Kenya has a large burden of TB and in 2004 was ranked tenth among the twenty-two countries that collectively contribute about 80% of the world's TB cases. The case notification rate increased from 57/100,000 in 1985 to 325/100,000 in 2005 with an average annual increase ranging from 12 to 16% over the same period. As in the rest of sub-Saharan Africa this large increase in TB is attributed primarily to the Human Immunodeficiency Virus (HIV).

The TB case detection rate however remains low at about 50% (according to WHO estimates), which means a large number of TB patients may not be diagnosed or are diagnosed but not reported and therefore probably not treated with the recommended drug regimens. With a HIV prevalence of about 60% in TB patients with a low case detection rate, TB transmission continues to increase within the communities. There is need to strengthen TB screening amongst PLHWA's and in all sites offering HIV treatment and care. The mode of TB presentation in PLWHA is complicated and requires additional skills and knowledge to be picked. This has immensely contributed to low TB case detection in these populations.

As in other countries, Kenya has been pursuing the 70% case detection and 85% treatment success rates which when achieved and sustained are predicted to have a significant epidemiological impact on the burden of TB. However in high HIV prevalence areas modeling results suggest that achieving these targets is difficult. Achievement of the global targets to reverse the trend of TB incidence in high HIV prevalence populations as applies to Kenya will not be possible without the collaboration of the two control programs.