Prevalence, Trends and Risk Factors of Infections in Post Renal Transplant Recipients in Kenyatta National Hospital

Abstract

Background: Infections in post renal transplant recipients remain a major concern despite advances in medical care post procedure. They are significantly higher compared to hospitalizations arising from allograft rejection. Broad objectives: To determine the prevalence, trends and the associated risk factors of post renal transplant infections Methodology: A retrospective cross-sectional study was conducted. This study was carried out at the renal unit of Kenyatta National Hospital. One hundred and seven renal transplant recipients’ files who had attended the clinic over the past five years were randomly selected. The patients were above 18 years of age. Data collection and analysis: Data on socio demographics and clinical characteristics were taken from the patient files and recorded in the data collection forms. These were analyzed with STATA version 13. Descriptive statistics were presented in tables and figures. Bivariate and multivariate regression analyses were done to determine the independent predictors. The level of significance was set at P ≤ 0.05. Results: The mean age of study participants was 41.3 (±12.5) years. Most of the study participants came from Nairobi county (20, 18.69%) followed by its neighboring counties like Murang’a (13, 12.15%). Bacterial infection (92, 86.97%) had the highest prevalence among the study population followed by viral (10, 9.43%) and fungal infections (4, 3.77%). Most bacterial infections occurred in less than six months into the post renal transplant period (29, 50%) while viral (16, 94.12%) and fungal infections (10, 83.33%) were most prevalent in more than 18 months. Female sex and diabetes mellitus were independent predictors of infections in renal transplant recipients. Conclusion: Infections in renal transplant recipients are still a major concern following the procedure in KNH. All patients with infections were treated. Most bacterial infections were experienced during the few first months of the post transplantation period. Most viral and fungal infections emerged in late stages of post renal transplant. Diabetes and female sex were identified as independent predictors of infections in renal transplant recipients post procedure. Recommendations: We recommend regular screening for infections in renal transplant recipients post procedure. Besides, culture and sensitivity should be done among those identified with infections.