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1.
Article | IMSEAR | ID: sea-217672

Résumé

Background: The emergence of multidrug-resistant tuberculosis (MDR-TB) (defined as resistance to at least isoniazid and rifampin) poses a threat to global TB control. Second line drugs are frequently associated with very high rates of unacceptable adverse drug reactions (ADRs), needing frequent interruption and change of regimen. Different studies have stated varying incidence of these adverse effects leading to discontinuation of ATT. Aims and Objectives: This study intends to find out the occurrence of side effects of anti-TB drugs in patients receiving MDR treatment. Material and Methods: The present prospective cross-sectional observational study was carried out at Drug-Resistant TB Center at Govt. Medical College Kota for a period of July 2018 to June 2019. Patients with adverse events after the introduction of treatment of MDR-TB were included in the study. We monitored the patients with adverse events after starting treatment till the patients were admitted and later followed up by recalling the patients at monthly intervals. Results: Out of total 148 patients majority patients (64.81%) were in the young age group (20–39 years) with male: female ratio 2:1. Out of the 148 patients, 112 patients developed at least one or more types of ADR and a total of 15 types of ADR. Gastrointestinal upset was the most common ADR reported (62.16%) followed by joint pain (41.89%) and headache (36.48%). About 60.74% of all ADRs were managed by symptomatic treatment. 32 (21.62%) patients required change of regimen.Twelve patients (8%) discontinued treatment due to adverse reactions. Conclusion: Treatment of MDR-TB with second-line antitubercular drugs is associated with high rate of adverse effects experienced in more than half of patient in this study. Ototoxicity and neuropsychiatric symptoms are major adverse effects lead to important drug withdrawl from the regimen. The health care professionals should be alert during the intensive phase of the treatment, identify symptoms at the earliest and hence help in minimizing morbidity.

2.
Article | IMSEAR | ID: sea-225769

Résumé

Background: Drug-induced hepatitis (DIH) is a side effect of the usage of anti-tuberculosis (TB) drugs, which can cause alteration in treatment regiments and prolonged treatment. This study aim is to identify the risk factors that can be used to predict the occurrenceof DIH on tuberculosis (TB) patients.Methods: This was a case-control study, conducted at Sanglah central general hospital in Denpasar from January to June 2021. Data collection was carried out through the medical records of inpatients and outpatients who received fixed-dose combination anti-TB drug.Results: There were 62 research samples which were divided into 31 samples in the case group and 31 samples in the control group. The clinical manifestations of DIH were vomiting (32.8%), nausea (15.7%), abdominal pain (13.1%), and hepatic encephalopathy (1.3%). Median time to onset of DIH was 18 (Interquartile range: 19) days. Low BMI was a significant risk factor for DIH (AOR=22.4; 95%CI 4.147-121.575; p<0.001). Other clinical characteristic variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not proven risk factors for DIH-TB.Conclusions: Low BMI was a significant risk factor for DIH. Other variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not risk factors for DIH in TBpatients

3.
Biomedical and Environmental Sciences ; (12): 418-425, 2017.
Article Dans Anglais | WPRIM | ID: wpr-311396

Résumé

<p><b>OBJECTIVE</b>The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN.</p><p><b>METHODS</b>In this study, suspected patients with TBLN and having different anti-TB treatment background were enrolled. All the samples were tested simultaneously by histology, Ziehl-Neelsen (ZN) staining, mycobacterial culture (culture), Xpert MTB/RIF (xpert), real-time PCR, and high-resolution melting curve PCR (HRM). Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed.</p><p><b>RESULTS</b>In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture (P < 0.0001). In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert (P < 0.05). However, the treatment history did not affect the performance of remaining tests (P > 0.05). For rifampicin drug susceptibility test (DST), the anti-TB treatment showed only significant influence on the success rate of culture DST (P = 0.001), but not on those of Xpert and HRM tests (P > 0.05).</p><p><b>CONCLUSION</b>Other tests as well as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.</p>


Sujets)
Adolescent , Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Antituberculeux , Utilisations thérapeutiques , Techniques bactériologiques , Résistance bactérienne aux médicaments , Tuberculose ganglionnaire , Diagnostic , Traitement médicamenteux , Microbiologie
4.
Biomedical and Environmental Sciences ; (12): 139-142, 2017.
Article Dans Anglais | WPRIM | ID: wpr-296505

