We are open 24 hours. Walk in or book a visit, and learn about our laboratory and HIV testing and counselling.
At Primegala
Laboratory Services
Common blood, urine and stool tests on site, with fast results.
- Open 24 hours, every day, including public holidays
- Maili Sita, opposite Kiamaina Primary School
- SHA accepted for eligible services
Frequently asked questions
Is TB testing and treatment free in Kenya?
Yes. Under Kenya's national TB programme, TB testing and treatment are provided free of charge at public and participating facilities. A clinician can tell you where to go if you need testing or treatment.
Can TB be cured?
Yes. Most TB can be cured with a full course of medicines, usually taken for six months. Stopping early, even when you feel better, can make the illness come back and can lead to drug-resistant TB.
Should my family be tested if I have TB?
Yes. Everyone who lives with a person who has TB of the lungs should be screened, even if they feel well. This is especially important for children under five and anyone living with HIV.