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Background: Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis. Anti-tuberculosis drug resistance is an emerging health problem in Kenya and especially in Coastal region. This is a major challenge in tuberculosis control. Diagnosis is based on Ziel-Neelsen staining alone and patients are treated without information on sensitivity patterns.Aim: This study aimed to determine drug susceptibility patterns of Mycobacterium tuberculosis in Coastal Kenya. Study Design: Hospital and laboratory based cross-sectional study was carried between April 2015 and July 2016 at Coast General Referral hospital; Tudor, Port-Reitz, Likoni Sub-County hospitals; Mlaleo, Kongowea and Mikindani health centers. Methodology: Sputum samples from patients with bacteriological confirmed TB on microscopy were cultured on Lowenstein Jensen (LJ) media. Strains of MTB complex from Lowenstein Jensen (LJ) slopes were subjected to drug susceptibility testing (DST) to first-line drugs including isoniazid (H), rifampicin (R), streptomycin (S) and Ethambutol (E) using proportional method on the Mycobacterium Growth Indicator Tube (MGIT) conventional method. Participants were offered diagnostic testing and counselling for HIV testing. Results: Drug sensitivity test was performed for a total of 210 Mycobacterium tuberculosis isolates for the first line anti-TB drugs. About seventy eight percent and twenty nine percent of the strains from new patients and previously treated patients were fully sensitive to all the drugs tested respectively. Prevalence of any resistance to one drug was 102 (48.6%, 95% CI: 20.45 -28.23). Any single drug resistance was most frequent in isoniazid 30 (16.0%), Ethambutol 20 (10.0%), Streptomycin 18 (18.3%) and Rifampicin 4 (2.1%) in newly diagnosed patients. Among previously treated patients any resistance to streptomycin, ethambutol, isoniaziad and rifampicin was 10 (58.8%), 9 (52.9%), 7 (41.2%) and 4 (23.5%) respectively. Prevalence of MDR-TB defined as resistant to at least both isoniazid and rifampicin was 10 (4.8%) among new and previously treated patients respectively. Conclusion: The current study reveals that the overall resistance to first line anti-TB drugs was high. Although the rate of MDR-TB was relatively low, this signifies that conditions favouring the spread of MDR-TB are on high rise. Therefore, it is essential to address the problems of development of drug resistant strains of TB by establishing good TB programmes (DOTS). Patients' adherence to anti-TB drugs and introducing drug sensitivity testing (DST) services at County level hospitals will minimize occurrence of drug resistant.

Background: Tuberculosis is an infectious disease with an estimated 2 million deaths every year. In 2013 the estimated global burden of disease was 9 million cases. Many patients get infected as a result of ignorance of the risk factors that contribute to disease transmission. Aim: This study was aimed to determine the risk factors in pulmonary tuberculosis among patients attending various clinics in Mombasa. Study Design: Hospital and laboratory based descriptive cross-sectional study was carried between May 2012 and May 2013 in Coast Provincial General Referral hospital (CPGH), Tudor, Port-Reitz, Mlaleo, Likoni and Mikandani districts and Sub-districts hospitals. Yonge et al.; IJTDH, 13(4): 1-10, 2016; Article no.IJTDH.23621 2 Methodology: Tuberculosis was diagnosed following standard clinical bacteriological and radiological procedures. Sputa from 500 tuberculosis suspects underwent mycobacteriologic evaluation using Ziel Nelsen smear microscopy, Lowenstein and Jensen and BACTEC MGIT 960 culturing. Consenting participants were screened for HIV infection by enzyme -linked immunosorbent assay. Patients were required to respond to a structured questionnaire on risk factors for transmission. Data collected from group were compared using univariate and multivariate analysis. The level of significance was set at p<0.05 and for each statistically significant, odds ratios and confidence interval were computed. Results: A Total, 210/500 (42%) of the suspects had mycobacterial disease and 78/210 (37.1%) were HIV co-infected. There were significantly more females than males associated with pulmonary tuberculosis infection (χ 2 =4.26, df=3; p<0.001). Monthly income was significant in disease with 130 (61.9%) of patients earning less than 5000 per month (2.65 (OR=2.65; 95% CI: 1.40-6.23, p<0.041). HIV (OR=2.18; 95% CI: 1.03-4.65, p<0.034), smoking (OR=2.16; 95% CI: 0.13-1.39, p<0.041) and overcrowding (OR=2.71; 95% CI: 1.41-5.62, p<0.051) were also statistically significant risk factors for pulmonary tuberculosis. Conclusion: Among TB patients in Mombasa Kenya, there was high prevalence of the TB risk factors. Effort should be given in creating awareness of the risk factors associated with TB transmission in order to reduce the rate of infection. Original Research Article

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