ASSESSMENT OF TREATMENT OUTCOME IN TUBERCULOSIS PATIENTS APPROACHING A TERTIARY CARE TEACHING HOSPITAL

Riya Jaison; Suja Abraham; Mary Sruthy Johny; Vasant Pk; Lakshmi R

doi:10.22159/ajpcr.2018.v11i5.25012

Authors

Riya Jaison Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi - 682 041, Kerala, India.
Suja Abraham Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi - 682 041, Kerala, India.
Mary Sruthy Johny Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi - 682 041, Kerala, India.
Vasant Pk Department of Internal Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi - 682 041, Kerala, India.
Lakshmi R Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi - 682 041, Kerala, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i5.25012

Keywords:

Tuberculosis, Mycobacterium, Treatment outcome

Abstract

Â Objectives: The main objectives of the study were to determine the treatment outcome of tuberculosis (TB) patients in a tertiary care hospital, factors associated with the success of treatment, the adverse drug reactions (ADRs) associated with anti-tubercular drugs, and the causality and severity evaluation of ADRs.

Methods: It was a prospective study conducted for 10 months to evaluate the treatment outcome in TB patients in a tertiary care teaching hospital in Kerala, India. A total of 101 patients were studied as per the inclusion and exclusion criteria. Treatment outcome analyzed according to the WHO guidelines, causality and severity assessment was done by Naranjo and HARTWID-SIEGEL scale, respectively. A standardized data collection form was prepared, and necessary data were collected from patient's medical records.

Results: A total of 101 patients mostly in the age group of 30â€“50 years were male population dominates pulmonary TB (PTB) was seen in 57 (56.43%) extra PTB in 44 (43.57%) in which pleural effusion TB was common (34.09%) other types were lymph node TB (15.74%), spine TB, TB meningitis (9.09% each), bone TB (6.481%) treatment outcome found to be success in 85 (84%) 10 (10%)treatment completed 1 (1%) died 4 were defaulters, 1 not evaluated, 82 developed ADR. On causality assessment it was possible and severity of moderate level.

Conclusion: By proper management and monitoring TB can be completely cured, and most of them have a favorable outcome with current treatment, and ADR can be managed by providing proper awareness of treatment modalities/disease.

Downloads

Download data is not yet available.

References

Arvind A, Jain V, Saravanan P, Mohan CG. Uridine monophosphate kinase as potential target for tuberculosis: From target to lead identification. Interdiscip Sci 2013;5:296-311.

Kumar GS, Venugopal AK, Kashyap MK, Raju R, Marimuthu A, Palapetta SM, et al. Gene expression profiling of tuberculous meningitis co-infected with HIV. J Proteomics Bioinform 2012;5:235-44.

Shaji J, Shaikh M. Drug resistant tuberculosis: Recent approach in polymer based nanomedicine. Int J Pharm Pharm Sci 2016;8:1-6.

Obasanya J, Patrobas P, Gidado M,Clement A, Liman H,Tari A, et al. Modules for the Training of Health Facility Workers in TB Control. 3rd ed. Zaria, Nigeria: Jodda Comm Press; 2007. p. 5-25.

Jensen PA, Lambert LA, Iademarco M, Ridzon R. Centres for disease control and prevention. Guidelines for preventing the transmission of mycobacterium tuberculosis in health care settings. MMWR Recomm Rep 2005;54:1-141.

Arvind A, Kumar V, Saravanan P, Mohan CG. Homology modeling, molecular dynamics and inhibitor binding study on MurD ligase of Mycobacterium tuberculosis. Interdiscip Sci Comput Life Sci 2012;4:223-38.

Friden TR, Sterling TR, Munsiff SS, Watt CJ, Dye C. Tuberculosis. Lancet 2003;362:887-99.

Surveillance Reports: Reported Tuberculosis in the United States 2005. Centers for Disease Control and Prevention Web Site.

Illahi RK, Pramestutie HR, Desyana MS. The use of counselling toolâ€ Lung TB Care to increase patients knowledge level (A study in tuberculosis patients at Malangâ€™s primar healthcare centers). Int J Pharm Pharm Sci 2018;10:1-4.

Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm 1992;49:2229-32.

Patra S, Lukhmana S, Tayler Smith K, Kannan AT, Satyanarayana S, Enarson DA, et al. Profile and treatment outcomes of elderly patients with tuberculosis in Delhi, India: Implications for their management. Trans R Soc Trop Med Hyg 2013;107:763-8.

IUTALD. International Union against Tuberculosis and Lung Disease (IUATLD). Management of Tuberculosis: A guide for Low-Income Countries. IUTALD; 2013.

American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America. Treatment of tuberculosis. MMWR 2003;52:1-77.

Bernard L, Stern R, Lew D, Hoffmeyer P. Serotonin syndrome after concomitant treatment with linezolid and citalopram. Clin Infect Dis 2003;36:1197.

Doster B, Murray FJ, Newman R, Woolpert SF. Ethambutol in the initial treatment of pulmonary tuberculosis. U.S. Public health service tuberculosis therapy trials. Am Rev Respir Dis 1973;107:177-90.

Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The hunter serotonin toxicity criteria: Simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003;96:635-42.

Halevy S, Shai A. Lichenoid drug eruptions. J Am Acad Dermatol 1993;29:249-55.

Whitacare CC, Reingold SC, Oâ€™Looney PA. A gender gap in autoimmunity. Science 1999;283:1277-8.

Yang Z, Kong Y, Wilson F. Foxma manifestations and diagnosis of extra pulmonary Tuberculosis. Rev Mal Respir 1997;14:S72-87.

