Infection rates and correlates of Non-Tuberculous Mycobacteria among Tuberculosis retreatment cases In Kenya

Abstract

Kenya is ranked among top African countries with high TB cases coupled with high HIV/AIDS burden. The TB problem has been compounded by the emergence of non-Tuberculous mycobacteria (NTM) as opportunistic infections in the HIV/AIDS patients, and their treatment is not directly analogous to that of TB. This cross sectional study characterized and identified the correlates of NTM among TB retreatment patients attending NTRL. The TB retreatment patients with BACTEC MGIT culture positive samples were consented and enrolled into the study. The patients' health record and structured interviews were used to gather information associated with NTM infection.The median (IQR) age of the 210 TB retreatment patients' enrolled was 35 (28-75) years. Majority 53.8% were females, 32.2% were aged ≥40 years, 18% were smokers, 22% HIV positive. About 37% had respiratory symptoms while 36.2% had animal contact. Eighty nine 89 (42.4%) of them were infected with NTM with M. intracellulare 47/75 (67%) being the most responsible for NTM infection. Female gender OR 1.8 (95%CI 1.1 to 3.1), Eastern region OR 2.2 (95%CI 1.1 to 4.6), Central region OR 2.3 (95%CI 1.1 to 5.1), animal contact OR 1.7 (95%CI 1.1 to 2.7) and livestock keeping OR 1.6 (95%CI 1.06 to 2.6) were associated with NTM infection.Infection due to NTM among TB retreatment cases is high in Kenya and missed diagnosis jeopardizes proper management. Involvement of NTM during management of clinical pulmonary TB is important in planning for prevention and treatment of TB in Kenya especially among patients with animal contacts.