Assessment of hearing loss in multi-drug resistant tuberculosis (MDR-TB) patients undergoing Aminoglycoside treatment

BACKGROUND Aminoglycoside treatment used for MDR-TB is likely to result in ototoxicity. The effects of a hearing loss with a MDR-TB diagnosis are likely to have an increased impact on the overall quality of life of an individual. However, there is minimal research in the area, which would therefore indicate a possible lack of awareness to the effect of aminoglycoside treatment on the quality of life of patients. While most studies on drug resistant TB are focused on the public health concerns of the disease, the human costs of MDR-TB are sometimes overlooked. OBJECTIVE This study aims to describe the psychological, social, economic and vocational impact of hearing loss on the quality of life of adults with Multi-Drug Resistant Tuberculosis. METHODS A Qualitative Phenomenological research study will be conducted on 10 participants. All participants will have a laboratory confirmed diagnosis of Multi-Drug Resistant Tuberculosis. A semi-structured interview questionnaire will be used to collect data. Face-to-face interviews will be conducted and the participants will be audio recorded. All interviews will be conducted by the researcher. RESULTS The study has not concluded. CONCLUSIONS The quality of life of a patient needs to be considered in the health care system during treatment, as this data may drive improved national health care planning with regards to treatment of patients diagnosed with MDR-TB. Therefore, for a comprehensive assessment of patient’s health status, it is very much essential to assess the overall impact of MDR-TB on health and patient’s perception of well-being. Besides routine clinical and bacteriological assessments, this assessment can be done by assessing quality of life which has several domains. Patients diagnosed with MDR-TB who further acquire an aminoglycoside induced hearing loss may have life-long effects on their quality of life even after completion of treatment.

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Ototoxic effect of anti-tubercular treatment on multi-drug resistant tuberculosis patient

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195583 ◽

2019 ◽

Vol 6 (1) ◽

pp. 8

Author(s):

Sachin Jain ◽

M. Aftab ◽

Shivendra Pratap Singh ◽

Abhishek Kumar Dubey ◽

Ved Prakash Upadhyay ◽

...

Keyword(s):

Hearing Loss ◽

Pure Tone Audiometry ◽

Control Program ◽

Tuberculosis Patient ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

Background: Multi-drug resistant tuberculosis (MDR-TB) is defined as tuberculosis caused by Mycobacterium tuberculosis resistant in vitro to the effects of isoniazid and rifampicin, with or without resistance to any other drugs. Regimen for MDR-TB comprises of 6 drugs - kanamycin, levofloxacin, ethionamide, pyrazinamide, ethambutol and cycloserine during 6-9 months of the intensive phase and 4 drugs levofloxacin, ethionamide, ethambutol and cycloserine during the 18 months of the continuation phase. The aim of our study was to document the incidence and severity of ototoxicity in MDR-TB patient receiving category IV treatment under the revised national tuberculosis control program.Methods: Prospective cohort study was carried out on proven case of MDR-TB patients. Total 61 patients were evaluated for the development of ototoxicity, for a period of one year. First three months of study pre-treatment baseline audiogram were recorded by pure tone audiometry, and repeat audiogram was done after six months and nine months. Results: Out of 61 patients 21 patients developed ototoxicity with incidence of 34.42%. Incidence of high frequency hearing loss was 21.31% and flat loss was 13.11%.Conclusions: MDR-TB patients, due to effect of aminoglycoside may develop mild to severe degree of hearing loss. As hearing loss in these patients is permanent, careful audiological monitoring should be done regularly.

