Abstract
Objective: Tuberculosis (TB) is one of the leading fatal infectious diseases and remains a major health problem worldwide. Moreover, adverse effects of TB treatment can escalate treatment default. This study aimed to evaluate the correlation between adverse reactions to anti-TB drugs and treatment default.
 Methods: We performed a cross-sectional study using medical record data of a total 172 adult patients with pulmonary TB who were treated with first-line anti-TB drugs at Dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia during 2014 and who experienced adverse reactions.
 Results: Of the total, 127 patients (73.8%) had minor adverse reactions and 45 patients (26.2%) experienced major adverse reactions. Predominant adverse reactions included gastrointestinal disorders (34%) and drug-induced hepatitis (60%). There was a significant correlation between adverse reactions to anti-TB drugs and treatment default cases (odds ratio (OR), 9.33; 95% confidence interval (CI), 4.20–20.72; p<0.001). The results of multivariate analysis showed that TB treatment outcome is affected by adverse drug reactions (OR, 10.91; 95% CI, 4.62–25.75; p<0.001), drug use in treating concomitant diseases (OR, 3.03; 95% CI, 1.30–7.05; p=0.010), and type of anti-TB drug used (OR, 2.41; 95% CI, 0.99–5.83; p=0.045).
 Conclusion: Based on these results, we showed that adverse reactions to anti-TB drugs can affect TB treatment outcome and can serve as a risk factor to treatment default.
Highlights
Tuberculosis (TB) is one of the leading fatal infectious diseases and remains a major health problem worldwide
In 2013, the World Health Organization (WHO) estimated that there were more than 9 million incident TB cases, 64% of which were new sputum smearpositive cases, and that about 3 million TB cases remain undiagnosed with 1.5 million TB-related deaths worldwide
From a total 172 patients included in this study, 127 patients (73.8%) experienced minor adverse reactions to anti-TB drugs, and 45 patients (26.2%) had major adverse reactions
Summary
Tuberculosis (TB) is one of the leading fatal infectious diseases and remains a major health problem worldwide. In 2013, the World Health Organization (WHO) estimated that there were more than 9 million incident TB cases, 64% of which were new sputum smearpositive cases, and that about 3 million TB cases remain undiagnosed with 1.5 million TB-related deaths worldwide. The factors contributing to TB treatment outcome include patient compliance, patient knowledge and behavior related to TB, and health services. Patient adverse reactions to TB treatment might escalate treatment default [3]. Further investigation is needed regarding whether adverse reactions to antiTB drugs represent an independent etiologic factor that may contribute to the outcome of TB treatment. The objective of this study was to determine whether there was a correlation of TB treatment default cases with drug side effects and other aspects of TB treatment
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