Distribution patterns of drug resistance Mycobacterium tuberculosis among HIV negative and positive tuberculosis patients in Western Kenya
Introduction:
Globally anti-tuberculosis drug resistance is one of the major challenges afecting control andrnprevention of tuberculosis. Kenya is ranked among 30 high burden TB countries globally. However there is scantyrninformation on second line antituberculosis drug resistance among tuberculosis patients.
Objectives:
this study aimedrnat determining Mycobacterium tuberculosis drug resistant strain distribution pattern in 10 counties of Western Kenyarnamong HIV positive and negative patients
Methodology:
A cross-sectional study was conducted in Western Kenya which comprises 10 counties. A multistage sampling method was used where a single sub-county was randomly selected followed by sampling one high volumernhealth facility from each sub-county. Consenting study subjects with at least two smear positive sputum at the timernof enrolment were randomly selected. The collected sputum was decontaminated with N-acetyl-l-cysteine-sodiumrnhydroxide NALC-NaOH and then stained with Ziehl Neelsen Stain before visualizing the presence of bacilli underrnmicroscope at 100 magnifcation with oil immersion. Further the identifed bacilli were cultured and susceptibilityrntest carried out using known frst and second line antimycobacterial tuberculosis. HIV testing was carried out usingrnDetermine HIV-1/2 rapid test Abbot Diagnostics Maidenhead United Kingdom. Those who had smear convertedrnwere dropped from the study. Finally drug susceptibility pattern across the 10 counties of Western Kenya wasrnevaluated.
Findings:
Results:
Our study showed that Mycobacterium tuberculosis drug resistance among HIV negative and positive casesrnin Western Kenya was prevalent in all the 10 counties surveyed. Based on the drug susceptibility tests 53.2 andrn42.7 of the study samples were resistant to at least one antituberculosis drug among HIV negative and HIV positivernpatients respectively. The data analysis revealed that among the HIV-positive and HIV-negative patients resistance tornINH was predominant 28.5 and 23.6 respectively followed by RIF 16.4 and 14.6 respectively. Second-linerndrug resistant strains identifed among HIV negative patients included Ethionamide 0.3 Gatifoxacin 0.3 Amikacin 0.3 and Capreomycin 0.3. There was no second line drug monoresistance among HIV positive TB patients.rnMulti/poly drug resistance were noted among HIV-negative patients in INHAMK 0.7 INHPZA 1 INHGFXrn0.7 INHETO 0.7 STYETO 1 ETHETO 1.0 INHKAN 0.7 and INHCAP 0.7 strains/cases at95 confdence interval. Among HIV positive patients INHGFX 1.1 INHETO 0.4 and INHKAN 0.4rnstrains of M. tuberculosis were identifed with a confdence interval of 95. Geographical distribution patterns analysisrnof M. tuberculosis drug polyresistant strains across the 10 counties were recorded. Among HIV TB patients resistantrnstrains were identifed in Nyamira INHGFX INHKAN Bungoma ETOSTY Busia ETHETO and STYETOrnHomabay RIFAMK. ETOETH and ETOSTY Kisumu ETHETO and PZAETO and in Kakamega Kisii andrnVihiga INHKAN and RIFAMK. There was no M. tuberculosis polyresistant strain identifed in Migori and Siayarncounties. Among HIV positive TB patients M. tuberculosis resistant strains were identifed in three counties NyamirarnINHKAN Homabay INHGFX and INHAMK and Kakamega INHGFX. There was no polyresistant M. tuberculosis strain identifed in Migori Bungoma Kisii Vihiga Busia Siaya and Kisumu Counties.
Conclusion:
Drug resistant M. tuberculosis strains prevalence is stillrnhigh among HIV negative and positive patients in Western Kenya with the most afected being HIV negative TBrnpatients. It is therefore probable that the existing controlrnmeasures are not adequate to control transmission ofrndrug resistant strains. Further miss diagnosis or delayedrndiagnosis of TB patients could be contributing to thernemergence of M. tuberculosis drug polyresistant strain
Publication Information
Author(s):
Focus County(s):
Bungoma County
Programme Area(s):
Infectious and Parasitic Diseases
Research Priority Area(s):
Disease Domain(s):
TB HIV/AIDS
Document History:
Publication Date: 22.Dec.2021
Conference Title:
Venue: