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Factors Contributing to Drug Resistant Tuberculosis: A Case Study of Tuberculosis Patients Attending Rift Valley Provincial General Hospital Nakuru, Kenya

Received: 26 August 2014     Accepted: 19 March 2015     Published: 6 May 2015
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Abstract

Tuberculosis remains a major cause of morbidity and mortality in Kenya. The main challenges compounding Tuberculosis control include drug resistant tuberculosis, Human Immunodeficiency Virus /Acquired Immunodeficiency Syndrome (HIV/AIDS) co-infections and the declining funding for tuberculosis control among others. Factors such as non-adherence to therapy, poor drug quality or poor prescribing practices have been reported to contribute to Drug Resistance TB. The study aimed at establishing factors that contribute to development of Drug Resistant Tuberculosis among patients on TB treatment attending the Rift Valley Provincial General Hospital, Nakuru. The study employed a cross-sectional descriptive survey of patients with tuberculosis. Primary data was collected using semi structured questionnaire while secondary data was retrieved from the patient’s treatment records. Clearance to conduct the study was sought from the Hospital Authorities and written consent obtained from the participants. Data was analyzed using computer Statistical Package for Social Science. Fifty three percent of the study participants were in the 21 – 40 years age brackets while the male to female ratio was 5:4. Majority (61.3 %) of the patients were co-infected with HIV/AIDS and 42.5 % were new smear positive pulmonary tuberculosis (PTB), 23.7 % were smear negative PTB or Extra-Pulmonary tuberculosis (EPTB), 28.5 % were retreatment and/ or relapse while 4.3 % were chronic and/ or multi-drug resistant tuberculosis (MDR-TB). Eighty five percent of the participants adhered to treatment while patients beginning to feel better was cited as the major factor (42.5 %) leading to non-adherence to treatment. High percentage of tuberculosis - HIV/AIDS co-infection and high prevalence of tuberculosis among women was observed in this study. There need for impact assessment of the 2007/ 2008 post-elections violence on the spread of TB and development of MDR-TB in the affected parts of Rift Valley Province.

Published in Science Research (Volume 3, Issue 3)
DOI 10.11648/j.sr.20150303.11
Page(s) 45-52
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Mycobacterium Tuberculosis, Drug Resistant, Treatment, Adherences, Rift Valley Provincial General Hospital

