Symptom experience of adverse drug reaction among male and female patients with newly diagnosed pulmonary tuberculosis in Thailand

Abstract

Background: Patients with newly diagnosed pulmonary tuberculosis often suffer from adverse drug reaction symptoms, which leads to the automatic discontinuation of anti-tuberculosis drugs. Thus, understanding symptom experience of adverse drug reactions is necessary.Objective: This study aimed to examine differences in symptoms experienced in four dimensions: presence, frequency, severity, and distress of adverse drug reactions, between male and female patients.Methods: This was a quantitative survey with a cross-sectional design, with data collected between January and April 2020. A total of 394 patients with newly diagnosed pulmonary tuberculosis was selected through a purposive sampling technique. The symptom experiences of adverse drug reactions were measured using a validated instrument. Data were analyzed using mean, standard deviation, and independent t-test.Results: The most commonly reported symptom was itchiness (24.1% in males and 34.9% in females). Vomiting occurred as the most frequent symptom among males (x̅ ± SD = 2.73 ± .88), and fatigue was found to be the most severe and distressing symptom across male patients (x̅ ± SD = 2.50 ± 1.61 and 2.06 ± 1.30, respectively). In contrast, yellowing of the eyes and skin was most frequent and severe among females (x̅ ± SD = 3.17 ± .75 and 3.83 ± 1.47, respectively). In addition, flu-like symptoms were evaluated as the most distressing symptom for female patients (x̅ ± SD = 2.80 ± 1.09). The symptom burdens of the females ranged significantly and reached higher than those of the male patients at a p-value of .05 (t = 3.33).Conclusion: Females taking anti-tuberculosis drugs should be carefully monitored to deal with adverse drug reaction symptoms. This finding would help to decrease the severity of disease and improve their quality of life.Funding: This study received funding from the Ratchadaphiseksomphot Endowment Fund, Chulalongkorn University, Bangkok, Thailand (GCUGR1125633058M).

Characteristics of and treatment outcomes in rifampicin-intolerant patients

“… 18 , 19 Although TB is more commonly diagnosed in males, and males are known to have more unfavourable treatment outcomes and higher mortality, 20 , 21 several studies suggest that drug intolerance is more commonly experienced by female patients. 22 , 23 We found that females were more likely to have intolerance to RIF, but there was no difference in treatment outcomes between males and females in our cohort, indicating that alternative treatment regimens could be constructed despite RIF-related adverse events in our population. We found no significant difference in treatment outcomes between RIF-tolerant and RIF-intolerant patients, although those who were unable to tolerate RIF had a significantly longer duration of therapy.…”

Efeitos adversos decorrentes do tratamento poliquimioterápico da tuberculose em pacientes com e sem HIV: Uma revisão integrativa

“…Em relação às diferenças da ocorrência de efeitos adversos do tratamento anti-TB entre homens e mulheres, os homens relataram vivenciar mais efeitos adversos que as mulheres. Uma possível razão para esse risco aumentado seria a maior tendência masculina ao tabagismo, ao etilismo e à drogadição comparados à população feminina (Thontham & Polsook, 2021).…”

“…Em relação aos sintomas decorrentes dos efeitos colaterais, homens declararam maior acontecimento de prurido relacionado à colestase intra-hepática. Em mulheres, a hiperbilirrubinemia foi o efeito colateral mais relatado, estando associado sobretudo aos medicamentos isoniazida e rifampicina, os quais se relacionam com o possível desenvolvimento de lesão hepática (Thontham & Polsook, 2021). Uma explicação para essa maior ocorrência seria a menor taxa de depuração hepática, menor índice de massa magra e divergências na atividade da enzima citocromo P450 (CYP) da parcela feminina, em comparação aos homens (Raftery et al, 2018).…”

Costs Associated with Adverse Drug Reactions Among HIV/TB Patients in Thailand

“…42 , 43 Male patients were more likely to encounter ADRs than female patients, because males were more susceptible to behavioral and social factors. 27 , 44 , 45 This resulted in an increase in transmission of disease.…”