Résumé

We assessed the incidence of adverse drug reactions (ADRs) with anti-TB medications and evaluated the risk factors for developing ADRs in previously treated tuberculosis patients in China. All patients received the first-line anti-TB regimen (2HREZS/6HRE) as recommended by the national guidelines. Clinical and laboratory evaluations were performed once a month. Out of the 354 participants, 262 (74.0%) experienced ADRs such as hyperuricemia (65.0%, 230/354), hepatotoxicity (6.2%, 22/354) and hearing disturbances (4.8%, 17/354). ADRs were significantly associated with diabetes mellitus [OR (95% CI): 15.5 (2.07-115.87)]; however, weight more than 50 kg [OR (95% CI): 0.41 (0.22-0.85)] was a protective factor for occurrence of ADRs. Hyperuricemia is the most common adverse event but, most patients with hyperuricemia showed increased tolerance for high uric acid levels. Low body weight and diabetes mellitus increased the risk of the occurrence of ADRs during anti-TB treatment.


Sujets)
Adolescent , Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Antituberculeux , Utilisations thérapeutiques , Diabète , Prévalence , Études rétrospectives , Facteurs de risque , Tuberculose pulmonaire , Traitement médicamenteux , Épidémiologie
5.
Braz. j. infect. dis ; 20(6): 585-591, Nov.-Dec. 2016. graf
Article Dans Anglais | LILACS | ID: biblio-828168

Résumé

ABSTRACT Novel strategies to combat the ever increasing burden of drug resistance in Mycobacterium tuberculosis (MTB) causing tuberculosis (TB) remains a global concern. The ability of MTB to sense and adapt to restricted iron conditions in the hostile environment is essential for their survival and confers the basis of their success as dreadful pathogen. The striking and clinically relevant virulence trait of MTB is its ability to form biofilms and adhere to the host cells. The present study elucidated the effect of iron deprivation on biofilm formation and cell adherence of Mycobacterium smegmatis, a non-pathogenic surrogate of MTB. Firstly, we showed that iron deprivation leads to enhanced cell sedimentation rate and altered colony morphology depicting alterations in cell surface envelope properties. We explored that biofilm formation and cell adherence to polystyrene surface as well as human oral epithelial cells were considerably reduced under iron deprivation both in presence of 2,2 BP (iron chelator) and siderophore mutant Δ011-14 strain. We further investigated that the potency of three first line anti-TB drugs (Isoniazid, Ethambutol, Rifampicin) to inhibit both biofilm formation and cell adhesion were enhanced under iron deprivation in contrast to the drugs when tested alone. Taken together, by virtue of the indispensability of iron for functional virulence traits in mycobacteria, iron deprivation strategies could be further exploited against this notorious human pathogen to explore novel drug targets.


Sujets)
Humains , Virulence , Adhérence bactérienne/effets des médicaments et des substances chimiques , Biofilms/croissance et développement , Mycobacterium smegmatis/pathogénicité , Cellules épithéliales/microbiologie , Fer/pharmacologie , Biofilms/effets des médicaments et des substances chimiques
6.
Chinese Pharmaceutical Journal ; (24): 1706-1709, 2016.
Article Dans Chinois | WPRIM | ID: wpr-858962

Résumé

OBJECTIVE: To find out the essentials of clinical pharmacists' work on making individualized anticoagulation therapy, tailored to patients with deep vein thrombosis and pulmonary tuberculosis, and on its pharmaceutical care. METHODS: The clinical pharmacist participated in one case of individualized anticoagulation therapy and provided pharmaceutical care to one patient with deep vein thrombosis and pulmonary tuberculosis. The patient used to take warfarin, but the treatment was ineffective, therefore the clinical pharmacist tried to find out the reason from such aspects as interactions among genetic polymorphism, anticoagulants and anti-TB drugs, then adjusted the therapy for the patient. RESULTS: A dosage regimen suitable for the patient was formulated, and medication education was carried out to the patient in terms of medication instructions, such as influencing factors on curative effects of warfarin and monitoring of INR, to improve the patient compliance related to anticoagulation therapy. CONCLUSION: Clinical pharmacists should start pharmaceutical service right from making individualized anticoagulation therapy and carrying out pharmaceutical care.

