Adverse Drug Reactions among Children with Tuberculosis in Tashkent, Uzbekistan, 2019

Abstract

The treatment of childhood tuberculosis can be challenging due to the lack of pediatric drug formulations and monitoring of drug-toxicity in routine settings. There are no published studies from Uzbekistan on the adverse drug reactions (ADR) associated with anti-tuberculosis treatment in children. In this study, we aimed to investigate the ADR associated with anti-tuberculosis treatment in children. This was a cohort study using secondary program data of children treated at the city and regional tuberculosis clinics in Tashkent, Uzbekistan. Of the 302 patients evaluated, 135 (44.7%) reported ADR. New tuberculosis was registered in 277 (92%) patients and 262 (87%) had extrapulmonary tuberculosis. Factors associated with ADR included treatment at a regional hospital (adjusted odds ratio, aOR = 1.75; p = 0.026), female sex (aOR = 2.2; p = 0.004), and treatment with second-line drugs (aOR = 8.82; p < 0.001). The most common ADRs were gastrointestinal disorders (28.5%) followed by hepatitis (8.9%) and dermatologic reactions (8.6%). Most of the ADRs were mild (55.6%) or moderate (43.7%), only one child had severe ADR. Patients with the identified risk factors should be closely monitored during the treatment. We also recommend expansion of ADR surveillance throughout the country for more representative data in the future.

Outcome of Abdominal Tuberculosis Complicated by Portal Hypertension, Pulmonary Tuberculosis, and Severe Acute Malnutrition

“…During observation, side effects occurred in the intensive phase, consistent with findings from a study by Abdusalomova M. et al This study identified gastrointestinal complaints as the most frequent side effects in children. 15 In this case, our patient exhibited nausea without vomiting during the first two weeks of therapy. Taking ATD APGHN at night, as described in the same study, can be a helpful strategy to manage these gastrointestinal side effects, which often improve without medication.…”

Review of Pediatric Tuberculosis in the Aftermath of COVID-19

“…There is a limited number of pharmaceutical formulations that can be reliably used to treat TB in children. Other issues include a lack of information on the toxicity of drugs and unpredictable levels of adherence to treatment [ 16 ]. Preventive medications have shown to reduce the development of active TB disease by 91% among infected children if they are treated prior to experiencing TB symptoms [ 10 ].…”

Frequency and risk of adverse reactions to TB therapy in children and adolescents

“…По данным литературных источников у 30-55 % детей и подростков в процессе лечения туберкулеза развиваются побочные реакции (ПР) [1][2][3][4][5][6]. При лечении пациентов с лекарственно-устойчивым туберкулезом с применением резервных препаратов частота ПР значительно возрастает по сравнению с использованием в режиме лечения только основных противотуберкулезных препаратов (ПТП) с 30,0 % до 78,0 % [7][8][9][10].…”