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Abstract #1036 Hypothyroidism Induced by Multi Drug Resistant Tuberculosis (MDR-TB) Treatment

Endocrine Practice ◽

10.1016/s1530-891x(20)47401-4 ◽

2018 ◽

Vol 24 ◽

pp. 236

Author(s):

Rulli Rosandi

Keyword(s):

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Tb Treatment ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

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SIDE EFFECTS ASSOCIATED WITH DRUGS USED IN TREATMENT OF MULTI DRUG RESISTANT TUBERCULOSIS AND TREATMENT RELATED FACTORS OF MULTI DRUG RESISTANT TUBERCULOSIS PATIENTS IN KATHMANDU VALLEY

SAARC Journal of Tuberculosis Lung Diseases and HIV/AIDS ◽

10.3126/saarctb.v14i1.17718 ◽

2017 ◽

Vol 14 (1) ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Chandra Prakash Bhatt ◽

B KC

Keyword(s):

Health Care ◽

Side Effects ◽

Drug Resistant ◽

Second Line ◽

Related Factors ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb ◽

Care Worker

Introduction: Treatment of multi drug resistant Mycobacterium tuberculosis (MDR-TB) with second line drugs is associated with adverse drug reactions and toxicity. Aim of this study were to determine side effects associated with drugs used in treatment of multi drug resistant tuberculosis and treatment related factors of MDR-TB patients.Methodology: A prospective study was carried out in National Tuberculosis Centre Bhaktapur Nepal. Questionnaires were used to collect data from patients.Results: Total 101 MDR TB patients were included among them majorities were male (52%) and mean age of the patients was 31.2 years. Majority of patients (87.1%) had previous history of tuberculosis treatment and 54.5% were in intensive phase of treatment. The side effect associated with drugs used in treatment of MDR-TB reported by patients were joint pain (21.2%), nausea (20.3%), hearing disturbances (11%), gastrointestinal disturbance (9.9%), depression (9.6%), itching (8.1%), hypothyroidism (6.4%), dizziness (6.4%), seizures (3.8%) and hepatitis (3.5%). Last month 25.74% patients missed one or more doses of drugs and 3.9% missed drug doses due to side effect of drugs. Majorities of the patients used vehicle to reach health centre (92.07%), time to reach the health center (59.4%) were less than 30 minutes but majorities of patients (57.4%) were not satisfied by the counseling of health care worker.Conclusion: The finding of this study shows that in MDR patients 12.8% were found new cases. Last month 3.9% patients were stopped the drugs due to side effects of drugs. Majority of patients (57.4%) were not satisfied by counseling of health care worker. Treatment of multi drug resistant tuberculosis with second line anti tubercular drugs is associated with side effects, health care worker counseling to MDR- TB patients with full attention is essential to encourage the patient’s moral and complete the treatment. Timely managing the side effects of medication is important in helping people to complete their treatment.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), Page: 1-6

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Intensive phase treatment outcome and associated factors among patients treated for multi drug resistant tuberculosis in Ethiopia: a retrospective cohort study

BMC Infectious Diseases ◽

10.1186/s12879-019-4411-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Teklu Molie ◽

Zelalem Teklemariam ◽

Eveline Klinkenberg ◽

Yadeta Dessie ◽

Andargachew Kumsa ◽

...

Keyword(s):

Treatment Outcome ◽

Retrospective Cohort ◽

Multinomial Logistic Regression ◽

Drug Resistant ◽

Contributing Factors ◽

Drug Resistant Tuberculosis ◽

Intensive Phase ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

Abstract Background Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia. Methods A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors. Results At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04–10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR = 1.047, 95% CI (1.024, 1.072)] and those with a history of hypokalemia [ARRR = 0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR = 3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR = 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR = 0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.

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Risk factors of Multidrug Resistant Tuberculosis in central Nepal: A pilot study

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i4.6238 ◽

2012 ◽

Vol 8 (4) ◽

pp. 392-397 ◽

Cited By ~ 6

Author(s):

S B Marahatta ◽

J Kaewkungwal ◽

P Ramasoota ◽

P Singhasivanon

Keyword(s):

