Department of Phthisiology and Pulmonology, Tashkent Pediatric Medical Institute, Tashkent 100140, Uzbekistan.
Alliance for Public Health, 01601 Kyiv, Ukraine.
Int J Environ Res Public Health. 2021 Jul 16;18(14):7574. doi: 10.3390/ijerph18147574.
The treatment of childhood tuberculosis can be challenging due to the lack of pediatric drug formulations and monitoring of drug-toxicity in routine settings. There are no published studies from Uzbekistan on the adverse drug reactions (ADR) associated with anti-tuberculosis treatment in children. In this study, we aimed to investigate the ADR associated with anti-tuberculosis treatment in children. This was a cohort study using secondary program data of children treated at the city and regional tuberculosis clinics in Tashkent, Uzbekistan. Of the 302 patients evaluated, 135 (44.7%) reported ADR. New tuberculosis was registered in 277 (92%) patients and 262 (87%) had extrapulmonary tuberculosis. Factors associated with ADR included treatment at a regional hospital (adjusted odds ratio, aOR = 1.75; = 0.026), female sex (aOR = 2.2; = 0.004), and treatment with second-line drugs (aOR = 8.82; < 0.001). The most common ADRs were gastrointestinal disorders (28.5%) followed by hepatitis (8.9%) and dermatologic reactions (8.6%). Most of the ADRs were mild (55.6%) or moderate (43.7%), only one child had severe ADR. Patients with the identified risk factors should be closely monitored during the treatment. We also recommend expansion of ADR surveillance throughout the country for more representative data in the future.
由于儿科药物制剂缺乏以及在常规环境中监测药物毒性,儿童结核病的治疗颇具挑战性。乌兹别克斯坦尚无关于儿童抗结核治疗相关药物不良反应(ADR)的发表研究。在这项研究中,我们旨在研究与儿童抗结核治疗相关的 ADR。这是一项使用乌兹别克斯坦塔什干市和地区结核病诊所儿童治疗的二级程序数据进行的队列研究。在评估的 302 名患者中,有 135 名(44.7%)报告了 ADR。277 名(92%)患者新诊断为结核病,262 名(87%)患者患有肺外结核病。与 ADR 相关的因素包括在地区医院治疗(调整后的优势比,aOR = 1.75; = 0.026)、女性(aOR = 2.2; = 0.004)和使用二线药物(aOR = 8.82; < 0.001)。最常见的 ADR 是胃肠道疾病(28.5%),其次是肝炎(8.9%)和皮肤反应(8.6%)。大多数 ADR 为轻度(55.6%)或中度(43.7%),只有一名儿童发生严重 ADR。应密切监测具有上述确定风险因素的患者的治疗情况。我们还建议在全国范围内扩大 ADR 监测,以便未来获得更具代表性的数据。