Serious Adverse Events during Antituberculous Treatment in Rwanda
Author Information
Author(s): Lorent Natalie, Sebatunzi Osee, Mukeshimana Gloria, Van den Ende Jef, Clerinx Joannes
Primary Institution: Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
Hypothesis
What are the incidence, causes, and risk factors for serious adverse events among patients on first-line antituberculous treatment?
Conclusion
Adverse events frequently complicate the course of antituberculous treatment and worsen treatment outcomes, especially in patients with extrapulmonary TB and advanced immunodeficiency.
Supporting Evidence
- 64 patients (26%) developed a serious adverse event.
- HIV-infection was associated with a higher risk of serious adverse events.
- Concurrent infection was the most common cause of serious adverse events.
- Adverse events were linked to a nearly two-fold higher risk of unsuccessful treatment outcomes.
- Extrapulmonary TB and CD4 count <100 cells/mm3 were independent predictors of serious adverse events.
Takeaway
Some people getting treated for tuberculosis can get really sick from the medicine, especially if they also have HIV. It's important to check for other infections if they start feeling worse.
Methodology
This was a prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital.
Potential Biases
Diagnostic work-up of adverse events may have been incomplete due to the observational nature of the study and limited diagnostic tools.
Limitations
The study may suffer from referral bias and the extent of the problem of adverse events on antituberculous treatment cannot be precisely determined.
Participant Demographics
Median age was 35 years, 55% male, and 66% HIV-positive with a median CD4 count of 104 cells/mm3.
Statistical Information
P-Value
0.002
Confidence Interval
95% CI 1.3–3.0
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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