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Dexamethasone now key drug for local Covid-19 patients

Health & Science - By Gatonye Gathura | November 15th 2020 at 12:00:00 GMT +0300

Dexamethasone has become the drug of choice for treating severely ill coronavirus patients in Kenyan hospitals.

The first clinical study to be published by the Ministry of Health on the treatment of Covid-19 in Kenya says dexamethasone is the preferred drug in private and public hospitals.

“As more data become available, dexamethasone became standard of care for severely ill patients on oxygen or requiring mechanical ventilators,” reads the study published last Thursday on the online medRxiv platform.

The study led by Loice Achieng, head of infectious diseases unit at Kenyatta National Hospital (KNH), involved data from 787 Covid-19 patients treated in six public and private hospitals between March and September this year.

The hospitals included KNH, Mbagathi Hospital, Coast General Teaching and Referral Hospital, Nairobi Hospital, Aga Khan University Hospital and Avenue Hospital in Nairobi.

The research authors, including Director-General of Health Patrick Amoth, said by adopting dexamethasone, also known as Dexamed, local hospitals have stopped using earlier treatments such as the antibiotic azithromycin and the antimalarial hydroxychloroquine.

Dexamethasone, which is on Kenya’s list of essential medicines for the treatment of various common conditions including arthritis, allergies, asthma, blood, skin and other disorders is readily available, easy to use and reportedly cheaper than recent Covid-19 alternatives.

It comes in oral and injectable versions. A 10-day ampoule costs about Sh140 locally.

According to the World Health Organisation (WHO), Dexamethasone is a corticosteroid used in a wide range of conditions for its anti-inflammatory and immuno-suppressant effects.

It was tested in hospitalised patients with Covid-19 in the United Kingdom’s national clinical trial and was found to have benefits for critically ill patients.

According to preliminary findings shared with WHO, and now available as a pre-print, for patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth.

The new ministry report says the country is still experiencing problems accessing newer medications being used in rich countries such as remdesivir. “Access to novel antivirals is still poor in the country,” says the report.

Kills men

The 21-page study, however, has few new insights including some facts that the disease is less severe in Kenya and Africa than elsewhere.

It also asserts that it kills more men than women; kills much older persons and those with other chronic diseases.

“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,” reads the report.

On why men are dying more, the team suggests it may be because of their high risk behaviour including smoking and possibly other genetic differences yet to be identified.

It also suggests the disease may have been less severe in Kenya due to the younger population compared to America and Europe.

The study, however, recommends strategies be identified to protect older persons with chronic illnesses to minimise further loss of lives.

But even as the number of daily Covid 19 deaths hits a new high in the country, the Pharmacy and Poisons Board has approved the experimental use of radiation in the treatment of severe Covid-19 patients at the Aga Khan University Hospital in a new survey.

The study, which will involve 20 patients, will investigate whether low dose radiation therapy can be safely administered to patients with severe Covid-19, and if this can improve outcomes in critically ill patients.

At the same time, the first application in Kenya to conduct clinical trials on the use of herbal products derived from citrus fruits for the experimental treatment of Covid-19 is in the offing.

The application on WHO's global Covid products development tracker has been made by a little known group called EMKSE Phytochem and Thermosystems EA which is based in Nairobi. The group is proposing to work with Kenya Medical Research Institute to test its products on 200 participants.

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