Delayed Treatment and Adverse Effects of Drug Resistance Tuberculosis Impact on Outcome, Survival and Quality of Life
DOI:
https://doi.org/10.36497/jri.v43i1.259Keywords:
anemia, arthralgia, delayed treatment, drug resistant TB, hyperuricemia, quality of life, recovery, survivalAbstract
Background: Global TB Report 2020 states that 78% of tuberculosis patients experience drug resistancy with a global treatment success rate of 57%. Drug resistance tuberculosis (DR TB) patients whom experience side effects such as arthralgia and hyperuricemia with inadequate treatment will affect the treatment result.
Methods: Retrospective cohort study to DR TB patients who underwent treatment from January 2015 to August 2020 at RSUD dr. Moewardi Surakarta. Survival analysis using Kaplan Meier method and Cox regression test for the effect of risk factors on the safety and survival of TB RO patients. Quality of life analysis using Mann Whitney test.
Results: From 372 patients, delayed treatment factor (OR=2.906; 95% CI=1.890-4.469; P≤0.001) and arthralgia factor (OR=1.775; 95% CI=1.148-2.744; P=0.010) were variables that had a significant effect on recovery of DR TB patients. Delayed treatment and arthralgia have risk (2,906 times and 1.775 times) for non-recovered DR TB patients. Delayed treatment factor with HR=14.772 (95% CI=13.381-16.163), arthralgia with HR=15.170 (95% CI=13.960-16.379), and anemia with HR=15.304 (95% CI=14.074-16.535; P=0.002) affect on the survival of DR TB patients. Anemia affect on the quality of life DR TB patients.
Conclusion: Delayed treatment for more than 14 days and arthralgia that is not treated adequately can affect the recovery of DR TB patients. The survival and quality of life of DR TB patients can be increased by monitoring the time of taking medication, monitoring side effects of drugs such as arthralgia, and adequate nutritional intake so that anemia does not occur.
Downloads
References
World Health Organization. Global tuberculosis report 2020. World Health Organization; 2020. 1–39 p.
Azam M, Fibriana AI, Indrawati F, Septiani I. Prevalensi dan determinan kejadian depresi pada pasien multi-drug resistance tuberculosis: Studi di RSUP Dr. Kariadi Semarang. Jurnal Respirologi Indonesia. 2020;40(2):88–96.
World Health Organization. WHO operational handbook on tuberculosis. Module 4: Treatment-drug-resistant tuberculosis treatment. Geneva; 2020.
Asgedom SW, Tesfaye D, Nirayo YL, Atey TM. Time to death and risk factors among tuberculosis patients in Northern Ethiopia. BMC Res Notes. 2018;11(1):e019593.
Alene KA, Clements ACA, McBryde ES, Jaramillo E, Lonnroth K, Shaweno D, et al. Sequelae of multidrug-resistant tuberculosis: protocol for a systematic review and meta-analysis. BMJ Open. 2018;8(2):19593.
Asres A, Jerene D, Deressa W. Delays to treatment initiation is associated with tuberculosis treatment outcomes among patients on directly observed treatment short course in Southwest Ethiopia: A follow-up study. BMC Pulm Med. 2018;18(1):1–11.
Reviono, Kusnanto P, Eko V, Pakiding H, Nurwidiasih D, Pulmonologi dan Ilmu Kedokteran Respirasi B, et al. Multidrug resistant tuberculosis (MDR-TB): Tinjauan epidemiologi dan faktor risiko efek samping obat anti tuberkulosis. Majalah Kedokteran Bandung. 2014;46(4):189–96.
Holden IK, Lillebaek T, Seersholm N, Andersen PH, Wejse C, Johansen IS. Predictors for pulmonary tuberculosis treatment outcome in Denmark 2009-2014. Sci Rep. 2019;9(1):12995.
Virenfeldt J, Rudolf F, Camara C, Furtado A, Gomes V, Aaby P, et al. Treatment delay affects clinical severity of tuberculosis: a longitudinal cohort study. BMJ Open. 2014;4(6):e004818.
Sangolli B, M RB, Savadi B, Ghodageri S, Sreeharsha. Profile of the adverse drug reactions among the multidrug resistant tuberculosis patients treated at a tertiary level hospital in southern India. IP Indian Journal of Immunology and Respiratory Medicine. 2020;3(4):158–64.
Sineke T, Evans D, Schnippel K, van Aswegen H, Berhanu R, Musakwa N, et al. The impact of adverse events on health-related quality of life among patients receiving treatment for drug-resistant tuberculosis in Johannesburg, South Africa. Health Qual Life Outcomes. 2019;17(1):94.
Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019;1450(1):15–31.
Bhargava A, Bhargava M. Tuberculosis deaths are predictable and preventable: Comprehensive assessment and clinical care is the key. J Clin Tuberc Other Mycobact Dis. 2020;19:100155.
Adiwinata R, Rasidi J, Marpaung M, Sakit Umum Daerah dr Kanujoso Djatiwibowo R, Timur K. Profil Klinis dan Evaluasi Pengobatan Pasien Rifampicin-Resistant dan Multidrug-Resistant Tuberculosis di RSUD Dr. Kanujoso Djatiwibowo Balikpapan. J Respir Indo. 2018;38(3):135–42.
Fantaw D, Feyissa M, Hamid S, Shibeshi W. Assessment of the survival status and risk factors for the mortality among multidrug resistant tuberculosis patients at adama and bishoftu general hospitals, Oromia, Ethiopia: A retrospective cohort study. Adv Pharmacoepidemiol Drug Saf. 2018;7(1):1000222.
Tefera KT, Mesfin N, Reta MM, Sisay MM, Tamirat KS, Akalu TY. Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia. BMC Infect Dis. 2019;19(1):1–8.
World Health Organization. WHOQOL user manual: Programme on mental health. 2012.
Kastien-Hilka T, Abulfathi A, Rosenkranz B, Bennett B, Schwenkglenks M, Sinanovic E. Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis- a systematic review of global literature with focus on South Africa. Health Qual Life Outcomes. 2016;14(1):42.
Downloads
Additional Files
Published
Issue
Section
License
- The authors own the copyright of published articles. Nevertheless, Jurnal Respirologi Indonesia has the first-to-publish license for the publication material.
- Jurnal Respirologi Indonesia has the right to archive, change the format and republish published articles by presenting the authors’ names.
- Articles are published electronically for open access and online for educational, research, and archiving purposes. Jurnal Respirologi Indonesia is not responsible for any copyright issues that might emerge from using any article except for the previous three purposes.
