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

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