Infectious Diseases

Biography

Biography: Gaurav Gupta

Abstract

BACKGROUND: Drug resistance Tuberculosis (DR-TB) is a public health crisis and its diagnosis and management is challenging task. One of the major obstacles in achieving successful treatment outcomes in DR-TB are adverse events affecting the adherence to the second line drugs (SLD).
OBJECTIVE: To evaluate the frequency of adverse events due to the second line drugs in Multidrug-Resistant Tuberculosis (MDR-TB) patients.
METHODS: A prospective cohort study was conducted at DOTS Plus site at AIIMS, New Delhi .The cohort of 81 MDR-TB were recruited between June 2014 to June 2016 and were provided with standardized RNCTP regimen. Patients were followed up and adverse events were primarily recognized with clinical evidence and/or laboratory investigations. Data was collected in pre-designed proforma. The data was analyzed by stata 14 and presented in mean (standard deviation)/median (min to max) and frequency (%) with confidence interval (95%).
RESULTS: 91 adverse events were reported in 52(64.1%) patients. Only 1.2 %( 1/81) of the patient stopped treatment, but 9.8% (8/81) required removal of the suspected drug(s) from the regimen due to adverse events. The grouped adverse events were most commonly gastrointestinal (70.6%), arthralgia (10.9%), ototoxicity (6.4%), psychiatric (5.5%), and hypothyroidism (2.1%).Eight (9.8%) patients had major adverse events requiring discontinuation or substitution of drugs that included psychiatric disturbances in 5(6.1%) followed by hearing loss and tinnitus in 3(3.7%).
CONCLUSIONS: In India Programmatic management of drug resistance tuberculosis (PMDT) guidelines provides excellent guidance for diagnosis and treatment of DR-TB. Adverse events can be catered if addressed at the time by the health care system and adherence can be assured for successful treatment outcomes.