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2023 年,在埃塞俄比亚阿姆哈拉地区西北部选定的公立医院接受抗逆转录病毒治疗的儿童中,主要药物不良反应的发生时间及其预测因素。

Time to major adverse drug reactions and its predictors among children on antiretroviral treatment at northwest Amhara selected public hospitals northwest; Ethiopia, 2023.

机构信息

Fintoselam Hospital, Obstetrics & Gynecology Ward, Fintoselam, Ethiopia.

Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

PLoS One. 2024 Oct 3;19(10):e0309796. doi: 10.1371/journal.pone.0309796. eCollection 2024.

Abstract

BACKGROUND

Adverse drug reaction is one of the emerging challenges in antiretroviral treatment. Determining the incidence rate and predictors among children on antiretroviral treatment (ART) is essential to improve treatment outcomes and minimize harm. And also, evidence regarding the time to major adverse drug reactions and its predictors among children on antiretroviral treatment is limited in Ethiopia.

OBJECTIVE

This study aimed to assess the time to major adverse drug reaction and its predictors among children on antiretroviral treatment at selected public hospitals in Northwest Amhara, Ethiopia, 2023.

METHOD

A retrospective cohort study was conducted among 380 children on antiretroviral treatment who enrolled from June 27, 2017, to May 31, 2022. Data was collected using a structured data extraction checklist. Data were entered into Epidata 4.6 and analyzed using STATA 14. The incidence rate of major adverse drug reactions was determined per person/months. The Cox proportional hazards regression model was used to identify predictors of major adverse drug responses. A p-value less than 0.05 with a 95% CI was used to declare statistical significance.

RESULT

The minimum and maximum follow-up time was 6 and 59 months, respectively. The study participants were followed for a total of 9916 person-months. The incidence rate of major adverse drug reactions was 3.5 /1000 person-months. Advanced clinical stages of HIV/AIDS (III and IV) [adjusted hazard ratio = 7.3, 95% CI: 2.74-19.60)], poor treatment adherence [adjusted hazard ratio = 0.33, 95% CI: 0.21-0.42], taking antiretroviral treatment twice and more [adjusted hazard ratio = 3.43, 955 CI: (1.26-9.33)] and not taking opportunistic infection prophylaxis [adjusted hazard ratio = 0.35, 95% CI: 0.23-0.52)] were predictors of major adverse drug reactions.

CONCLUSION

The incidence rate of major adverse drug reactions among children on antiretroviral treatment was congruent with studies in Ethiopia. Advanced clinical stages of HIV/AIDS, poor treatment adherence, taking antiretroviral treatment medications twice or more, and not taking opportunistic infection prophylaxis were predictors of major adverse drug reactions.

摘要

背景

药物不良反应是抗逆转录病毒治疗中面临的新兴挑战之一。确定接受抗逆转录病毒治疗(ART)的儿童中药物不良反应的发生率和预测因素对于改善治疗结果和最小化危害至关重要。此外,关于接受抗逆转录病毒治疗的儿童中主要药物不良反应发生时间及其预测因素的证据在埃塞俄比亚有限。

目的

本研究旨在评估 2023 年在埃塞俄比亚西北阿玛哈拉选定公立医院接受抗逆转录病毒治疗的儿童中主要药物不良反应发生时间及其预测因素。

方法

这是一项回顾性队列研究,共纳入了 2017 年 6 月 27 日至 2022 年 5 月 31 日期间登记的 380 名接受抗逆转录病毒治疗的儿童。使用结构化数据提取清单收集数据。数据录入 Epidata 4.6 并使用 STATA 14 进行分析。主要药物不良反应的发生率按人/月计算。使用 Cox 比例风险回归模型确定主要药物不良反应的预测因素。p 值<0.05 和 95%置信区间用于宣布统计学意义。

结果

最小和最大随访时间分别为 6 个月和 59 个月。研究参与者共随访了 9916 人月。主要药物不良反应的发生率为 3.5/1000 人月。艾滋病毒/艾滋病的晚期临床阶段(III 和 IV)[调整后的危险比=7.3,95%置信区间:2.74-19.60]、治疗依从性差[调整后的危险比=0.33,95%置信区间:0.21-0.42]、服用抗逆转录病毒药物两次或以上[调整后的危险比=3.43,95%置信区间:(1.26-9.33)]和未服用机会性感染预防药物[调整后的危险比=0.35,95%置信区间:0.23-0.52)]是主要药物不良反应的预测因素。

结论

接受抗逆转录病毒治疗的儿童中主要药物不良反应的发生率与埃塞俄比亚的研究一致。艾滋病毒/艾滋病的晚期临床阶段、治疗依从性差、服用抗逆转录病毒药物两次或以上以及未服用机会性感染预防药物是主要药物不良反应的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0eb/11449323/c22f57393f25/pone.0309796.g001.jpg

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