Adverse reactions among patients being treated for multi-drug resistant tuberculosis in Egypt from July 2006 to January 2009
Aboda Mahmoud El-Tantawy;
Abstract
Tuberculosis (TB) remains a major global health problem, responsible for ill health among millions of people each year. TB ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV).
Emergence of drug resistance during the course of tuberculosis treatment and especially development of multi-drug resistant (MDR) TB is a major health hazard in many countries worldwide and is considered as an obstacle against TB control.
This study included 138 patients admitted at Abbassia Chest Hospital; during the period from 1st July 2006 to 1st January 2009;27 patients in year 2006,42 in year 2007 and 69 in year 2008. All patients were resistant at least to Rifampicin and INH.
In this study, 71.7% of the patients were males and 28.3% were females. The mean of age of the studied group was 37.6 years. The special habits detected among the studied cases were tobacco smoking, drug addiction and alcohol intake. According to type of resistance, “Resistance in previously treated cases” was 95.7% and “resistance in new cases” was 4.3%. The most common co-morbidities associated with MDR-TB in the studied cases were diabetes (34.8%), Chronic liver diseases (3.6) and chronic obstructive lung disease (2.9%).
All patients received Ofloxacin and almost shared Ethionamide (137), Cycloserine(136), PAS(137) but they were different as regard to the injectable aminoglycosides. Kanamycin was the most frequent injectable drug (73), followed by amikacin (42) then Capreomycin (18) and Streptomycin was the least one (5 patients). Also, two drugs from 1st line were received Ethambutol (25) and pyrazinamide (3 patients only).
On laboratory monitoring, there were elevations of SGPT beginning from 3rd month after treatment, but the elevations were statistically significant beginning from 6th month.
In the studied cases, side effects of drugs were; 58.7% GIT manifestations, 51.4% Peripheral Neuritis, Hypokalemia 25.4%, Irritable Bowel Syndrome 23.9%, Ototoxicity 18.8%, Skin reaction 12.3%, Hypothyroidism 9.4%, Hepatotoxicity 8.7%, Hypoalbunemia 5.1%, Depression 3.6%, Gynecomastia 2.2%, Hyponatremia 0.7%, Hypomagnesaemia 2.2%, Dizziness 0.7%, Nephrotoxicity 2.9%.
Most of the drugs side effects started to appear within the first 7 months of treatment. The frequency of nephrotoxicity, hepatotoxicity and hypoalbunemia were significantly higher in diabetic than in non-diabetic cases.
The overall prevalence of adverse reactions is 96.4 which started to appear, in average, in the first 7 months after treatment initiation.
88.4% of the studied cases were cured, 8% died, 0.7% was lost to follow-up and 2.9% completed treatment.
Emergence of drug resistance during the course of tuberculosis treatment and especially development of multi-drug resistant (MDR) TB is a major health hazard in many countries worldwide and is considered as an obstacle against TB control.
This study included 138 patients admitted at Abbassia Chest Hospital; during the period from 1st July 2006 to 1st January 2009;27 patients in year 2006,42 in year 2007 and 69 in year 2008. All patients were resistant at least to Rifampicin and INH.
In this study, 71.7% of the patients were males and 28.3% were females. The mean of age of the studied group was 37.6 years. The special habits detected among the studied cases were tobacco smoking, drug addiction and alcohol intake. According to type of resistance, “Resistance in previously treated cases” was 95.7% and “resistance in new cases” was 4.3%. The most common co-morbidities associated with MDR-TB in the studied cases were diabetes (34.8%), Chronic liver diseases (3.6) and chronic obstructive lung disease (2.9%).
All patients received Ofloxacin and almost shared Ethionamide (137), Cycloserine(136), PAS(137) but they were different as regard to the injectable aminoglycosides. Kanamycin was the most frequent injectable drug (73), followed by amikacin (42) then Capreomycin (18) and Streptomycin was the least one (5 patients). Also, two drugs from 1st line were received Ethambutol (25) and pyrazinamide (3 patients only).
On laboratory monitoring, there were elevations of SGPT beginning from 3rd month after treatment, but the elevations were statistically significant beginning from 6th month.
In the studied cases, side effects of drugs were; 58.7% GIT manifestations, 51.4% Peripheral Neuritis, Hypokalemia 25.4%, Irritable Bowel Syndrome 23.9%, Ototoxicity 18.8%, Skin reaction 12.3%, Hypothyroidism 9.4%, Hepatotoxicity 8.7%, Hypoalbunemia 5.1%, Depression 3.6%, Gynecomastia 2.2%, Hyponatremia 0.7%, Hypomagnesaemia 2.2%, Dizziness 0.7%, Nephrotoxicity 2.9%.
Most of the drugs side effects started to appear within the first 7 months of treatment. The frequency of nephrotoxicity, hepatotoxicity and hypoalbunemia were significantly higher in diabetic than in non-diabetic cases.
The overall prevalence of adverse reactions is 96.4 which started to appear, in average, in the first 7 months after treatment initiation.
88.4% of the studied cases were cured, 8% died, 0.7% was lost to follow-up and 2.9% completed treatment.
Other data
| Title | Adverse reactions among patients being treated for multi-drug resistant tuberculosis in Egypt from July 2006 to January 2009 | Other Titles | الآثار الجانبية لعلاج الدرن المقاوم للأدوية المتعددة في مصر في الفترة من يوليو 2006 حتى يناير2009 | Authors | Aboda Mahmoud El-Tantawy | Issue Date | 2014 |
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