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埃塞俄比亚东部选定医院接受抗逆转录病毒治疗的儿科患者药物不良反应患病率:8年回顾性横断面研究

Prevalence of Adverse Drug Reactions among Pediatric Patients on Antiretroviral Therapy in Selected Hospitals in Eastern Ethiopia: 8-Year Retrospective Cross-Sectional Study.

作者信息

Abdela Jemal, Assefa Anteneh, Shamele Sufiyan

机构信息

1 Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

2 Department of Pharmacy, College of Medical and Health Sciences, Wachemo University, Hossana, Ethiopia.

出版信息

J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958218823208. doi: 10.1177/2325958218823208.

Abstract

BACKGROUND

Antiretroviral-related adverse drug reactions (ADRs) are one of the leading causes of drug changes, poor adherence, and treatment failure. Therefore, this study was designed to assess the magnitude of ADR and associated factors among pediatric patients on antiretroviral therapy (ART).

METHODS

A retrospective cross-sectional study was conducted by reviewing the medical records of pediatric patients on ART at Hiwot Fana Specialized University Hospital and Jugal Hospital ART clinics. The collected data were coded, entered, and analyzed using SPSS, IBM version 16. The associations of selected categorical variables were done using binary logistic and multivariate logistic regression.

RESULTS

Of 186 medical records of pediatric patients on ART, 153 (82.25%) were reviewed. From the total medical records assessed, ADRs were observed in 23 (15.03%) of pediatric patients on ART, of which the most commonly encountered ADRs were anemia (34.8%) and followed by rash (17.4%). Most of ADRs were ranked as grade 3 (39.13%) and followed by grade 2 (30.4%) based on the degree of their severity. The likelihood of developing ADR was significantly associated with the regimen AZT/3TC/NVP (adjusted odds ratio: 6.420; 95% confidence interval: 1.056-39.018) relative to pediatric patients on D4T/3TC/NVP regimen.

CONCLUSION

This study indicated that few pediatric patients on ART experienced ADRs. Most of the observed ADRs were ranked as grade 2 and 3 in terms of their severity. Drug out of stock and ADRs were the 2 most common reasons for antiretroviral (ARV) drug regimen change that could affect patient's treatment outcome and limited future option.

摘要

背景

抗逆转录病毒相关药物不良反应(ADR)是导致药物更换、依从性差和治疗失败的主要原因之一。因此,本研究旨在评估接受抗逆转录病毒治疗(ART)的儿科患者中ADR的发生率及相关因素。

方法

通过回顾希沃特·法纳专科医院和朱加尔医院ART诊所接受ART治疗的儿科患者的病历,进行了一项回顾性横断面研究。收集的数据进行编码、录入,并使用IBM版本16的SPSS进行分析。选定分类变量的关联性分析采用二元逻辑回归和多变量逻辑回归。

结果

在186份接受ART治疗的儿科患者病历中,153份(82.25%)被纳入回顾。在评估的所有病历中,接受ART治疗的儿科患者中有23例(15.03%)出现了ADR,其中最常见的ADR是贫血(34.8%),其次是皮疹(17.4%)。根据严重程度,大多数ADR被列为3级(39.13%),其次是2级(30.4%)。与接受D4T/3TC/NVP方案治疗的儿科患者相比,使用AZT/3TC/NVP方案发生ADR的可能性显著增加(调整后的比值比:6.420;95%置信区间:1.056 - 39.018)。

结论

本研究表明,接受ART治疗的儿科患者中很少有发生ADR的情况。观察到的大多数ADR在严重程度上被列为2级和3级。药物缺货和ADR是抗逆转录病毒(ARV)药物方案变更的两个最常见原因,这可能影响患者的治疗结果并限制未来的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2b1/6748515/79d53c7b2bf2/10.1177_2325958218823208-fig1.jpg

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