The Ebola drug remdesivir has been the most used trial medicine in the treatment of Covid 19 patients at Nairobi Hospital in Kenya.
However, despite being the only approved drug for the treatment against the virus, it has not been found very beneficial at this top-tier private hospital.
In a study involving 326 hospitalized Covid 19 patients in an eight-month period, remdesivir was the most used among several trial medicines. “Remdesivir was the commonest investigational drug and was administered to 39 patients.”
Other trial drugs included chloroquine and hydroxychloroquine in a few patients while the arthritis drug tocilizumab had been administered only to three patients. The few patients put on tocilizumab, the study suggests was due to its high cost.
“However, neither the use of remdesivir nor antibiotics improved the outcomes of the patients,” says the study.
Majority of the patients 273 or about 83 per cent of study participants did not receive any drugs associated with the treatment of Covid 19.
Consequently the authors: Kizito Mariita of Nairobi Hospital, Angela Wanjala of the Mission for Essential Drugs and Supplies and Carol Maina of the University of Nairobi say Covid 19 treatment at the hospital was mainly supportive.
Supportive treatment, the study published in May in the African Journal of Pharmacy and Pharmacology says had included antibiotics and the steroid dexamethasone.
The patients were mainly managed with paracetamol, ascorbic acid, anticoagulants, antihistamines, and cough syrups, in that order of frequency.
Among the study participants, 32 died with 283 recovering while 11 were transferred to other hospitals.
Most likely to die were older patients and those having multiple comorbidities and severe illness. While the majority of the patients were males there was no gender difference in reported deaths. However, being male increased the likelihood of being admitted to the ICU
Hypertension was the most prevalent comorbidity which had been diagnosed in 95 of the study participants.
Sixty-five of the patients had diabetes while 36 had both hypertension and diabetes. A few patients reported having chronic respiratory conditions including asthma.
In the absence of Covid 19 treatment, the authors emphasize on the need for elderly people especially those with comorbidities to take all necessary precautions to prevent infection.
This is the second study on the clinical treatment of Covid 19 in Kenya covering six public and private hospitals and posted on the preprint server medRxiv in November last year.
The earlier study published by the Ministry of Health involved data for 787 Covid-19 patients treated between March and September last year.
Despite being one of the few clinical studies from the continent; almost seven months on the preprint is still awaiting review.
This underlines the difficulties Africans face in the publication of their studies internationally and especially in high impact journals owned and dominated by the West.
Similar to the new study the earlier work had found higher deaths among older patients and those with heart comorbidities.
Almost half of the patients admitted in the six hospitals had other diseases, including heart conditions 17 per cent; diabetes 15 per cent; HIV 7 per cent; cancers 4 per cent; kidney disease 3 per cent; and respiratory ailments at three per cent.
By Gatonye Gathura
The new study is available here: https://doi.org/10.5897/AJPP2021.5233