Treatment outcomes among patients with multi-drug resistant tuberculosis in Abbassia Chest Hospital from July 2006 to June 2010

Elmahallawy, Ibrahim I.; Bakr, Ramadan; Mabrouk, Ali A.; Omar, Rasha M.

doi:10.1016/j.ejcdt.2012.08.018

Cited by 10 publications

(17 citation statements)

References 2 publications

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“…This is in contrary to studies from Egypt [12] (39.5%), Botswana [8] (16.2%), Russia [13] (17.2%), Peru [14] (10%) and Lesotho [9] (69%). 3.5% hypothyroidism was reported in one study evaluating adverse drug reactions collectively from five DOTS-Plus centres [3].…”

Section: Discussioncontrasting

confidence: 85%

Hypothyroidism in MDR-TB treatment – Rare occurrence but a major concern

Akshata

Swapna

Chakraborty

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Context: To achieve good cure rate during treatment of MDR-TB, strict adherence to treatment regimen is a must. As the second line drugs have great potential to cause adverse drug reactions (ADR), identifying these adverse reactions and treating them early is major factor in preventing default. Hypothyroidism is one such ADR caused by thioamides (ethionamide, prothionamide) and paraamino salicylic acid.Aims: To study the frequency of occurrence of hypothyroidism and its implication in MDR-TB treatment.Settings and design: Retrospective analysis of 488 patients enrolled in our institute for MDR-TB treatment treated with standardised Cat IV treatment, as per RNTCP-PMDT guidelines.Methods and material: Retrospective analysis of 484 (4 had hypothyroidism before treatment initiation) patients treated in our institute was done. Thyroid function test was done at baseline and repeated when indicated by symptoms during clinical follow up. Patients developing hypothyroidism (defined as TSH > 10 microIU/ml) during treatment and the reasons for same are analysed. Its implication in treatment outcome is studied.Results: Out of the 484 study population, 19 (3.9%) had at least one documented record of TSH > 10.0 microIU/ml after treatment initiation. Median time from initiation of MDR-TB treatment to development of hypothyroidism was 153 days (range 32-441 days).Conclusions: Occurrence of hypothyroidism is rare in MDRTB treatment. But symptomatic hypothyroidism is a major factor influencing the patient compliance towards the treatment regimen. As the drugs in regimen are effective in disease treatment, the major hindrance in achieving good cure-rate is to prevent defaulters. Identifying hypothyroidism early helps to prevent default.

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Section: Discussioncontrasting

confidence: 85%

Hypothyroidism in MDR-TB treatment – Rare occurrence but a major concern

Akshata

Swapna

Chakraborty

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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“…Hypothyroidism was reported less frequently (3.1%) in our study. In comparison few studies reported hypothyroidism ranging from 10% -39.5% [5] [6] [8]. In our study, as per the guidelines TSH was done at baseline and was repeated on clinical suspicion.…”

Section: Discussionmentioning

confidence: 85%

“…Other studies reported depression between 6.2% -18.3% [5]- [7]. A study from Egypt showed that 26.5% MDR-TB patients had depression [8]. Cycloserine being the culprit drug was discontinued in few severe cases and in majority it was continued along with anti-depressant therapy.…”

Section: Discussionmentioning

confidence: 99%

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Adverse Drug Reactions in Management of Multi Drug Resistant Tuberculosis, in Tertiary Chest Institute

Akshata¹,

Chakrabarthy²,

Swapna³

et al. 2015

JTR

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Background: Multidrug resistant tuberculosis is a global threat. Effective treatment is implemented as per RNTCP guidelines. But the drugs used have great potential to develop adverse drug reactions. Such drug reactions if not managed optimally can lead to unfavourable treatment outcome. Hence, the study is to know the occurrence of adverse drug reactions. Aims: To study the occurrence of adverse drug reactions in treatment of multidrug resistant tuberculosis and hence the factors affecting the treatment. Settings and Design: Retrospective analysis of patients treated with standardised regimen for MDR-TB, as per RNTCP guidelines at a tertiary chest institute between august 2011 and December 2014. Methods and Material: Retrospective analysis of 607 patients' records reviewed for the occurrence of adverse drug reactions. All adverse reactions are noted and diagnosed either clinically or by laboratory evidence. Results: Among the 607 patients included in the study, majority had one or more adverse drug reactions. The most common was gastritis (71.7%), which was easily treatable, and the least common was visual impairment (0.2%). Only 1.7% discontinued the treatment citing adverse drug reactions and 10.5% required permanent discontinuation of the offending drug. Conclusion: Treatment of MDR-TB is challenging mainly due to the long duration of treatment and the potential adverse reactions of the drugs used. These reactions are frequent but majority of them can be successfully managed without treatment interruption. Training the peripheral health centre workers to identify and refer the patients with adverse reaction bears a major impact on treatment outcome. Keywords MDR-TB, ADR, Adherence, Outcome J. S. Akshata et al. 28

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“…An additional 6 studies were excluded since they provided qualitative data on factors associated with success in therapy and adverse effects observed on patients. Five more studies were removed due to lack of response from their authors in search of additional data on the outcomes of the surgical and non-surgical groups [11][12][13][14][15].…”

Section: Data Extractionmentioning

confidence: 99%

Comparative Evaluation of Treatment for Multi drug Resistant Tuberculosis with and without Surgical Resection: A Systematic Review–Meta Analysis of Retrospective Clinical Data

Shigute¹,

Gedamu²,

Tesfaye³

et al. 2017

J Med Diagn Meth

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Background: Tuberculosis is still one of the major causes of mortality and morbidity in the world with nearly 1.3 million deaths recorded in 2012. Multi drug resistant tuberculosis has caused high number of deaths and new infections in the same year. The optimal management of MDR TB has been retarded by lack of controlled trials to indicate a fixed drug regimen to be applied universally. Surgical resection, often involving lobectomy and pneumoctomy, is used in patients failing to show improvements with the drug therapy. Objective: To conduct systematic review meta-analysis on comparative evaluation of treatment for MDR TB with and without surgical resection. Methods: Eligible studies were identified from databases using key phrases MDR TB, MDR TB treatment, and clinical outcomes for MDR TB therapy. Statistical analysis was performed by Comprehensive meta-analysis (CMA) version 2.2.064 software. Results: Twenty (20) studies fully met the inclusion criteria. Meta-analysis was performed on 630 MDR patients with and 2149 patients without surgery. The analysis produced success rates of 0.845, 0.520, failure rates of 0.157, 0.100, death rates of 0.172, 0.084 and default rates of 0.184, 0.038 for the non-surgical and surgical groups respectively. Conclusion: Adjuvant surgical resection results in clinically significant increase in success rates of MDR TB therapy and a reduction in the rates of failure, death and default.

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Treatment outcomes among patients with multi-drug resistant tuberculosis in Abbassia Chest Hospital from July 2006 to June 2010

Cited by 10 publications

References 2 publications

Hypothyroidism in MDR-TB treatment – Rare occurrence but a major concern

Hypothyroidism in MDR-TB treatment – Rare occurrence but a major concern

Adverse Drug Reactions in Management of Multi Drug Resistant Tuberculosis, in Tertiary Chest Institute

Comparative Evaluation of Treatment for Multi drug Resistant Tuberculosis with and without Surgical Resection: A Systematic Review–Meta Analysis of Retrospective Clinical Data

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