Adverse drug reactions and its determinants among patients treated for multidrug resistant tuberculosis at alert hospital, addis ababa, Ethiopia

Abstract

Background: Successful treatment of multidrug resistant tuberculosis requires therapy with several effective drugs some of which are highly toxic, less efficacious and expensive. Drug related adverse reactions are common causes for drug discontinuation and poor treatment outcome among patients treated for drug resistant tuberculosis. Studies related with safety of the drug and prevalence of adverse effects among patients treated for multidrug resistant tuberculosis in Ethiopia is not studied well. Method: Retrospective medical record review was conducted at ALERT hospital from April 21 to May 20, 2014. The study involved patient cohort who started multidrug resistant tuberculosis treatment at ALERT hospital between November 21, 2011 and October 20, 2013. The collected data was cleaned, organized and entered in to computer for analysis using SPSS version 16.0. The frequency, cross tabulation and charts are used to present the results. The mean and standard deviation was calculated for continuous variables. A P-value of less than 0.05 was considered for statistical significance. Result: Between November 21, 2011 and October 20, 2013 158 individuals were diagnosed with multidrug resistant tuberculosis and registered for treatment at ALERT hospital. Analysis was done for 117 patients who fulfilled the inclusion criteria. Almost all patients, 116 (99.14%) developed at least one adverse drug reaction. Hypokalemia 99 (84.6%), gastrointestinal adverse effects 70 (59.83%) and psychiatric disorders 33 (28.2%) were among the most frequently occurred adverse drug reactions. High cycloserine dose and residing at Addis Ababa were independently associated with occurrence of psychiatric disorder and treatment duration of more than 12 months was independently associated with hypothyroidism. Conclusions: The adverse drug reactions related with multidrug resistant tuberculosis treatment were commonly encountered among patients involved in the study. The adverse drug reactions resulted in deaths, permanent drug discontinuation and offending drug removal from drug regimen