7.
Journal of Modern Laboratory Medicine ; (4): 134-137, 2016.
Article Dans Chinois | WPRIM | ID: wpr-487852

Résumé

Objective To evaluate the value of four methods in diagnosis of pulmonary tuberculosis,including T-SPOT,fluo-rescent PCR,anti-TB antibody test,and acid-fast staining.Methods Retrospective analysis of 530 cases between January 2012 and December 2014 who had taken four methods,and calculated the sensitivity specificity,positive predictive value,neg-ative predictive value,Kappa value,Youden index,positive likelihood ratio,negative likelihood ratio,Pairedχ2 test.Consider clinical diagnosis as the gold standard.Results The sensitivity,negative predictive value,Youden index of T-SPOT were 95.90%,97.29%,0.82,respectively,and all of these were the highest.The negative likelihood ratio of T-SPOT was 0.05, which was the lowest.Misdiagnosis rate of PCR was 87.18%,which was the highest.Positive likelihood of anti-TB antibody test was the lowest,6.48,while other indicators were no advantage.The specificity,positive predictive value and positive likelihood ratio of acid-fast staining were 99.70%,98.90%,153.83,respectively,and the three of these were highest.Pair-wise comparison between the four methods were significantly different.Conclusion The T-SPOT and acid-fast staining can be used as important methods,and the anti-TB antibody can provide result quickly,and PCR method is more suitable for ex-amination of sterile body fluids.

8.
Br J Med Med Res ; 2015; 8(10): 836-841
Article Dans Anglais | IMSEAR | ID: sea-180757

Résumé

Background: The eight month’s treatment regimen (2RHZE/6EH) was used by the Nigerian National TB and Leprosy Control Programme for the management of tuberculosis cases since 2003 when they commenced operation until October 2010 when the six month’s treatment regimen (2RHZE/4RH) was introduced. This study compared the treatment outcomes of patients managed with eight and six month’s treatment regimen between October 2009 and December 2011. Methods: A desk review was carried out on the programme data of the Lagos State Tuberculosis and Leprosy Control Programme (LSTBLCP). The treatment outcomes of new smear positive TB patients managed between October 2009 and September 2010 (the eight month’s treatment regimen period) and January to December 2011 (six month’s treatment regimen period) were compared using Epi Info 2007 statistical software. Results: A total of 4249 and 4167 smear positive TB patients were registered during the eight and six month’s treatment regimen period respectively. The prevalence of HIV among TB patients was significantly higher (14.4%) during the eight month’s treatment regime period compared with the six month’s (12.1%) treatment regime period (P = .02). The cure rate of patients managed during the eight month’s treatment regimen period was significantly lower (67.2%) and defaulter rate significantly higher (16.7%) compared with the cure (73.9%) and defaulter rates (12.2%) of patients managed during the six month’s treatment regimen period (P<.001). However the failure and death rates of patients managed during the eight and six month’s treatment regimen periods were comparable (P>.05). Among TB/HIV co-infected patients, the death rate was significantly higher among patients managed during the six month’s regimen period and the default rate was significantly higher in patients managed during the eight month’s treatment regimen period (p<.05). Conclusion: Patients had better treatment outcomes during the six month’s treatment regimen period in Lagos State. Sustaining these gains will be essential in reaching the national and global targets.

9.
Chinese Pharmaceutical Journal ; (24): 1078-1080, 2014.
Article Dans Chinois | WPRIM | ID: wpr-859691

Résumé

OBJECTIVE: To observe the prophylactic effect of hepatic protectants in the anti-TB treatment of acquired im-mund deficiency syndrome patients. METHODS: Cases from 2008 through 2013 with or without hepatic protectants were analysed to compare the changes in transaminase. RESULTS: Patients with hepatic protectants showed a 26.9% of rate of hepatic injury, while those without hepatic protectants showed a 37.9% of rate of hepatic injury. CONCLUSION: Prophylactic application of hepatic protectants can decrease the occurrence of hepatic injury during the anti-TB treatment of AIDS patients.

10.
Asian Pacific Journal of Tropical Medicine ; (12): 952-959, 2013.
Article Dans Anglais | WPRIM | ID: wpr-819751

Résumé

OBJECTIVE@#To evaluate the success rate of tuberculosis intervention programme at a specialist hospital in Ibadan, Nigeria through a retrospective study as well as carry out physicochemical evaluation of anti-tuberculous agents as a way of eliminating drug-related failure.@*METHODS@#The retrospective study involved the use of quarterly tuberculosis central register at the Government Chest Hospital, Ibadan between 1st quarter (2003) to 4th quarter (2009). Relevant data were extracted from these register with the aid of data collection forms. The basic physicochemical analyses of the drugs given to the patients were also carried out using the International Pharmacopoeia methods.@*RESULTS@#All the drugs examined for their physicochemical properties passed the International Pharmacopeia recommended tests. A total number of 1 260 patients enrolled at the hospital were assessed through case notes. This comprises of 59.4% males of which 69.23% new cases were also males. There was a significant (P0.05). Failure rates in all categories were higher in males than females (P>0.05).@*CONCLUSIONS@#More enlightenment and counseling is still required to meet up with the target for TB control.


