Drug susceptibility profiles of pulmonary Mycobacterium tuberculosis isolates from patients in informal urban settlements in Nairobi, Kenya
Abstract
Background
Anti-tuberculosis drug
resistance is an emerging health problem in Kenya and especially
in slums. Slum environments create a conducive environment for
the spread of tuberculosis (TB) due to high population density
and lack of basic amenities such as decent housing, access to
clean water, lack of drainage and basic sanitation. Furthermore,
ineffective health services in crowded and poorer populations,
poor patient compliance, a large pool of untreated cases,
delayed diagnosis and inappropriate treatment regimens are
likely to favour selection and spread of drug resistant
Mycobacterium tuberculosis (Mtb) strains in such settings,
however, precise data on this problem are only sparsely
available. To address this question, this study aimed at
determining drug resistance patterns of Mtb strains obtained
from pulmonary TB patients who sought health care in randomly
selected informal settings.
Methods
This is a cross-sectional
study conducted between September 2014 and March 2015, sputum
samples were collected from 223 consenting adult patients and
subjected to primary isolation and drug susceptibility testing.
Socio-demographic data was collected and all data analysed using
SPSS v20.
Results
Drug susceptibility testing
against first line drugs was successfully carried out on 184
isolates. Resistance to at-least one drug was observed in 33 %
of the isolates. The highest prevalence of resistance to any
drug was identified against isoniazid,(INH) (23.9 %) followed by
Ethambutol (EMB) (13.6 %). The highest proportion of mono
resistance was observed against INH, 25 (13.6 %). Multidrug
resistance (MDR) was observed in 4.4 % of the new cases. There
was no significant difference in the proportion of any
resistance by sex, age or previous treatment.
Conclusion
Levels of drug resistance
have reached an alarming level in this population. Capacity of
laboratories to conduct TB culture and DST should be
strengthened in order to adequately manage TB patients and stop
further creation and spread of MDR TB.
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Source:
BMC Infectious Diseases
