The threat of multi-drug resistant tuberculosis (MDR-TB) has been heightened by the displacement of an estimated 300,000 people in Kenya's recent political crisis, health workers have said.

"During the violence, many displaced people were disrupted from their lives, which meant disruption from drugs," said Dr Henderson Irimu, head of the HIV/TB treatment care at the Kenyatta National Hospital, the country's largest referral hospital. "Due to the violence it was impossible for people to come for medication."

Irimu said there had been an increase in MDR-TB, a form of the disease that does not respond to standard treatment, usually because of a failure to complete first-line treatment. When patients are co-infected with HIV, it is often lethal.

"So far we have seven new cases of MDR-TB who were brought at the hospital from Mathare internally displaced settlement [in the capital, Nairobi]," he said. "Some would come and admit to not having taken TB medication since the violence began."

"Patients who were found to have developed resistance to first line medication require to be treated in isolation for a period of four months to reduce the spread, but there is a need for a special clinic or ward facility for MDR-TB," he added.

According to Alice Nyatecho, programme officer at Kenya's National AIDS Control Council, there are a number of reasons for an increase in resistance but, most important is the disruption of lives caused by the violence, triggered by disputed election results in December.

"The internally displaced people's situation is very fluid all over the affected areas," she told IRIN/PlusNews. "The figures are different every other day and this has made it impossible to have a definite figure as to who is on medication and who is not."
"Some of the internally displaced people will move from one camp to another and start off new records all over again," she added. "In the month of February we had 230,000 internally displaced people registered, but three weeks down the line 20,000 left the camps either because some were taken in by their relatives or decided to relocate to another camp or their rural areas."

Congestion and lack of proper sanitation among the displaced only serve to increase new infections, Nyatecho noted, with unidentified infected people potentially sharing the same tent as uninfected individuals, inadvertently passing on MDR-TB.

Kenya is ranked 10th out of the 22 countries in the world that account for 80 percent of the global TB burden. The Ministry of Health has raised the alarm about the need to deal with the rising number of MDR-TB cases, which in addition to being difficult to treat, costs, in many cases, more than $10,000 per patient, compared to about $20 per patient for a course of the regular Directly Observed Treatment Short-Course, DOTS.

An estimated 6.1 percent of Kenyan adults are belived to be HIV positive.

PlusNews