Sudre P, Hirschel BJ, Gatell JM, Schwander S, Vella S, Katlama C, et al. Tuberculosis among European patients with the acquired immune deficiency syndrome. The AIDS in Europe study group. Tuber Lung Dis 1996;77:322-8.

Stelianides S, Belmatoug N, Fantin B. Manifestations and diagnosis of extrapulmonary tuberculosis. Rev Mal Respir 1997;14 Suppl 5:S72-87.

Nissapatron V, Kuppuswamy I, Rohela M, Khairul A, Fong MY. Extra pulmonary tuberculosis in Penisular Malasya: Retrospective study of 195 cases. Southeast Asian J Trop Med Public Health 2004;35:123-35.

Ormerold LP, Horsefield N. Frequency and type of reactivation anti TB drugs: Observation in routine treatment. Tubercule Lung Dis 1996;77:37-42.

Sharma SK, Mohan A. Extra pulmonary tuberculosis. Indian J Med Res 2004;120:316-53.

Ariyothaini N, Paka P, Akarasewi P. Ciggerate smoking and its relation to pulmonary tuberculosis in adults. Southeast Asian J Trop Med Public Health 2004;35:219-27.

Addington WW. Patient compliance: The most serious remaining problem in the control of tuberculosis in the United States. Chest 1979;76:741-3.

Lewis JG, Chamberlain DA. Alcohol consumption and smoking habits in male patients with pulmonary tuberculosis. Br J Prev Soc Med 1963;17:149-52.

Pulido F, Pena JM, Rubio R. Relapse of tuberculosis after treatment in HIV-infected patients. Arch Intern Med 1997;157:227-32.

Bhal S, Sarin R, Jaiswal A, Choudary A, Singala N, Mukherjee S. Revised national tuberculosis control programme; an urban experience. Indian J Tuberc 1998;45:207-10.

Shargie E, Linditjorn B. DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: A retrospective trend analysis. BMC Public Health 2005;5:1471-7.

Ministry of Health and Family Welfare. Revised National tuberculosis control programme status report. New-Delhi, India: Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirmala Bhavan; 2012. p. 7-17.

Chennaveerappa PK, Siddharam SM, Halesha BR, Vittal BG, Jayashree N. Treatment outcome of tuberculosis patients registered at dots centre in a teaching hospital, south India. Int J Biol Med Res 2011;2:487-9.

Mukesh M, Prathap MM, Sabitha M. Structural model of the alpha phosphoglucomutase: A promising target for the treatment of mycobacterium tuberculosis. Int J Pharm Pharm Sci 2013;5:107-14.

Dholakia Y, Danani U, Desai C. Relapse Following directly observed treatment short course-a follow-up study. India J Tuberc 2000;47:233 6.

Fraser W, Balasubramanian R, Mohan A, Sharma SK. Extra pulmonary Tuberculosis: Management and Control. Indian J Tuber 2000;47:123-8.

Chakaya JM, Kibuga D, Ngâ€™angâ€™a L, Githui WA, Mansoer JR, Gakiria G, et al. Tuberculosis retreatment outcomes within the public services in Nairobi, Kenya. East Afr Med J 2002;79:11-5.

Schaberg T, Rahban K, Lode H. Risk factors for side effects of isoniazid, Rifampicin and Pyrazinamide in patients hospitalized for pulmonary tuberculosis. Eur Respir 1996;9:2026-30.

Durand F, Jebark G, Pessayer D, Fournier N, Berand J, Hepatotoxicity of anti-tuberculosis drugs: Rational for monitoring liver status. Drug safety 1996;15:394-405.

Dossing M, Wilcke TR, Askgaard DS, Nyboo B. Liver injury during. An 11-year study. Tuber Lung Dis 1996;77:31.

Singh J, Grag PK, Tandon RK. Hepatotoxicity due to anti tuberculosis therapy. Clinical profile and reintroduction of therapy. J Clin Gastroentrol 1996;22:211-4.

Sharma SK, Balamurugan A, Saha PK, Pande RM, Mehra NK. Evaluation of clinical and immunogenetic risk factors for the development of hepatotoxicity during anti-tuberculosis treatment. Am J Respir Crit Care Med 2002;166:916-9.

Koju D, Rao BS, Shrestha B, Shakya R, Makaju R. Occurance of side-effects in urban nepalese population under DOTS Treatment, 200. Kathmandu Univ J Sci Eng Technol 2005;1:166-72.

Nagamaya N, Shisshido Y, Masunda K, Baba M, Tamura A, Nagai H, et al. Leukopenia due to anti-tuberculosis chemotherapy including rifampicin and isoniazid. Kekkaru 2004;79:341-8.

Tak DK, Acharya LD. Safety evaluation of Ant tubercular therapy in India. J Clin Diagn Res 2009;3:1395-401.

Romanilos T, Casagran A, Barbeta E, Diestre J, Grau J, Marquillas E, et al. Pulmonary Tuberculosis: Effectiveness and tolerance of a 6-month treatment schedule using four drugs[Article in Spanish]. Rev Clin Esp 1990;186:116-8.

Getahun B, Ameni G, Biadgiligo S, Medhin G. Mortality and other associated risk factors in a cohort of tuberculosis patient treated under DOTS programme in Addis Ababa, Ethiopia. BMC Infect Dis 2011;11:127-34.

Bernard N, Margret N. Factors associated with default from treatment among tuberculosis patient in Nairobi province, Kenya: A case control study. BMC Public Health 2011;11:696.