The analysis indicates most Kenyans being diagnosed with drug-resistant TB have never taken anti-TB drugs, and are HIV-negative.
Half of the new patients also have normal body weight, which shows healthy people are increasingly vulnerable to the infection.
Most of the new cases are being reported in Nairobi, particularly in the most populous Embakasi subcounty.
Outcomes for patients with drug-resistant TB (DRTB) are poor and only 27 per cent are cured each year in Kenya.
“It is crystal clear the DRTB is now more of a menace than it was thought before. Patients who have never taken anti-TBs, have normal BMI (body mass index) and are HIV negative are vulnerable to DRTB,” said James Maragia, the county medical laboratory coordinator at Turkana.
He presented the results at the recent Kemri Annual Scientific and Health Conference.
“Nairobi leads with the highest of DRTB cases emanating from public facilities,” he said.
The analysis is based on the 2021 tuberculosis annual report, which shows that most new DRTB patients had never taken anti-tuberculosis drugs, an indication of active community transmission of the resistant strains.
Drug-resistant TB bacteria are resistant to at least one of the first-line existing medications, resulting in fewer treatment options and increasing mortality rates. In Kenya, the death rate is nine per cent.
They are spread the same way that drug-susceptible (ordinary) TB is spread — through the air from one person to another.
But in many other parts of the world, the majority of DRTB are from patients with ordinary TB who fail to stick to a treatment plan.
Previous reports have also shown that drug-resistant TB has increased by 40 per cent in Kenya despite the global picture showing a downward trend by 22 per cent.
Maragia’s analysis is titled 'Active Community Transmission for Drug-Resistant Tuberculosis: Are We Safe?” It has not been peer-reviewed.
The analysis shows males (66.8 per cent) aged 24 to 44 account for most DRTB cases. The majority (68.7 per cent) are HIV-negative. Nutritionally, patients with a BMI of less than 18.5 accounted for most of the cases, with a proportion of 46 per cent, closely followed by people with normal BMI, recording 44.1 per cent.
“Accurate diagnosis and treatment should be available and accessible to all eligible clients, regardless of their previous anti-TB drug interaction and interruption,” Maragia said.
The data also showed an increase in multi-drug resistance to two of the most important TB drugs, isoniazid (INH) and rifampicin (R).
The study showed 57.5 per cent of the patients had bacteria resistant to Rifampicin while 29 per cent were resistant to Isoniazid.
“Poor outcomes were recorded where the death rate stood at 9.1 per cent, the cure rate at 27.5 per cent and loss to followup at 3.1 per cent,” Maragia reported.
All counties recorded new cases except Lamu. Nairobi accounted for 14.8 per cent, with the Embakasi sub-county leading with 5.1 per cent. This is closely followed by Meru (7.9 per cent), Mombasa (7.1 per cent), Embu (7.1 per cent) and Nakuru (5.4 per cent).
Most cases are identified at public facilities (83.6 per cent), a few in private facilities (9.7 per cent) and least some at prisons (1.8 per cent).
Generally 2020, marked by the Covid-19 outbreak, contributed the highest number of new DRTB cases (39.4 per cent), while 2019 accounted for the lowest (25.1 per cent).
Patients with drug-resistant tuberculosis can be treated over six months with an oral regimen, according to a treatment regimen that the World Health Organization recommended last year.
The new regimen allows countries to treat patients with either BPaLM (a combination of bedaquiline, pretomanid, linezolid and moxifloxacin) or BPaL (bedaquiline, pretomanid and linezolid).
Previously, patients were put on nine-month or longer regimens or injections in multidrug-resistance patients aged below 15 who have not had previous exposure to bedaquiline, pretomanid and linezolid.
(Edited by V. Graham)
