Adverse Events Associated with Multidrug-Resistant Tuberculosis Treatment in Mali

Événements indésirables associés au traitement de la tuberculose multirésistante au Mali

Résumé

This study aimed to determine the incidence of adverse effects and their impact on the treatment of multidrug resistant tuberculosis (MDR-TB) in the department of pneumology at the teaching Hospital of   Point-G. A prospective cross-sectional study was conducted from January 2018 to August 2019 and the participants were all hospitalized MDR-TB patients and receiving a 9-months standardized shorter MDR-TB regimen. Adverse Drug Reaction (ADR) were assessed based on clinical and laboratory outcomes and the assessment of ADR causality was performed using the World Health Organization algorithm. Adverse events were recorded in 86.2% (n=31) of patients, with an average age of 40 years old (ranging from 18 to 77 years). The most observed adverse events were digestive disorders with 37.3%, followed by pain upon injection (19.3%). WHO grade IV toxicity of hearing loss (mixed or bilateral deafness) was observed in 3.62% (n=3) of participants. The causality of the WHO adverse events was "probable and possible" in 24.1% (n=20). Management of these adverse events consisted of counseling and antihistamine drugs prescription. The evolution was favorable in 42% of cases, however the fatality rate was 5.6%.  Various adverse events were observed in this study population. Therefore, special attention through pharmacovigilance is needed to improve the management of serious adverse events in this group of patients.

Keywords: Adverse events, MDR-TB, TB Treatment, second-line anti-tuberculosis drugs, Mali.