Pattern of Adverse Drug Reactions and Performed Monitoring Laboratory-Tests in Patients Receiving Anti Tuberculosis Treatment in an Endemic Region, Zabol
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Abstract
Background: Efficient anti TB treatment considered crucial globally. Anti TB drugs can cause various adverse drug reactions (ADRs). Clinical and laboratory monitoring will decrease rate of these ADRs, improve patient safety as well as drug adherence and treatment outcome. Methods: In this cross-sectional study total of 136 newly diagnosed TB patients were included. All patients received standard anti-TB 4 drug regimen. Predesigned data collection forms were used to gather patient’s lab data as well as clinical symptoms they experienced during treatment course. Monthly follow up visits or phone calls were also performed by investigators and all health issues were recorded. Results: The majority of our patients aged over 70-year-old. About 54% of them were female. We recorded at least one ADR in 80.8% of patients, and hepatic-gastrointestinal (GI) ADRs ranked first (64.7%). Although ADRs were more common in women and patients over 70-year-old, but there was no statistically significant relationship between sex or age and rate of ADRs (P> 0.05). We also observed that recommended baseline laboratory tests for monitoring anti TB treatment was not performed in any of our patients, except complete blood count (CBC) that was performed in 11 cases. This led to diagnoses of anemia and thrombocytopenia in one case. Conclusion: The majority of our patients experienced ADR. Recommended drug monitoring tests that could guarantee safe and effective treatment were not performed routinely in our TB management centres. These facts highlighted the importance of improving surveillance system for TB management based on national standards.
2. Prasad R, Singh A, Gupta N. Adverse drug reactions in tuberculosis and management. Indian Journal of Tuberculosis.2019: 66(4): 520-532.
3. Taramian S, Joukar F, Asgharnezhad M, Biabani A, Mansour Ghanaei F. Side effects of first-line anti tuberculosis drugs. Journal of Guilan University of Medical Sciences. 2013;22(85):42-7.
4. Nasehi M, Mirhaghani L. National TB management guide. Second edition available from: www.who.int/tb/publications/...guidelines/en/.
5. Gülbay BE, Gürkan ÖU, Yıldız ÖA, Önen ZP, Erkekol FÖ, Baççıoğlu A. Side effects due to primary anti-tuberculosis drugs during the initial phase of therapy in 1149 hospitalized patients for tuberculosis. Respir Med. 2006;100(10):1834-42.
6.Mohamadi Azni S, Mansourian A, Nokandeh Z. Epidemiological study of tuberculosis in Damghan city (Iran) during 2003-2007. Koomesh. 2008; 9(4):315-20.
7. Epidemiology of tuberculosis in Iran. Available from: www.tb-lep.behdasht.gov.ir
8. Arsang S, Kazemnejad A, Amani F. Epidemiology of tuberculosis in Iran (2001-08). Journal of Gorgan University of Medical Sciences. 2011;13(3):78-86.
9. Beiranvand R, Ghalavandi S, Delpisheh A, Sayemiri K, Karimi A. Epidemiological investigation of Tuberculosis in Ilam province during 2005-2012. J Ilam Univ Med Sci. 2014;21(7):1-8.
10. Metanat M, Salehi M, SHarifimoud B, Jahantigh A, Rouhani Z. Epidemiology of extra pulmonary tuberculosis in Zahedan. Zahedan Journal of Research in Medical Sciences. 2006; 7(4): 275- 282.
11. Farah M, Tverdal A, Selmer R, Heldal E, Bjune G. Tuberculosis in Norway by country of birth, 1986–1999. Int J Tuberc Lung Dis. 2003;7(3):232-5.
12. Allison S. Rhines. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis. 2013: 93(1): 104-107.
13. Kassa E, Enawgaw B, Gelaw A, Gelaw B. Effect of anti-tuberculosis drugs on hematological profiles of tuberculosis patients attending at University of Gondar Hospital, Northwest Ethiopia. BMC Hematol. 2016;16:1.
14. Marra F, Marra C, Bruchet N, et al. Adverse drug reactions associated with first-line anti-tuberculosis drug regimens. Int J Tuberc Lung Dis. 2007;11(8):868-75.
15. Damasceno GS, Guaraldo L, Engstrom EM, et al. Adverse reactions to antituberculosis drugs in Manguinhos, Rio de Janeiro, Brazil. Clinics. 2013; 68(3): 329-37.
16. Imam F, Sharma M, Khayyam KU, et al. Adverse drug reaction prevalence and mechanisms of action of first-line anti-tubercular drugs. Saudi Pharm J. 2020;28(3):316-324.
17. Rajendra Prasad a, Abhijeet Singh b, Nikhil Gupta. Adverse drug reactions in tuberculosis and management. Indian Journal of Tuberculosis.2019; 66 (4): 520-532.
18. Lv X, Tang S, Xia Y, Wang X, Yuan Y, Hu D. Adverse reactions due to directly observed treatment strategy therapy in Chinese tuberculosis patients a prospective study. PloS One. 2013;8(6):67-35.
19. Gholami K, Kamali E, Hajiabdolbaghi M, Shalviri G. Evaluation of anti-tuberculosis induced adverse reactions in hospitalized patients. Pharm Pract (Granada). 2006;4(3):8-134.
20. Evans ldsevans RS, Lloyd JF, Stoddard GJ, Nebeker JR, Samore MH. Risk factors for adverse drug events: A 10-year analysis. Ann Pharmacother. 2005;39(7-8):1161-8.
21. Gray E L, Goldberg HF. Baseline abnormal liver function tests are more important than age in the development of isoniazid-induced hepatoxicity for patients receiving preventive therapy for latent tuberculosis infection. Intern Med J. 2016; 46(3):281-7.
22. Vieira DEO, Gomes M. Adverse effects of tuberculosis treatment: experience at an outpatient clinic of a teaching hospital in the city of São Paulo, Brazil. Jornal Brasileiro de Pneumologia. 2008;34(12):1049-55.
23. Damasceno GS, Guaraldo L, Engstrom EM, Theme Filha MM, Souza-Santos R, Vasconcelos AGG. Adverse reactions to antituberculosis drugs in Manguinhos, Rio de Janeiro, Brazil. Clinics. 2013;68(3):329-37.
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| Issue | Vol 11, No 3 (Summer 2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Tuberculosis; Adverse Drug Reactions; Anti TB Treatment | ||
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