Abstract
Objective: India accounts for about one-fourth of the global TB burden. WHO TB statistics for India for 2018 gives an estimated incidence fig. of 2.69 million cases (199 per one lakh population). Drug-induced Hepatotoxicity is responsible for significant morbidity and mortality of the TB patient if these drugs continued after symptoms of hepatotoxicity develop. Whether the hepatotoxicity is due to individual drugs or due to additive effects is still unclear. The management therapy for TB patients with anti-TB DIH is imperative to ensure successful TB treatment and not recurrence DIH. Aim of the current study is to find out the pattern of Liver enzyme raised after antitubercular therapy in the tribal population of Koraput district where different phylogenetic populations reside where clinically it was observed by the physician little early onset of hepatotoxicity than national and international data.
 Methods: A prospective study was done after clearance from the Institutional Ethical Committee, Saheed Laxman Nayak Medical College, Koraput, from January 2019 to December 2019. Patients with>15 y of age with pulmonary and extrapulmonary tuberculosis with normal liver enzymes were included. Patients having abnormal liver enzymes before treatment, seropositive TB patients with human immunodeficiency virus infection, pregnant ladies and children<15 y of age were excluded.
 Results: Out of 922 patients in total; 4.78% (44) tuberculosis patients developed anti TB DIH. 68.18% (30) patients are below 50 y of age and 31.82% (14) are above 50 y of age group among TB patients with DIH. Age has no statistically significant influence on the occurrence of anti-TB DIH, but there is a statistically significant influence of sex on the occurrence of anti TB DIH. The mean occurrence of anti TB DIH is 18±18.16 d. One case of anti TB DIH patients shows signs and symptoms as early as on day 6th. The commonest symptoms are nausea and vomiting in 64% of patients who developed DIH. Interruption of ATT after DIH occurred in 79.54% of patients with recurrence in only 9.9% of patients after the reintroduction of ATT.
 Conclusion: Anti TB DIH mostly occurred between 7-28 d of starting the ATT in this geographical region. The duration of the anti TB ATT regimen is prolonged due to DIH. We recommend that all patients should have LTs 2 w after starting ATT, even if asymptomatic.
Highlights
Tuberculosis (TB) continues to remain as one of the most significant infectious diseases across much of the world
Out of 922 patients in total; 4.78% (44) tuberculosis patients developed anti TB Drug-Induced Hepatotoxicity (DIH). 68.18% (30) patients are below 50 y of age and 31.82% (14) are above 50 y of age group among TB patients with DIH
Anti TB DIH mostly occurred between 7-28 d of starting the Anti Tubercular Therapy (ATT) in this geographical region
Summary
Tuberculosis (TB) continues to remain as one of the most significant infectious diseases across much of the world. It carries an alarming socioeconomic burden on the individual and society. Tuberculosis remains an important cause of ill health and is one of the top 10 causes of death universally. In 2018, geographically, most tuberculosis cases were in the World Health Organization (WHO) regions of South-East Asia (44%), Africa (24%) and the Western Pacific (18%). India (27%), China (9%), Indonesia (8%), the Philippines (6%), Pakistan (6%), Nigeria (4%), Bangladesh (4%), and South Africa (3%) accounted for two-thirds of the universal total [1]. For 2018, WHO TB statistics for India give an estimated incidence fig. of 2.69 million TB cases (199 per one lakh population) [3]. 50303 and 71131 patients are notified with TB in both the public and private sector in ODISHA in 2018 and 2017 respectively [3]
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More From: International Journal of Pharmacy and Pharmaceutical Sciences
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