Risk Factors ◽

Social Stigma ◽

Smoking Habit ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

National Tuberculosis ◽

Mdr Tb ◽

History Of

Introduction Tuberculosis is the most widespread infectious disease in Nepal and poses a serious threat to the health and development of the country. Incidences of drug resistant tuberculosis in Nepal are increasing and this tuberculosisis a major threat to successfully controlling tuberculosis . Objective The general objective of the study was to assess the risk factors of multi-drug resistant tuberculosis among the patients attending the National Tuberculosis Centre, Bhaktpur Nepal. Methods An observational study/ case-control study with a Atotal number of 55 multi-drug resistant tuberculosis cases and 55 controls. The study was conducted among the patient attending in the National Tuberculosis Centre , Bhaktpur Nepal for six months, between May–October 2010. sImulti-drug resistant tuberculosis wasThe collected data was analysed in SPSS 11.5 version. The association between categorical variables were analysed by chi-square tests, OR and their 95% CI were measured. Results The total number of patients used for the study was 110, of which among them 55 were cases and 55 were controls . Our study revealed that there were significant associations between history of prior TB MDR-TB OR =2.799 (95 % CI 1.159 to 6.667) (p=0.020); smoking habit OR =2.350 and (95%CI 1.071 to 5.159) (p=0.032); social stigma social stigma OR 2.655 (95%CI r 1.071 to 5.159) (p=0.013); knowledge on MDR-TB OR =9.643 (95% CI 3.339 to 27.846) (p < 0.001)and knowledge on DOTS Plus OR=16.714 (95% CI is ranging from 4.656 to 60.008) (p< 0.001). However, there was no association found between alcohol drinking habits and ventilation in the room. Conclusion Our study revealed that there were significant associations between history of prior tuberculosis, smoking habit social stigma social stigma, knowledge on multi-drug resistant tuberculosis and knowledge on DOTS Plus with multi-drug resistant tuberculosis However there was no association between alcohol drinking habit and ventilation in room with multi-drug resistant tuberculosis. http://dx.doi.org/10.3126/kumj.v8i4.6238 Kathmandu Univ Med J 2010;8(4):392-7

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Person-centred care in practice: perspectives from a short course regimen for multi-drug resistant tuberculosis in Karakalpakstan, Uzbekistan

BMC Infectious Diseases ◽

10.1186/s12879-020-05407-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shona Horter ◽

Beverley Stringer ◽

Nell Gray ◽

Nargiza Parpieva ◽

Khasan Safaev ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Treatment Regimen ◽

World Health ◽

Drug Resistant ◽

Shared Decision ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

Abstract Introduction Person-centred care, an internationally recognised priority, describes the involvement of people in their care and treatment decisions, and the consideration of their needs and priorities within service delivery. Clarity is required regarding how it may be implemented in practice within different contexts. The standard multi-drug resistant tuberculosis (MDR-TB) treatment regimen is lengthy, toxic and insufficiently effective. 2019 World Health Organisation guidelines include a shorter (9–11-month) regimen and recommend that people with MDR-TB be involved in the choice of treatment option. We examine the perspectives and experiences of people with MDR-TB and health-care workers (HCW) regarding person-centred care in an MDR-TB programme in Karakalpakstan, Uzbekistan, run by Médecins Sans Frontières and the Ministry of Health. Methods A qualitative study comprising 48 interviews with 24 people with MDR-TB and 20 HCW was conducted in June–July 2019. Participants were recruited purposively to include a range of treatment-taking experiences and professional positions. Interview data were analysed thematically using coding to identify emerging patterns, concepts, and categories relating to person-centred care, with Nvivo12. Results People with MDR-TB were unfamiliar with shared decision-making and felt uncomfortable taking responsibility for their treatment choice. HCW were viewed as having greater knowledge and expertise, and patients trusted HCW to act in their best interests, deferring the choice of appropriate treatment course to them. HCW had concerns about involving people in treatment choices, preferring that doctors made decisions. People with MDR-TB wanted to be involved in discussions about their treatment, and have their preference sought, and were comfortable choosing whether treatment was ambulatory or hospital-based. Participants felt it important that people with MDR-TB had knowledge and understanding about their treatment and disease, to foster their sense of preparedness and ownership for treatment. Involving people in their care was said to motivate sustained treatment-taking, and it appeared important to have evidence of treatment need and effect. Conclusions There is a preference for doctors choosing the treatment regimen, linked to shared decision-making unfamiliarity and practitioner-patient knowledge imbalance. Involving people in their care, through discussions, information, and preference-seeking could foster ownership and self-responsibility, supporting sustained engagement with treatment.

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