Patient Level Delay in Diagnosis of Multi-Drug Resistant Tuberculosis among Patients Attending Tertiary Care Hospital in Haryana

Background: Tuberculosis is a serious public health issue in India. The treatment regimen followed is Directly observed treatment short-course (DOTS) and Programmatic Management of Drug resistant Tuberculosis (PMDT) approach. In a long period of treatment adverse drug reactions (ADRs) can be an important programmatic issue. Thus, study was undertaken to assess the ADRs caused by antitubercular therapy in indoor patients in a tertiary care hospital at Surat.Methods: The Observational, prospective study was carried out for one year period. The causality was determined by WHO UMC scale and severity was determined by Modified Hartwig and Siegel scale. Chi square test was applied for statistical analysis.Results: Among 255 tuberculosis patients, 85 (33.3%) patients developed ADRs. Occurrence of ADRs was more among females (46.6%). The commonly involved systems are gastrointestinal (40.6%) followed by haematological (17.9%). The most common ADRs observed were nausea and vomiting (21.7%). High percentage of ADRs causing drugs were isoniazid (30.6%) followed by rifampicin (26.1%). Causality assessment showed 60.4% ADRs were possible, 37.7% ADRs were probable and 1.9% ADRs was certain. Severity assessment scale showed 81.1% of moderate, 12.3% of mild and 6.6% of severe grading. Occurrence of ADRs was more among PMDT (60%) in comparison to DOTS therapy (31.06%) [p value = 0.0084 (significant p value < 0.05)].Conclusions: Antitubercular treatment is safer but early detection, management and reporting of ADRs is required to prevent it at initial stage and helps to decrease default rate.

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A study of adverse drug reactions in patients receiving treatment for multi-drug resistant tuberculosis

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20170329 ◽

2017 ◽

Vol 6 (2) ◽

pp. 354

Author(s):

Mayur P. Shinde ◽

Nimish R. Halasawadekar ◽

Sunita J. Ramanand ◽

Shraddha M. Pore ◽

Jayprakash B. Ramanand ◽

...

Keyword(s):

Early Detection ◽

Adverse Drug Reactions ◽

Tertiary Care ◽

Care Hospital ◽

Drug Resistant ◽

Drug Reactions ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

Background: A high frequency of adverse drug reactions (ADRs) is one of the major challenges in the treatment of Multi-drug resistant tuberculosis (MDR-TB). Patients may refuse to continue treatment if ADRs are not properly addressed, drugs may be stopped unnecessarily and treatment may be terminated prematurely by inexperienced health workers, resulting in a high proportion of failure.Methods: Patients diagnosed for MDR-TB and registered in Drug Resistant TB centre (DR-TB) of tertiary care hospital during period of July 2014 to June 2015 were enrolled in the study. Data of patients hospitalized for the complaints of ADR in DR-TB centre during study period was collected.Results: Out of 468 patients, 60 (12.82%) patients developed at least one adverse reaction and were hospitalised for the same. Among 109 reported ADRs, Gastrointestinal upset was the most common ADR reported (5.98%) followed by psychosis (4.91%) and ototoxicity (2.99%).Conclusions: The health providers, the patients and their relatives should be sensitised about these ADRs for early detection and treatment. It can also be suggested that the setup of DR-TB centre should be integrated with psychiatry and ENT specialities, with all the provisions of early detection of ADR and treatment.

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Treatment outcome of multi-drug resistant tuberculosis patients on second line anti-tuberculosis dugs at tertiary care hospital at Himachal Pradesh, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203387 ◽

2020 ◽

Vol 7 (8) ◽

pp. 3119

Author(s):

Anita Kumari ◽

Parveen K. Sharma ◽

Rekha Bansal

Keyword(s):

Tertiary Care ◽

Successful Outcome ◽

Care Hospital ◽

Drug Resistant ◽

Second Line ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

Background: MDR-TB treatment defaulter are potentially harmful to community as these can relapse and spread infection, developed resistance to second line anti tubercular drugs and may result in to extensive drug resistant tuberculosis (XDR-TB) and major challenges for successful outcome. Objective was to study treatment outcome of multi-drug resistant tuberculosis patients on second line anti-tuberculosis drugs at tertiary care hospital at Himachal Pradesh.Methods: It was prospective observational study carried out after approval from institutional ethics committee. A total 104 MDR/RR-TB case enrolled for study from November 2012 to October 2013. Data were collected in predesigned proforma and entered in to Microsoft excel worksheet 2007 and analyzed with the help of SPSS software version 17. Chi-square test was applied to find out the association between independent variable and outcome of MDR-TB and p<0.05 was considered statistically significant.Results: Among all 104 patients initiated on treatment 73.07% patients were alive, completed intensive phase and switch to continuation phase of treatment, 14.42% patients were died, 5.76% defaulted, 0.96% patient was transferred out and 5.76% patients were turned out XDR-TB and switched to regimen of XDR-TB treatment.Conclusions: Treatment and control of MDR-TB require sound infrastructure and well equipped laboratory facilities to provide quality and prompt diagnosis. Lack of knowledge, awareness, long duration of treatment and defaulters are major challenges for successful outcome.

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