Adverse drug reactions and risk factors for discontinuation of multidrug-resistant tuberculosis regimens in Gujarat, western India.

Abstract

The predictors for discontinuation of multidrug-resistant tuberculosis (MDR-TB) regimens have not been studied in Gujarat. We aimed to find out the adverse drug reactions (ADRs) and predictors for discontinuation of MDR-TB regimens. We conducted this cross-sectional study in Bhavnagar district of Gujarat from September to November 2016 through home visits and personal interviews of 94 patients with MDR-TB. Sixty-nine patients with MDR-TB (73%) reported ADRs. Tingling (42.6%), headache (37.2%), numbness (36.2%), dizziness (34%) and nausea (33%) were the most common ADRs. Of the 94 patients, 7.4% were compelled to think of discontinuing their treatment due to ADRs; 8.5% had discontinued Cat-I/Cat-II regimen in the past; 11.7% had discontinued their MDR-TB regimen in the past; 13.8% had their drug regimen changed due to ADRs and 94.7% had good adherence to their current regimen (took at least 80% of their doses till date). ADRs were the reason for 75% of the patients who discontinued their Cat-I/Cat-II regimen in the past and 64% of the patients who discontinued their MDR-TB regimen in the past. Tobacco chewing, poor adherence and thought of discontinuing an MDR-TB regimen due to ADRs were significant predictors for discontinuation on bivariate analysis. On multiple logistic regression, none of the predictors were significant. The frequency of ADRs among patients with MDR-TB is high. ADRs were the primary reason for discontinuing MDR-TB drugs.