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Kimenye K

Magiti E

Nyerere A

Kiplimo R

Kipruto H

Sumumu H

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Prime Journal of Social Science

ISSN: 2315-5051

Volume 6, Issue 2-3, pp. 1458-1466

© Prime Journals  

 

 

Full Length Research

 

 Title

Delay to treatment initiation among Rifampicin resistant tuberculosis patients in Kenya

 

 Author(s)

1*Kamene Kimenye, 1Esther Magiri, 1Andrew Nyerere, 2Richard Kiplimo, 3Hillary Kipruto, and 4Hirao Sumumu

 

 Address(es)

1Jomo Kenyatta University of Agriculture & Technology: JKUAT

2National Tuberculosis Leprosy & Lung Disease Program: NTLD-P

3World Health Organization: WHO

4Research Institute of Tuberculosis: RIT Japan

*Corresponding authorís email: kimaureen@gmail.com

 

 Accepted Date

20th March, 2017

 

 Citation

Kamene Kimenye, Esther Magiri, Andrew Nyerere, Richard Kiplimo, Hillary Kipruto, and Hirao Sumumu (2017). Delay to treatment initiation among Rifampicin resistant tuberculosis patients in Kenya. Prim. J. Soc. Sci. 6(2-3): 1458-1466.

 

 Abstract

Drug resistant TB surveillance aims at early detection and treatment of drug resistant tuberculosis to prevent transmission, morbidity and mortality of those who are infected. The delay to RR TB treatment initiation in Kenya has been undefined and its association to treatment outcomes unknown. To determine association of delay in RR TB treatment initiation and treatment outcomes among patients enrolled on treatment between January 2010 and June 2013 in Kenya. A retrospective cohort review of208 randomly selected RR TB patients, enrolled on treatment between January 2010 and June 2013, was carried out. Delay was defined as the time from sample collection to treatment initiation calculated in days, which was on the right side of the median. Logistic regression was done to establish association between delay to RR TB treatment initiation and treatment outcomes, and factors associated with delay to treatment initiation.Of the 208 patients,63% (130) of the participants were male while 37%(78) were female with a male to female ratio of 1.7:1. The youngest and theoldestwere 2 and 66 years old respectively. The average age at registration was 34.48 years of age [95% CI 32.7,36.3] and an average weight of 50kgs [95% CI: 47.73,50.94]. 26.92% (56) were HIV positive, 95% (53) of them were on ART. Sixty-four percent 65% of the patients were diagnosed based on culture and conventional DST while 35% by GeneXpert. The median time to treatment (delay) was 66 days, with a mean of 99 days to treatment and a range of 0 to 599 days. The treatment success rate was 82% (59% cured, 23% treatment completed). The unfavourable outcomes accounted for 18%. There wasno significant difference between delay orno delay to treatment outcomes as evidenced by X2 = (0.1858), p =0.666 which is more than 0.05. The male patient was 0.03048 times more likely to have unfavourable outcome than the female patient while patients from North Eastern region were23.46 times more likely than patients from the central region to have unfavourable outcomes. Univate analysis showed that use of culture and DST for diagnosis of RR TB was significantly associated with delay to treatment initiation and initiating treatment during the second quarter of the year (P of 0.000 and 0.005 respectively). Delay to treatment initiation among RR TB patients is not associated with treatment outcomes.GeneXpert significantly reduces time to treatment initiation compared to culture and DST. Efforts for early diagnosis and treatment should be enhanced to reduce TB transmission and morbidity.

Key Words:
Delay, RR TB treatment outcomes.

 

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