East Africia Partnership

Treatment of Drug Resistant Tuberculosis (MDR TB)

Drug resistant tuberculosis is spreading rapidly. In Kenya, there was a 600% increase in MDR-TB last year. According to UNITAID, “Treating MDR TB is a lengthy, expensive and extremely challenging process. It requires patients to submit to arduous treatment carrying many side effects for up to two years.” UNITAID states that fewer than 2.5% of the approximately 500,000 people with MDR-TB receive appropriate treatment and fewer than 5% of cases are identified. In Kenya, the provincial ministries of health are surveying those who have TB and HIV and there is a high incidence. Of the 289 patients with MDR TB diagnosed last year, only 14 are on treatment due to the high cost of treatment. Dr. Mboloi, from the Moi Hospital in Eldoret stated that Kenya is very susceptible to a growing number of MDR TB cases because “in many rural clinics, most TB cases would pass for malaria. This leads to resistance when the patient is finally put on TB drugs (ibid).”

The East Africa Partnership (EAP) has been establishing health centers in remote areas of Kenya and Tanzania to treat the local population. Each center addresses the needs of 25,000 mostly nomadic people. Each center is equipped with laboratory equipment for the diagnosis of TB. Each year we treat 2-5 people with TB each week at our health centers, many of whom have not responded to first-line antibiotics available through the government in Kenya for $91. Many of these patients are from nomadic tribes, such as the Maasai, who will not go to the designated hospitals for treatment. They walk back and forth from their village to the dispensary or chemist shop to get treatment or medications, exposing their family and village to TB, until they succumb to the disease. The government cannot afford the $19,637 to provide second-line drugs.

As part of our goal of providing for the needs of the people of this region, the EAP has proposed a clinical trial to show that a drug combination used effectively in humans in Russia and Eastern Europe to treat MDR TB can used to make first line antibiotics effective in the treatment of this growing disease. One of the primary advantages of treating MDR TB with these first line drugs is the lower cost of treatment for the Kenyan government and the availability of these drugs.

This proposed project involves: 1) testing for TB and the drug resistant strain at local health centers in 2-4 hours using a new testing procedure that can detect TB and its resistant strain at the local health facilities within 2 hours. Upon detection, we can then provide a simple treatment regimen three times a day with return visits every two weeks to monitor progress. This program can be used by all tribes in Kenya, including nomadic people, without requiring their presence at a large treatment hospital. This ability to treat Kenyans with MDR TB will provide a method of increased compliance and a higher success rate in the treatment of this disease. The EAP has been able to successfully treat 100% of the people resistant to RMP and >30% of the people resistant to INH. The use of this new medical treatment, along with first line drugs, provides the first real opportunity for the Kenyan government to treat cases of MDR TB in a cost-effective manner and for those Kenyans in remote areas. If this drug trial is successful in Kenya, this drug can be used to treat other resistant diseases such as pneumonia, strep, staph and malaria. The success of this drug trial will not only save numerous Kenyan lives at a lower cost, it will also usher in the ability of the Kenyan government to successfully treat those members of their Kenyan family that live in remote places and don’t have the availability of immediately accessible health care facilities for multiple drug-resistant diseases.

501(c)3 # 27-0570704