Sujets)
Femelle , Humains , Mâle , Antituberculeux , Chimie , Utilisations thérapeutiques , Thérapie sous observation directe , Nigeria , Études rétrospectives , Centres de soins secondaires , Résultat thérapeutique , Tuberculose , Traitement médicamenteux , Épidémiologie
11.
Infectio ; 16(3): 148-153, jul.-set. 2012. tab
Article Dans Espagnol | LILACS, COLNAL | ID: lil-675164

Résumé

Objetivo: Analizar los factores sociodemográficos y clínicos de los pacientes con diagnóstico de tuberculosis resistente en el municipio de Armenia durante el período 2006-2009. Métodos: Se realizó un estudio descriptivo y retrospectivo con base en la notificación de pacientes con tuberculosis resistentes durante el período de estudio. Los datos fueron tomados de los registros consignados en las fichas de notificación y las tarjetas individuales de tratamiento categoría IV. Resultados: Entre 2006 y 2009, 678 pacientes ingresaron en el programa de control de la tuberculosis. De ellos, 14 casos (2,0%) fueron resistentes al menos a un medicamento, y entre estos, 7 (50%) fueron multirresistentes. El 21% estuvo asociado a infección por virus de la inmunodeficiencia humana. La tasa de fallecimientos en pacientes con tuberculosis con farmacorresistencia múltiple fue del 71%. Se encontró amplificación de la resistencia en 2 casos, quienes presentaron deterioro en el estado de salud y deceso. Conclusión: La situación en Armenia de resistencia a antituberculosos es de proporción similar a la del resto del país. Se encontraron factores de riesgo conocidos en los casos de resistencia (coinfección con virus de la inmunodeficiencia humana, farmacodependencia, abandono social) en la mayoría de casos, pero también de resistencia primaria y sin factores de riesgo con farmacorresistencia múltiple y una alta mortalidad, lo que llama la atención para mejorar la vigilancia y el control de los casos en tratamiento en la ciudad.


Objective: To analyze the socio-demographic and clinical diagnosis of patients with resistant tuberculosis in the municipality of Armenia in the period 2006-2009. Methods: We performed a retrospective descriptive study based on the notification of patients with resistant tuberculosis during the study period, data were taken from registrations under notification forms and individual treatment cards category IV. Results: 678 patients were admitted to the program of tuberculosis control between 2006 and 2009, 14 cases (2,0%) were resistant to at least one drug and from these cases 7 were multidrug resistant (MDR). In 21% of cases there was co-infection with HIV. The death rate in patients with MDR-TB was 71%. Amplification in resistance was observed in two cases which lead to further deterioration in the health status and death. Conclusion: Armenia has levels of resistance to anti tuberculosis drugs similar to the reported in the rest of Colombia. We found factors already know to be associated with resistance (drug addiction, social abandon, HIV co infection) but there were also cases without these factors and with primary MDR and high mortality, therefore is urgent to improve the public health measures for cases under treatment in this city.


Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Tuberculose , Diagnostic Clinique , Démographie/classification , Multirésistance aux médicaments , Préparations pharmaceutiques , Facteurs de risque , VIH (Virus de l'Immunodéficience Humaine) , Colombie , Troubles liés à une substance , Infections , Antituberculeux
12.
Acta Medica Philippina ; : 9-12, 2011.
Article Dans Anglais | WPRIM | ID: wpr-633802

Résumé

RATIONALE: Among the first line antituberculosis (anti-TB) drugs, the major drug incriminated in the development of hepatotoxicity is isoniazid (INH). The human N-acetyl transferase2 (NAT2) gene is mainly responsible for INH metabolism. This gene exhibits a hereditarily determined polymorphism. There is presently no study on the predominant NAT2 genotype among Filipinos. There are also no Filipino studies on the incidence of hepatitis and other adverse effects of first line anti-TB drugs. OBJECTIVES: To determine the predominant NAT2 genotype and its association with the development of hepatitis among Filipino children given first line anti-TB drugs (INH, rifampicin and pyrazinamide) and to determine the incidence of hepatitis and other serious adverse reactions to these drugs. STUDY DESIGN: Prospective cohort study SETTING: Tertiary government hospital in Metro Manila STUDY POPULATION: Children on to 18 years old with pulmonary tuberculosis and normal liver function test at baseline. METHODS: Total bilirubin (TB), direct bilirubin (DB) and liver transaminases (AST and ALT) were checked routinely at baseline and at thow, four, eight and 12 weeks after starting treatment. Within the first month of treatment, blood was also taken for NAT2 genotyping. The identification of the three NAT2 polymorphisms that are associated with a slow acetylator status - 481C to T (NAT2*5), 950G to A (NAT2*6) and 857G to A (NAT2*7) was carried out by polymerase chain reaction-restriction fragment length polymorphism. All patients were followed up for a total of six months. The presense of any adverse effects like gastroinstestinal symptoms, rash, hepatitis or drug fever was also monitored. RESULTS: A total of 24 children [mean age: 5 years; 11 males] were included. Majority (96%) were diagnosed by passive detection and mean Z score was - 1.38 (1 to -3). No patient developed hepatotoxicity or any side effects to anti-TB drugs. In 23 patients who had NAT2 genotyping, 39% and 22% were alleles homozygous for the NAT2*6 and NAT2*7, respectively. There was a combination of alleles in only three (13%) subjects. CONCLUSION: NAT2*6 and NAT2*7 alleles associated with a slow acetylator status were detected among our patients although the presence of these variants did not lead to any hepatotoxicity nor any treatment-related side effects. A larger study with broader genotype analysis is needed to confirm the present findings.