References
[1] World Health Organization Global Tuberculosis Report 2013. www.who.int (Accessed on 5th May 2014).
[2] Warker R. and Edward C. The Chemotherapy of Tuberculosis. Clinical Pharmacy and Therapeutic. 3rd Edition. Churchill Livingstone. 2004, pp 583-93.
[3] Ministry of Health: National Leprosy and Tuberculosis Guideline (MOH/NLTP), 2005. http://www.nltp.co.ke/docs/National_NLTP_Guideline.pdf (Accessed on March 19th, 2014)
[4] Osterberg L. and Blaschke T. Adherence to Medication: A Review. New England Journal of Medicine 2005, 353: 487 – 497.
[5] Zignol M., Hosseini M.S., Wright A., Lambregts–van Weezenbeek C., Nunn P., Watt C.J., Williams B.G., and Dye C. Global incidence of Multi-Drug resistant Tuberculosis. Journal of infectious diseases. 2006, 194(4):479 – 485.
[6] Chan E.D., Laurel V., Strand M.J., Chan J.F., Mai-Lan N. H., Goble M., and Iseman M. D. Treatment and Outcome Analysis of 205 Patients with Multidrug-resistant Tuberculosis. American Journal of Respiratory and Critical Care Medicine 2004, 169(10): 1103 – 1109.
[7] World Health Organization, 2008. Guidelines for the programmatic management of drug-resistant tuberculosis. Emergency update 2008. WHO/HTM/TB/2008.402 http://whqlibdoc.who.int/publications/2008/9789241547581_eng.pdf
[8] World Health Organization Report, 2010. Global Tuberculosis Control. www.who_reports/reports/Global_Tuberculosis_Control_2010.pdf (Accessed on 5th May 2014).
[9] Ministry of Public Health and Sanitation (MPHS), 2010. Guidelines for the Management of Drug Resistant Tuberculosis in Kenya. Division of Leprosy, Tuberculosis and Lung Disease, Ministry of Public Health and Sanitation.
[10] Slama K., Tachfouti N., Obtel M., Nejjari C. Factors associated with treatment default by tuberculosis patients in Fez, Morocco. Eastern Mediterranean Health Journal 2013, 19(8): 687 – 693.
[11] Kaona F.A.D., Tuba M., Siziya S. and Sikaona L. An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC Public Health 2004, 4:68
[12] Odusanya O.O. and Babafeni O.J. Patterns of delays among pulmonary tuberculosis patients in Lagos, Nigeria. BMC Public Health 2004, 4: 17.
[13] Ministry of Health: National Leprosy and Tuberculosis Guideline (MOH/NLTP), 2006. National Leprosy and Tuberculosis Program Guidelines. Nairobi, Kenya
[14] Ministry of Health: National Leprosy and Tuberculosis Guideline (MOH/NLTP) Annual Report, 2007. Nairobi, Kenya
[15] Ponyk R.M., Makhubele M.B., Hargreaves J.R., Tollman S.M., Hausler H.P. Assessing health seeking behaviour among tuberculosis patients in South Africa. International Journal of Tuberculosis and Lung Disease 2001, 5(7): 619 – 627.
[16] Kenya Demographic and Health Survey (KDHS), 2003. Kenya Central Bureau of Statistics (CBS), Ministry of Health (MOH) Kenya, and ORC Macro. 2004. Calverton, Maryland: CBS, MOH, and ORC Macro.
[17] Saira Z., Tyaba H., Khawaja T.M. Socioeconomic Factors Contributing to Multidrug-Resistant Tuberculosis (MDR-TB). Journal of Biomedical Science and Research 2010, 2 (4): 279-283.
[18] Ngamvithayapong J., Winkvist A. and Diwan V. High AIDS awareness may cause tuberculosis patient delay: results from an HIV epidemic area, Thailand. AIDS 2000, 14: 1413 -1419.
[19] Frieden T.R. and Sbarbaro J.A. Promoting adherence to treatment for tuberculosis: the importance of direct observation. Bulletin of the World Health Organization 2007, 85(5): 407–409.
[20] Sharma S.K., Mohan A. Multidrug-Resistant Tuberculosis: A Menace That Threatens To Destabilize Tuberculosis Control. Chest 2006, 130(1): 261 – 272.
[21] Patrice J., Patrice S., Severine F., Kye Seng G., Christophe S., David W.H., Warren D.J., Nalin R., Pape J.W., Fitzgeral D.W. Multidrug-resistant tuberculosis at an HIV testing center in Haiti. AIDS 2006, 20: 415 – 418.
Cite This Article
  • APA Style

    Lucia Kipkoech Keter, Silas Kandie Cherogony, Richard Kipserem Korir, Charles Mutai. (2015). Factors Contributing to Drug Resistant Tuberculosis: A Case Study of Tuberculosis Patients Attending Rift Valley Provincial General Hospital Nakuru, Kenya. Science Research, 3(3), 45-52. https://doi.org/10.11648/j.sr.20150303.11

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    ACS Style

    Lucia Kipkoech Keter; Silas Kandie Cherogony; Richard Kipserem Korir; Charles Mutai. Factors Contributing to Drug Resistant Tuberculosis: A Case Study of Tuberculosis Patients Attending Rift Valley Provincial General Hospital Nakuru, Kenya. Sci. Res. 2015, 3(3), 45-52. doi: 10.11648/j.sr.20150303.11

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    AMA Style

    Lucia Kipkoech Keter, Silas Kandie Cherogony, Richard Kipserem Korir, Charles Mutai. Factors Contributing to Drug Resistant Tuberculosis: A Case Study of Tuberculosis Patients Attending Rift Valley Provincial General Hospital Nakuru, Kenya. Sci Res. 2015;3(3):45-52. doi: 10.11648/j.sr.20150303.11

