Adverse events in the treatment of MDR-TB patients within and outside the NTP in Pham Ngoc Thach hospital, Ho Chi Minh City, Vietnam
Examines the treatment of multi-drug resistant-TB patients within and outside the National Tuberculosis Control Program
Abstract
Background
Treatment outcomes of a high proportion of inpatients with multi-drug resistant tuberculosis (MDR-TB) were not reported to the Vietnamese National Tuberculosis Program because they received treatment outside of the green light committee (GLC) program. The study aimed:
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to describe the strengths and weaknesses of treatment of GLC and non-GLC MDR-TB patients as well as the factors influencing treatment completion
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to determine the incidence of adverse drug reactions.
Results
This cross-sectional study comprised 2 elements:
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in-depth interviews with clinical doctors, hospital pharmacists; and focus group discussions with MDR-TB patients;
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a review of the charts of all GLC and non-GLC MDR-TB patients in 2010.
A total of 282 MDR-TB patients were recruited, including 79(28 %) MDR-TB patients treated through the GLC program and 203(72 %) MDR-TB patients treated outside of the GLC program. The main strengths of GLC treatment were the supply of quality assured second line TB drugs, routine monitoring and clinical evaluation, free diagnostic tests and close clinical monitoring. The greatest barriers to patients treated outside of the GLC program was difficulty paying for second line TB drugs and other treatment costs. There was no significant difference between the incidence of adverse events among GLC (46.8 %) and non-GLC treated patients (52.2 %; p = 0.417). Among 143 patients who reported 226 adverse reaction events, arthralgia/joint pain (35.8 %), gastrointestinal (14.2 %), ototoxicity (8.4 %), cutaneous (6.6 %), and giddiness (5.8 %) were the most common.
Conclusions
The non-GLC MDR-TB patients face substantial barriers to treatment, and require greater support if they are to complete treatment and improve disease outcomes. Staff training about the management of adverse drug reactions is needed.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Nguyen Binh Hoa, Nguyen Viet Nhung, Pham Huyen Khanh, Nguyen Viet Hai, Bui Thi Tu Quyen (2015) Adverse events in the treatment of MDR-TB patients within and outside the NTP in Pham Ngoc Thach hospital, Ho Chi Minh City, Vietnam. BMC Research Notes (2015) 8:809 DOI 10.1186/s13104-015-1806-4