Sujets)
Humains , Mâle , Femelle , Adolescent , Enfant , Nourrisson , Isoniazide , Pyrazinamide , Rifampicine , Allèles , Bilirubine , Tests de la fonction hépatique , Transaminases , Antituberculeux , Tuberculose pulmonaire , Hépatite , Polymorphisme génétique
13.
Indian J Pediatr ; 2009 Jul; 76(7): 739-742
Article Dans Anglais | IMSEAR | ID: sea-142328

Résumé

There has been significant change in management of tuberculosis ever since pre-chemotherapeutic era to the present day RNTCP protocol based on specific disease catrogies. This has been based on knowledge of rational use of anti-TB drugs. DOTS has added new dimensions to TB control program. Public-private partership will foster the way ahead for better outcome, only if every physician follows management protocol.


Sujets)
Adolescent , Antituberculeux/usage thérapeutique , Enfant , Enfant d'âge préscolaire , Contrôle des maladies transmissibles/tendances , Thérapie sous observation directe/méthodes , Prise en charge de la maladie , Femelle , Prévision , Humains , Inde , Programmes nationaux de santé , Prévalence , Tuberculose/diagnostic , Tuberculose/traitement médicamenteux , Tuberculose/épidémiologie
14.
Chinese Journal of Epidemiology ; (12): 286-289, 2009.
Article Dans Chinois | WPRIM | ID: wpr-266550

Résumé

Objective To study the features of liver damage caused by anti-TB medicines among patients with TB-HBV co-infection, in order to complement and improve the implementation of DOTs strategy in the region. Methods A historical cohort study was conducted including the process of reviewing and analyzing files of the 781 naive TB patients hospitalized from June 2004 to October 2005. Cases were divided into HBsAg (+) group and HBsAg (-) group. Results The overall damage rate among the 781 investigation cases was 20.74%, including 121 cases (74.69%) in HBsAg (+) group and 41 cases (25.31%) in HBsAg (-) group. Data showed that liver damage rate and average value of ALT and AST of HBsAg (+) group were higher than those in HBsAg (-) group. First case with liver damage in HBsAg (+) group happened on the 7th day of the treatment, while the first liver damage case happened in HBsAg (-) group was on the 16th day. The average onset in HBsAg (+) group was earlier than HBsAg (-) group for 18.09 days. The average time of liver function recovery in HBsAg (+) group was 57.02 days and in HBsAg (-) group it was 27.56 days while the appearance among HBsAg (+) group was 29.46 days later than in HBsAg (-) group. Conclusion The incidence rate of liver damage caused by anti-TB medicines was higher among HBV positive patients than those HBV negative patients. Patients co-infected with HBV infection appeared to be more serious, with higher incidence on liver damage and earlier onset, as well as with the degree of damage to the liver.

15.
China Pharmacy ; (12)2005.
Article Dans Chinois | WPRIM | ID: wpr-529268

Résumé

OBJECTIVE:To evaluate the management of the free anti-TB drugs in He'nan province,and to analyze ex-periences and find out the gap.METHODS:Based on the requirements of the Chinese TB Control Program-Free anti-TB drug management manual,a questionnaire comprised of 17 items was developed and 20 TB drug storerooms at city or county level were randomly sampled for on the spot investigation.RESULTS:Of the total drug storerooms investigated,75% had yearly drug demand plan,but only 35% was up to the standard in inventory control,95% had no expired drug,90% had inventory/supply vouchers and detailed inventory records,only 25% achieved conformity between records and physical counts.The condition of drug storerooms and the storage of drugs were unable to meet the requirement.CONCLUSION:Tuberculosis Control Agency at different levels haven't paid due attention to the management of free anti-TB drugs.The personnel in this agency should raise their drug management responsibility from aspects of saving public belongings and ensuring patients' medication quality.

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