Serum Analysis of Major Biochemical Changes among Patients with Multi-drug Resistant Tuberculosis (MDR-TB) in Mekelle Hospital, Tigray, Ethiopia
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Date
2014-07
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Addis Abeba University
Abstract
Introduction: Adverse drug reaction (ADRs) defined as: any unintended adverse response to a
drug occurring at a therapeutic dose and resulting in either death, drug withdrawal, change in the
administration of the frequency or dose of the drug, is one of the major concerns about SLDs to
treat MDR-TB. Hypothyroidism, liver toxicity, renal dysfunction and electrolyte disturbances
have been reported among the prevalent ADRs during MDR-TB treatment. However, these
ADRs had not investigated in Ethiopia.
Objectives: The aim of this study was to investigate the sero- prevalence of adverse drug
reactions (ADRs) and associated risk factors among MDR-TB patients with second line drugs.
Methods: this prospective, observational cohort study was carried out from August 2013 to April
2014 in Mekellle Hospital. 68 confirmed pulmonary MDR-TB patients by Tigray Regional
Laboratory were followed and evaluated for ADRs development during the study period.
Routine laboratory test according to ADRs monitoring schedule was done in Ayder Referral
Hospital in collaboration with Mekelle Hospital. Demographic and clinical information were
extracted from standardized clinical files.
Results: There were 67.6% male and 32.4% female patients. The mean patient age was 32.62 ±
(11.173) years. Among the 68 patients screened for adverse drug reactions, electrolyte related
abnormality (hypokalemia 47/68(69.11%), hypomagnesaemia18/68(26.47%) and hypocalcaemia
8/68(11.76 %) was 83.80%, nephrotoxicity 22/68(32.35%), hypothyroidism16/68(23.53%) and
hepatotoxicity 10/68(14.71%) were recorded.
Conclusions: High rate of hypokalemia, nephrotoxicity, hypothyroidism and hepatotoxicity was
observed in this cohort. This is a treatable and reversible; however, it may go undiagnosed in the
absence of regular monitoring. Care providers should not wait for clinical symptoms, as this risks
compromising treatment adherence. Electrolyte related abnormalities and renal toxicity was the
most prevalent among others. Higher magnitude of ADRs was observed among older, females
and HIV co-infected patients on ART/anti-TB.
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Keywords
Adverse drug reactions, MDR-TB, second line ant-TB drugs