Tuberculosis in Kenya 1984: A third national survey and a comparison with earlier surveys in 1964 and 1974

Abstract

A survey of all patients newly registered in a 6 month period was carried out in 1984 in the same random sample of 11 of the 30 districts in Kenya that were surveyed in 1964 and 1974. Of the 1961 patients included, 85.4% had pulmonary tuberculosis, 12.1% had extra-pulmonary tuberculosis and 2.5% had both. About half (52%) of the 286 patients with extra-pulmonary disease had lymph node involvement, 22% bone and joint disease and 7% meningitis. A sputum specimen was collected from 1159 (67%) of the 1724 patients with pulmonary tuberculosis. Of the patients with no history of previous chemotherapy, 66% of 997 with a smear result and 76% of 981 with a culture were positive; 7.1% of the 748 strains tested were resistant to isoniazid, 0.5% to streptomycin and 1.3% to both drugs (none of these strains was resistant to rifampicin). A comparison of the data with those from 1964 and 1974 suggested that the characteristics of the registered patients and of their disease were, on the whole, similar. Between 1964 and 1974 there had been a modest decline in the estimated annual registration rate of pulmonary tuberculosis; the decline was greatest in children and there was a marked increase in the older age groups. Between 1974 and 1984 there was a further small decline in the overall rate but an increase in the youngest age groups (0–9 years) and in the oldest age group (60 years or more).