Drug resistant tuberculosis in Kenya: trends, characteristics and treatment outcomes, 2008 – 2016
Background: Drug resistant (DR) tuberculosis (TB) remains a major public health concern. Failure to treat patients with TB adequately increases the risk of transmission of infection to the general population. Treatment of DR TB is characterized by lengthy treatment duration, use of toxic and less effective drugs and high likelihood of adverse treatment outcomes that include adverse drug reactions, high mortality and loss to follow up.
Objective: To determine the trends, characteristics and treatment outcomes of patients >15 years notified with DR‐TB in Kenya from 2008 to 2016
Design: Retrospective descriptive cross‐sectional study
Setting: Tuberculosis treatment centers in Kenya
Subjects: Persons above 15 years notified with DR TB
Results: We reviewed records of 1903 DR‐TB patients who were notified between 2008 and 2016. The public sector made the highest contribution of the notified cases (80%). Most of the cases were male (62.3%). The HIV testing rate was 99.5%, with the TB/HIV co‐infection being 36%. Initiation of antiretroviral therapy among those who tested positive for HIV was 94.6%. Co‐trimoxazole preventive therapy uptake was 99.3%. Most patients had secondary DRTB (77.3%). Multi‐drug resistant TB accounted for 78.4% of the DR TB cases while mono drug resistance was observed in 26% of the cases. Treatment success was achieved in 79% of the cases. Mortality and treatment failure during the study period was 11% and 0.2% respectively.
Conclusion: An upward trend in notified DR‐TB cases was observed during the period under review. The public sector gave the most contribution. Active surveillance on patients lost to follow up while on treatment and poor drug adherence will be of importance to reduce the potential of development of drug resistance.