Prevalence and Risk Factors of Adverse Drug Reactions Associated Multidrug Resistant Tuberculosis Treatments in Selected Treatment Centers in Addis Ababa Ethiopia

Abstract

Introduction: The key to successful elimination of tuberculosis (TB) is treatment of cases with optimum chemotherapy. Irrational anti-TB drug use over time has led to drug-resistant TB. The treatment of MDR-TB with second line drugs is long, complex and costly, and has a considerable rate of adverse effects. The level of ADR reporting is low in Ethiopia due to different factors. This Study conducted in a selected treated area in Addis Ababa, Ethiopia and helped the health care centers to understand the prevalence of ADR related MDR-TB and be aware of those adverse effects in order to detect them early and be prepared to take proper steps when they occur. Aim of the Study: To determine the prevalence and risk factor of adverse drug reactions associated treatments of Multidrug Resistant tuberculosis. Method: This was a cross sectional study, which was conducted between March 2012 and February 2013 at St. Peter TB specialized hospital and AHRI/ALERT. 73 MDR TB patients, who were on MDR TB treatments, enrolled to the study. Adverse Drug Reactions associated MDR TB treatments were assessed by patient history review and questionnaire. Chemistry laboratory was used to test renal function, thyroid function, liver enzyme and potassium level. Result: In 72 patients, at least two ADRs were found. The mean age of the study population (Mean ± SD) was 28 ± 8.8. In this study the most commonly found adverse * Corresponding author.

Nephrotoxicity and ototoxic symptoms of injectable second-line anti-tubercular drugs among patients treated for MDR-TB in Ethiopia: a retrospective cohort study

“…The analysis of medical records indicates that clinically diagnosed nephrotoxicity accounts for 62 (6.7%) cases while clinically diagnosed ototoxic symptoms were detected in 42 (4.8%) of subjects, of which 16 (1.7%) patients had persistence of such symptoms. This observations are comparable to other studies in the setting which reported prevalence of 8.8% renal insufficiency and 6.0% hearing impairment [21, 38] which reported comparable findings in small cohort of patients. However, ototoxic symptom finding in our study was several times lower than a study from Iran [39] which reported 14.5% auditory toxicity and Pakistan study [40] which reported 21% ototoxicity and a UK study [35] which reported 55% of ototoxicity.…”

“…In Ethiopia, specific studies on two major adverse drug reactions (ototoxicity and nephrotoxicity) associated with use of injectable second-line drugs in patients treated for MDR-TB are scarce. Previous study [21] has reported the prevalence and risk factors of all adverse drug reactions associated with MDR-TB treatment in two treatment centers in Addis Ababa. This study was a cross-sectional study which used small number ( n = 72) patients and children were excluded despite their high risk for toxicity [12].…”

“…This study was a cross-sectional study which used small number ( n = 72) patients and children were excluded despite their high risk for toxicity [12]. In previous study [21], hearing loss was reported in 6 patients (8.3%), and renal failure was reported in only 5 patients (6.9%); however, this study focused on description of all adverse reactions associated with all regimens of MDR-TB, and did not undertake specific study of ototoxicity and nephrotoxicity of injectable second-line drugs in large population. Because of small number of subjects studied, generalization of the findings to wider population appears difficult.…”

Incidence and predictors of major adverse drug events among drug-resistant tuberculosis patients on second-line anti-tuberculosis treatment in Amhara regional state public hospitals; Ethiopia: a retrospective cohort study

“…Censored was defined as a DR-TB patient who didn’t develop any major adverse drug event at the end of the study, transferred out, cured, completed, failed or lost to follow up before developing any major adverse drug event. Major adverse drug events are serious adverse events that are often complicated to monitor and can be life threatening to warrant extra attention in monitoring for early detection and prompt management pertaining to the following medical conditions [4, 5, 22].…”

Determinants of Adverse Drug Reactions Due to Tuberculosis Therapy in African Countries: a Systematic Scoping Review Protocol

“…Several studies have reported the risk factors associated with adverse drug reactions due to tuberculosis drugs (10,(23)(24)(25). Chung-Delgado, Revilla-Montag (10) conducted a study in Lima-Peru and found that old age (over 40 years), anemia, medication for multidrug resistant tuberculosis, overweight/obesity status, and smoking history are independent risk factors associated with ADRs due to antituberculosis treatment.…”