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  • @article{10.11648/j.sr.20150303.11,
      author = {Lucia Kipkoech Keter and Silas Kandie Cherogony and Richard Kipserem Korir and Charles Mutai},
      title = {Factors Contributing to Drug Resistant Tuberculosis: A Case Study of Tuberculosis Patients Attending Rift Valley Provincial General Hospital Nakuru, Kenya},
      journal = {Science Research},
      volume = {3},
      number = {3},
      pages = {45-52},
      doi = {10.11648/j.sr.20150303.11},
      url = {https://doi.org/10.11648/j.sr.20150303.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sr.20150303.11},
      abstract = {Tuberculosis remains a major cause of morbidity and mortality in Kenya. The main challenges compounding Tuberculosis control include drug resistant tuberculosis, Human Immunodeficiency Virus /Acquired Immunodeficiency Syndrome (HIV/AIDS) co-infections and the declining funding for tuberculosis control among others. Factors such as non-adherence to therapy, poor drug quality or poor prescribing practices have been reported to contribute to Drug Resistance TB. The study aimed at establishing factors that contribute to development of Drug Resistant Tuberculosis among patients on TB treatment attending the Rift Valley Provincial General Hospital, Nakuru. The study employed a cross-sectional descriptive survey of patients with tuberculosis. Primary data was collected using semi structured questionnaire while secondary data was retrieved from the patient’s treatment records. Clearance to conduct the study was sought from the Hospital Authorities and written consent obtained from the participants. Data was analyzed using computer Statistical Package for Social Science. Fifty three percent of the study participants were in the 21 – 40 years age brackets while the male to female ratio was 5:4. Majority (61.3 %) of the patients were co-infected with HIV/AIDS and 42.5 % were new smear positive pulmonary tuberculosis (PTB), 23.7 % were smear negative PTB or Extra-Pulmonary tuberculosis (EPTB), 28.5 % were retreatment and/ or relapse while 4.3 % were chronic and/ or multi-drug resistant tuberculosis (MDR-TB). Eighty five percent of the participants adhered to treatment while patients beginning to feel better was cited as the major factor (42.5 %) leading to non-adherence to treatment. High percentage of tuberculosis - HIV/AIDS co-infection and high prevalence of tuberculosis among women was observed in this study. There need for impact assessment of the 2007/ 2008 post-elections violence on the spread of TB and development of MDR-TB in the affected parts of Rift Valley Province.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Factors Contributing to Drug Resistant Tuberculosis: A Case Study of Tuberculosis Patients Attending Rift Valley Provincial General Hospital Nakuru, Kenya
    AU  - Lucia Kipkoech Keter
    AU  - Silas Kandie Cherogony
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    AB  - Tuberculosis remains a major cause of morbidity and mortality in Kenya. The main challenges compounding Tuberculosis control include drug resistant tuberculosis, Human Immunodeficiency Virus /Acquired Immunodeficiency Syndrome (HIV/AIDS) co-infections and the declining funding for tuberculosis control among others. Factors such as non-adherence to therapy, poor drug quality or poor prescribing practices have been reported to contribute to Drug Resistance TB. The study aimed at establishing factors that contribute to development of Drug Resistant Tuberculosis among patients on TB treatment attending the Rift Valley Provincial General Hospital, Nakuru. The study employed a cross-sectional descriptive survey of patients with tuberculosis. Primary data was collected using semi structured questionnaire while secondary data was retrieved from the patient’s treatment records. Clearance to conduct the study was sought from the Hospital Authorities and written consent obtained from the participants. Data was analyzed using computer Statistical Package for Social Science. Fifty three percent of the study participants were in the 21 – 40 years age brackets while the male to female ratio was 5:4. Majority (61.3 %) of the patients were co-infected with HIV/AIDS and 42.5 % were new smear positive pulmonary tuberculosis (PTB), 23.7 % were smear negative PTB or Extra-Pulmonary tuberculosis (EPTB), 28.5 % were retreatment and/ or relapse while 4.3 % were chronic and/ or multi-drug resistant tuberculosis (MDR-TB). Eighty five percent of the participants adhered to treatment while patients beginning to feel better was cited as the major factor (42.5 %) leading to non-adherence to treatment. High percentage of tuberculosis - HIV/AIDS co-infection and high prevalence of tuberculosis among women was observed in this study. There need for impact assessment of the 2007/ 2008 post-elections violence on the spread of TB and development of MDR-TB in the affected parts of Rift Valley Province.
    VL  - 3
    IS  - 3
    ER  - 

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Author Information
  • Kenya Medical Research Institute, Mbagathi Road, NAIROBI, Kenya

  • Kenya Medical Training College, NAIROBI, Kenya

  • Kenya Medical Research Institute, Mbagathi Road, NAIROBI, Kenya

  • Kenya Medical Research Institute, Mbagathi Road, NAIROBI, Kenya

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