12 January 2016

Kenya: Growing Resistance to Antibiotics a Ticking Time Bomb, Health Experts Warn


You are seven times more likely to die of pneumonia, diarrhoea, gonorrhoea and other diseases that were easily cured in the past, thanks to drug resistance, health experts warn.

For this same reason, some women who undergo caesarian section may die of infections from their wounds.

A report, The State of World's Antibiotics 2015, prepared by the Centre for Disease Dynamics Economics and Policy in Washington in America that was released in October last year, warns that 70 per cent of antibiotics in the world have lost their ability to cure common diseases.

The government is not evangelical about it, and the few times it is mentioned, the magnitude of this ticking time bomb is cocooned in the mouthful of a term: Antimicrobial resistance.

Antimicrobial resistance is used to describe what occurs when disease-causing organisms change in ways that make medicines ineffective in killing them.

Prof Samuel Kariuki, a microbiologist and head of the Centre for Microbiology Research at Kenya Medical Research Institute (Kemri) who contributed to the report warns: "We are gradually running out of options to treat infections that we have in our home settings."

Prof Kariuki has monitored the use of antibiotics in the region for more than two decades.


The World Health Organisation 2013 report on antimicrobial resistance made special mention of seven diseases that have evolved into 'modern plagues' due to drug resistance: sepsis -that is a common blood stream infections--, diarrhoea, pneumonia, urinary tract infections and gonorrhoea.

Ironically most of these are diseases that are responsible for most inpatient in hospitals in Kenya.

These diseases are normally treated successfully within three days to a week, but now they either kill or make patients stay longer in hospital.

The little available data on the levels of resistance in other diseases in Kenya does not offer much hope either.

Kenya's 2011 working group of Global Antibiotic Resistance Partnership (GARP) reported that 75 per cent of diarrhoeal pathogens were resistant to three or more drugs in 2001.

The bacterium Streptococcus Pneumoniae which causes Pneumonia and sometimes meningitis rose from 25 per cent in the 1980s to 43 in 2003; half of severe pneumonia infections were resistant to penicillin in 2005; 60 per cent of Haemophilus influenzae which causes meningitis and other strains of arthritis were resistant to the recommended drug Septrin in 2002.

A study published last year by Prof Kariuki and other microbiologists for the globally acclaimed medical journals' company--Elsevier-- which also publishes the Lancet, reported that the situation has worsened with the pathogen Salmonella now responsible for more than 55 per cent of deaths of children in Africa.

Antibiotics are categorised as first - which are most affordable and used in developing countries, second and third-line.

When a patient does not get well when the first line drugs are used, the doctor gives the second and the third being the strongest and the last option for treatment.

Usually when the third line treatment fails, medics are forced to prescribe a combination of several antibiotics, with fewer chances of success and a host of multiple and adverse side effects on the patient.

However, as Prof Kariuki says, the second and third--they are called carbapenems-- are alternative options that are barely affordable.

For instance, a dose of a drug such as Ceftriaxone used as a broad-range treatment for dangerous diseases such as Meningitis cost more than Sh5,000.

The resistance is a great source of worry for the government as it is a financial health issue as well as a public health scare especially on illnesses that are already choking the healthcare system.

It cost the taxpayer and donors as much as Sh3 million to treat one patient and Sh20,000 for one of the 1.6 million people with HIV.

Several factors have been implicated but in Kenya abuse of antibiotics by people takes most blame.

In an interview with the Nation last year, then president of Pharmaceutical Society of Kenya Dr Paul Mwaniki said there was a direct link between out of pocket expenditure in healthcare and drugs resistance.

"When prescribed medication is worth Sh200 and a patient is not able to afford the whole dose, patients buy half of it for Sh100, saying he will come for the remaining tablets or capsules, but as soon as they feel better, they do not," Dr Mwaniki said.

This haphazard use of antibiotics could be one of the reasons as to why in just ten years, between 2000 and 2010, consumption of antibiotics grew by 30 per cent from 30 billion to 39 billion standard units, according to data WHO collected from 71 countries.

A whopping 80 per cent of these drugs are used in the community where there is not only lack of a medical diagnosis or prescription, but also creates room for inappropriate use on coughs or a cold that just need home remedies.


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