dc.contributor.author | Kinyua, Roseline K | |
dc.date.accessioned | 2013-06-03T13:29:35Z | |
dc.date.available | 2013-06-03T13:29:35Z | |
dc.date.issued | 2007 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/28770 | |
dc.description.abstract | ABSTRACT
Background The Kenyatta National Hospital continues to receive an increasing number of
patients who have been diagnosed to have tuberculosis (pulmonary and extra pulmonary) as
reflected by the number of new daily registrations at the TB clinic and the overall new entries
made at the records department from both the inpatients and outpatient clinical departments.
Globally the TB pandemic has been compounded by high levels of anti-tuberculous drug
resistance including multidrug resistant TB (MDR - TB). In Kenya the level of total drug
resistance is still less than 10%. However certain population groups have been found to have a
disproportionately higher prevalence of anti-tuberculous drug resistance including pockets of
MDR- TB recently reported in Nairobi . Besides , the city of Nairobi is inhabited by different
population groups from both within the country and the neighboring countries. The Kenyatta
National Hospital serves as a national referral hospital and a primary health care center for the
Nairobi residents. Objective: The primary objective was to determine the prevalence of resistance
to all the four first line anti-tuberculous drugs and the resistant patterns of the individual drugs as
well as to the various combinations of these drugs. The secondary objectives were to determine the
demographic and socioeconomic characteristics of those with either of the strains (sensitive or
resistant) and the co-morbid factors including HIV infection that may be associated with drug
resistance. Study Design: A prospective study that involved culture and drug sensitivity testing of
the first line anti-tuberculosis drugs (streptomycin, isoniazid, rifampicin, ethambutol) using ,
Lowestein Jensten culture media (conventional method) and resistant ratio method to analyze all
sputum samples Our study population consisted of patients with pulmonary tuberculosis who
attended the tuberculosis outpatient clinic or were admitted to any of the general wards. The
diagnosis for tuberculosis was made either by a positive sputum smear microscopy for Ziehl
Neelson staining or positive microbiological (culture) method from 1st June 2007 to 30th
September 2007 at the Kenyatta National and Referral Hospital, Nairobi Kenya. Results: The
following rates of resistance were found in the 81 samples tested: total resistance was 34%,
isoniazid mono-resistance was 30%, isoniazid + rifampicin 2.5%,resistance to all the four drugs
2.5%. There was no difference in the demographic and socioeconomic characteristics among those
with the resistant and sensitive strains. No difference was found in the HIV status between the two
populations (those with the resistant and sensitive strains). Other co-morbid factors associated with
the resistant strains were not statistically significant and were considered to be possible incidental
associations. Conclusion: These data show higher total drug resistance and isoniazid monoresistance
rates than those found at the Kenyatta National Hospital, in previous studies. The trend
of MDR-TB has not been well defined. However drug resistance and especially MDR-TB in the
context of the high prevalence of HIV in the study population should be closely monitored. | |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.subject | Drug resistance | en |
dc.subject | Anti-tuberculous | en |
dc.subject | Kenyatta National Hospital (KNH) | en |
dc.title | The level and pattern of anti-tuberculous drug resistance at the Kenyatta national hospital | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | School of Medicine, University of Nairobi | en |