Delay to Treatment Initiation among Rifampicin Resistant Tuberculosis Patients in Kenya

Abstract

Drug-resistant tuberculosis surveillance attempts to detect and treat drug-resistant tuberculosis as early as possible in order to avoid transmission, illness, and mortality among people who are afflicted. In Kenya, the delay in starting RR TB treatment has not been established, and its relationship to treatment outcomes is unknown. To investigate the relationship between delayed RR TB therapy commencement and treatment results in Kenyan patients enrolled between January 2010 and June 2013. A retrospective cohort review of 208 randomly chosen RR TB patients treated between January 2010 and June 2013 was conducted. Delay was defined as the interval in days between sample collection and treatment beginning that was on the right side of the median. Logistic regression was used to determine the relationship between the delay in starting RR TB treatment and treatment outcomes, as well as the factors related with the delay. The male to female ratio in the 208 cases was 1.7:1. The youngest and oldest were 2 and 66 years old, respectively. The average age at registration was 34.48 years old [95% CI 32.7,36.3] and the average weight was 50kg [95% CI: 47.73,50.94]. 26.92% (56) were HIV +, and 95% (53) were on ART. 64% Culture and traditional DST were used to diagnose 65% of the patients, while GeneXpert was used to diagnose 35%. The average time to therapy (delay) was 99 days, with a range of 0 to 599 days. The treatment was 82% successful (59% cured, 23% completed). Unfavorable outcomes accounted for 18% of all outcomes. As indicated by X2 = (0.1858), p =0.666, which is more than 0.05, there was no significant difference between delayed and undelayed treatment outcomes. Male patients were 0.03048 times more likely to have an unfavorable outcome than female patients, and patients from the North Eastern region were 23.46 times more likely to have an unfavorable outcome than patients from the Central region.  According to a single study, using culture and DST for RR TB diagnosis was substantially linked with delaying treatment beginning and starting treatment in the second quarter of the year (P of 0.000 and 0.005 respectively). Delay in starting treatment is not connected with treatment results in RR TB patients. When compared to culture and DST, GeneXpert considerably lowers time to therapy initiation. Early diagnostic and treatment efforts should be increased to prevent TB transmission and morbidity. Keywords: Delay to treatment, Rifampicin, Resistant, Tuberculosis, Patients