| dc.description.abstract | Introduction: Drug resistant tuberculosis treatment involves a number of toxic drugs that lead to adverse drug effects. The prevalence of adverse drug effects lies between 12% - 57% across different African countries. These effects can be life threatening and may lead to death, if not well managed. Therefore, this study determined and described the prevalence of adverse drug effects of the second-line drugs and factors associated in two selected healthcare facilities in Uganda.
Methods: The study was a cross-section study that employed qualitative and quantitative research methods. It was conducted in Uganda at Mulago National and Mbarara Regional referral hospitals among 856 multi-drug resistant tuberculosis patients receiving second line anti-tuberculosis drugs. Secondary data were analysed to determine and describe the prevalence of adverse drug effects and associated factors. Adverse drug effects were determined from records of the laboratory tests or clinically using the clinical notes. Further, the study explored the health workers’ perceptions and patients’ experiences on patient centred care of adverse drug effects.
Prevalence of ADE was calculated as a percentage. Prevalence ratios were used for bi-variable analysis where variables with a p-value less than 0.20 were selected for multi-variable analysis. The selected variables had their prevalence ratios adjusted using modified Poisson (glm loglink) regression model.
Results: Adverse drug effects were observed in 43.1% (369/856) muti-drug resistant tuberculosis patients and 17% (145/856) had more than 1 adverse drug effect. Patients who didn’t receive adherence enablers (food) (adj.PR=0.61, 95%; 0.51, 0.71) and (transport) (adj.PR=1.9, 95%; 1.21, 3.11), who did drug abuse (alcohol) (adj.PR=1.2, 95%; 1.05, 1.43), where started on long term (adj.PR=1.4, 95%; 1.07, 1.76) and individualised regimen (adj.PR=1.5, 95%; 1.11, 1.93), and received DOT from follow up facilities (adj.PR=1.6, 95%; 1.10, 2.41) were significantly associated with second line anti TB treatment adverse drug effects.
Most of the patients (12/16) experienced joint pains due to the drugs, with some saying that they were hurting a lot to an extent that they couldn’t walk or do anything. Most (7/8) of the health workers confirmed this assertion about most of the patients getting joint pains which are usually managed with pain killers. Furthermore, they added that patient centred care was used to manage these patients. This was done through health education and continuous counselling to ensure that patients adhere and complete treatment. All the patients (16/16) said whenever they complained, the health workers listened and responded to their complaints.
Conclusion: The prevalence of adverse drug effects from second line anti-TB treatment is still high (43.1%) among the muti-drug resistant tuberculosis patients. This study also showed that through patient centred care, patients’ complaints were handled this showed a good relationship between health workers and patients. | en_US |
