Factors associated with sputum conversion time among patients with drug-resistant tuberculosis in Kenya

Abstract

Background: Drug-resistant tuberculosis (DR-TB) is a form of antimicrobial resistance that is difficult and costly to treat. It is caused by TB bacteria that are resistant to at least one of the first-line existing TB medications, resulting in fewer treatment options and increasing mortality rates. Treatment for this form of TB, known as DR-TB, requires a minimum of 18-24 months of treatment with drugs that are less effective, more toxic, and more expensive than those needed for drug-susceptible TB.

Methods: This was a retrospective review of secondary data for patients diagnosed with DR-TB in Kenya from 2014 to 2019. Each patient had a two-year follow-up period to monitor sputum conversion time and the associated factors. The enrolled patients comprised all patients diagnosed with DR-TB within the 47 counties in Kenya and enrolled at any drug-resistant registered treatment center.

Results: A total of 2674 patients were enrolled for review to establish factors associated with conversion and we only found out that the type of resistance a patient enrolled on gender, intensive phase regiment, modification of intensive phase, and waiting time before treatment initiation were the only significant factors that would influence when a patient would convert from being sputum positive to negative.

Conclusions: Patients with resistant TB require correct diagnosis and timely start of medication with good follow-up to avoid being lost to follow-up or failing on the medication started. Additionally, healthcare workers need continuous training to gain more knowledge in case of detection for patients coming to hospitals.