Drug Resistant Tuberculosis Centre Research Articles

Profile of adverse drug reactions in multiple drug resistant tuberculosis patients at drug resistant-tuberculosis center - Miraj, Maharashtra

Background: Drug resistant tuberculosis (DR-TB) has been an emerging global public health threat and area of serious concern on to global efforts of TB control initiative. Objectives: To elucidate the profile of adverse drug reactions (ADRs) associated with antitubercular treatment regime for DR-TB. Materials and Methods: A retrospective, record-based, observational type of epidemiological study was conducted on multi DR (MDR)-TB patients. The sample size includes, total of 468 patients were admitted in DR-TB center Miraj during year 1st July 2013 to 30th June 2015. A structured pro forma was designed and utilized to collect the data that include variables on ADR profile of diagnosed MDR-TB cases on supervised DOTS-Plus regimen under programmatic management of DR-TB under Revised National Tuberculosis Control Program. The data were analyzed into frequency percentage distribution and presented in tabular form. Results: Out of total 468 MDR-TB patients, 12.82% were reported with ADRs. Out of total 109 ADRs, gastrointestinal upset was maximum, 5.98% followed by psychosis 4.91%, hearing impairment 2.99%, and rest were in between 0.21% and 1.49%, respectively. Max, 56.67% ADRs were seen in undernourished patients with major involvement pertained to central nervous system. Around, 50% ADRs were managed by symptomatically, whereas others were managed by changing the antitubercular drug (33.33%), use of vitamin B6 and use of antidepressant. Conclusion: Early detection, management and reporting of ADRs remain key factors in the management of MDR-TB with remarkable relevance to prevent emergence threat of global MDR-TB.

Adverse events among patients of multi drug resistant tuberculosis receiving second line anti TB treatment

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>As per WHO’s “Global Tuberculosis Report, 2012”, India accounts for an estimated 64000 patients out of 310000 cases of drug resistant TB estimated to have occurred amongst the notified cases of TB across the globe in a year. <strong> </strong><span lang="EN-US">MDR-TB is a man-made phenomenon– poor treatment; poor drugs, poor adherence lead to the development of MDR-TB. </span><span lang="EN-US"> </span><span lang="EN-US">Treatment of MDR-TB is difficult, much costlier, challenging and needs experience and skills. Reserve drugs are frequently associated with high rates of unacceptable adverse drug reactions, needing change of regimen. Therefore, it is imperative to monitor and treat adverse drug reactions. <strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>The present prospective observational study was carried out at Drug Resistant Tuberculosis Centre at Govt. Medical College, Aurangabad, Maharashtra, to monitor patients for early detection of adverse events after starting treatment till the patients were admitted and later followed up personally or telephonically at regular intervals.</p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> We observed adverse drug reactions among </span>90/265 (33.96 %) patients of whom 90/265 (33.96 %) had gastro intestinal ADRs, followed by ototoxicity 15/265 (5.66%), psychiatric manifestations 14/265 (5.28%), injection site pain swelling 13/265 (4.90%), arthralgia 11/265 (4.15%), dermatological ADRs 7/265 (2.64%), peripheral neuropathy 5/265 (1.88%), renal dysfunction 3/265 (1.13%), <span lang="EN-US">change of therapy was only required in 13 psychiatric and 12 ototoxic ADRs.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> ADRs are more common in MDR TB patients on second line anti tubercular treatment. Good counseling, spacing drugs, high protein diet helps patients to tolerate therapy better and default rate to drop.</span></p>

Role of drug-resistant tuberculosis center in improving the treatment outcome in tuberculosis patients

A person’s state of health is a key resource for living a fulfilling and rewarding life. The term ‘health’ encompasses a person’s physical, mental, and social capabilities. Regardless of age, a person’s health depends on his or her ability to maintain homeostasis, adapt to adverse situations, and maintain relationships. However, many Americans define their own […]

Exploring the role of drug resistant tuberculosis center in the programmatic management: An Indian perspective

Global tuberculosis control report – 2012 has revealed that 3.7% of new cases and 20% of retreated cases are estimated to have multi-drug resistant (MDR) TB worldwide. Specific strategies have been implemented under the Programmatic Management of Drug Resistant TB in India (PMDT) to address the MDR-TB problem. Considering the long duration of treatment, PMDT recommends that treatment of drug resistant forms of TB should be decentralized. However, to supervise and guide the health care providers in the complex medical needs, an expert resource center called as Drug-resistant TB (DR-TB) center has been proposed. A DR-TB center plays a crucial role at different levels in the management of drug resistant forms of TB such as pre-treatment evaluation; initiation of treatment; maintenance of hospital wards & airborne infection control measures; management of severe adverse drug reactions; modification in the choice of drugs based on the drug sensitivity test results; and as a clinical expert resource for guidance to the program managers and the health care providers. To conclude, DR-TB center plays a defining role in the overall integrated model of care in RNTCP-PMDT services.

Efficacy and Safety of Unsupervised Chemotherapy at a Multi Drug Resistant Tuberculosis Center in India

Efficacy and Safety of Unsupervised Chemotherapy at a Multi Drug Resistant Tuberculosis Center in India