Alarm as antibiotics lose power to cure

As near as end of this year, diseases that had been conquered by advances in medicine could kill many Kenyans if the power of available antibiotics is not preserved, experts have warned.

Due to Antimicrobial Resistance (AMR ) — a scientific term that means antibiotics are losing their power to cure — pneumonia, diarrhoeal infections and other common illness that ail Kenyans will no longer be treatable.

Concerns over AMR dominated discussions within the science community late last month, when a  global report commissioned by British Prime Minister David Cameron revealed that  this resistance will claim 10 million extra lives each year and cost the global economy 64 trillion pounds in the next 35 years.

Because of imprudent use of antibiotics by Kenyans, wrong prescription by healthcare workers, failure to take entire prescribed dosage and abuse caused by over-the-counter purchase of drugs — AMR has bred a new apocalyptic surge of modern plague, said Professor Sam Kariuki, the director of the Centre for Microbiology Research at the Kenya Medical Research Institute.

RESISTANCE TO ANTIBIOTICS

Historically, Kenya has experienced its fair share of resistance to antibiotics on diseases that have caused headaches for the government, according to the 2011 report from Global Antibiotic Resistance Partnership (Garp) analysis in Kenya.

This is a threat that comes when there has not been new inventions of antibiotics in 25 years.

In 1998, 50 per cent of the strains of typhoid fever were resistant to the recommended antibiotics — Ampicillin, Chloramphenicol, Tetracycline, Streptomycin and Cotrimoxazole — and that figure rose to 82 in certain parts of Thika, Embu and Nairobi by 2002.

There is not much hope in figures observed in other gastrointestinal infections, even now.

Because of the mobile nature of bacteria, strains that cause havoc in Asia have been found in Kenya.

He stated: “No one may be talking about this now, but in the near future, the deaths will cause a public health crisis everybody will have to notice”.

DIE OF WOUNDS

Due to AMR, routine medical interventions such as common surgeries, among them caesarean section births and hip replacement, which rely on prophylactic antibiotics to prevent infections, will become very dangerous.

“Mothers will die of the wounds,” stated Prof Kariuki.

Other procedures that suppress the immune system such as radio and chemotherapy will equally be dangerous.

In this discourse blame is apportioned with caution.

Some people, Prof Kariuki said, fail to take the full dosage because of lack of awareness of the harm caused by taking half the dose in the long term, and others can only afford half the medication.

Other people buy drugs over the counter because they had a previous experience of disease mimicking the signs they experience; others buy drugs because they cannot access a qualified medical personnel who will charge them for consultation and lab tests.

The above mentioned medical seeking behaviours, coupled with weak pharmaceutical policies that create loopholes for untrained and unlicensed people to sell drugs, is an ingredient for disaster.

POOR KNOWLEDGE

Knowledge about the use of the drugs is also poor among healthcare workers.

Studies have shown that three out of four medical workers in district hospitals prescribe antibiotics that would ideally be used for very severe cases of pneumonia on very subtle cases of the disease.

Just like WHO, Prof Kariuki cites the solutions to the crisis as sparing use of the available drugs and gearing health towards preventive medicine that would involve vaccine and hygiene.

National studies conducted by Kemri in collaboration with international  health organisations show that resistance to drugs meant to treat deadly strains of bacteria that cause diseases such as dysentery had risen to as high as 100 per cent.

Dr Patrick Oyaro, the director of Kemri’s HIV management branch — Family Aids Care and Education Services (Faces) — reported 254 new infections of Multi-drug Resistance Tuberculosis in 2013 alone.

These were initially normal cases of TB. Then the patient defaulted on taking their first line medications, which usually take six months, and developed the more virulent multi-drug resistant TB.

Dr Oyaro says that this data paints a picture that is both a medical as it is a financial issue because up to 20 contacts will be infected by one infectious TB case.