Adverse drug reactions and resultant health-related quality of life during multidrug-resistant tuberculosis treatment in South Africa
View File(s)
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Kelly, Ana Maria by View
Title | Page Views |
---|
Popular Works for Kelly, Ana Maria by Download
Title | Downloads |
---|
View Citations
Citations
Background/Significance: The incidence of multidrug-resistant tuberculosis (MDR-TB) is on the rise globally. MDR-TB takes a minimum of 2 years to treat and the treatment regimen produces many adverse drug reactions (ADRs). The World Health Organization (WHO) has called for further research on the treatment of community- based MDR-TB patients as care is being decentralized to outpatient settings. In the WHO’s TB progress report for 2015, they note there is a dearth of literature about anti- TB drug-induced mortality, morbidity and loss in quality of life, particularly in low- resource settings.
Purpose: This study directly addresses this gap in knowledge by examining the effect of ADRs from MDR-TB treatment on heath-related quality of life (HRQOL) for patients in a low-resource, high HIV-burden population in South Africa.
Methods: A cross-sectional, observational study design was used to: 1) describe patient and clinical characteristics of community-based MDR-TB patients; 2) examine the relationship between Aim 1 characteristics and ADRs; and 3) examine the effect of each ADR on HRQOL, controlling for Aim 1 characteristics. MDR-TB patients in the initial intensive phase of treatment were recruited using convenience sampling from an outpatient MDR-TB clinic in South Africa. Patient interviews were conducted in English or isi Zulu and included questions on individual characteristics (age, sex, education, employment, relationship status, alcohol/smoking, stigma, and adherence) and environmental characteristics (housing status, food insecurity, social support and discrimination). ADRs and symptom bother over the past month of treatment were collected using a symptom checklist and HRQOL was collected using the EQ-5D. A medical chart data abstraction was conducted to capture MDR-TB treatment, HIV/AIDS status and treatment, co-morbidities, BMI, and laboratory values.
Results: Aim 1: The majority of participants (=121) were co-infected with HIV (75%), female (51%), and did not have enough food to eat everyday (51%). Aim 2: All but two participants reported at least one ADR (98%) with an average of 8.6 per person. In the multivariable analysis, being female and starting MDR-TB treatment with elevated liver enzymes were significantly related to an increase in total ADRs. There was no significant difference in ADRs by HIV status. Aim 3: An increase in total ADRs was significantly related to a decrease in HRQOL. Of the 18 ADRs assessed, six were associated with a decrease in HRQOL in the final model: tinnitus, gastrointestinal symptoms: nausea/vomiting and diarrhea, and symptoms affecting movement: myalgia, arthralgia, and peripheral neuropathy. Patient and clinical characteristics that remained significant were the loss of relationship and hospitalization during treatment, with past hospitalization associated with increased HRQOL.
Implications: This study helps fill the knowledge gap on the effect of ADRs from MDR-TB treatment on HRQOL. For clinicians, findings reinforce the need to improve detection, documentation and management of ADRs. Further research is needed to determine effective ADR management techniques to improve HRQOL outcomes for patients on this lengthy and challenging treatment.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Self-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Cross-Sectional |
Research Approach | Quantitative Research |
Keywords | Mycobacterium Tuberculosis; Mycobacterium Tuberculosis Drug Effects; Tuberculosis, Multidrug resistant Epidemiology; Tuberculosis, Multidrug Resistant Prevention and Control; Anti HIV Agents Adverse Effects; South Africa |
CINAHL Subject(s) | Tuberculosis, Multidrug-Resistant--Drug Therapy; Anti-HIV Agents--Adverse Effects; Mycobacterium Tuberculosis; South Africa; Adverse Drug Event |
Grantor | Michigan State University |
Level | PhD |
Year | 2015 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
Challenges to providing patient-centered care for multidrug-resistant tuberculosis (MDR-TB) in South Africa
Kelly, Ana Maria; Smith, Barbara Ann; Farley, Jason E. (2016-07-13)Session presented on Sunday, July 24, 2016: Purpose: The incidence of multidrug-resistant tuberculosis (MDR-TB) is on the rise globally. MDR-TB takes a minimum of 2 years to treat and the treatment regimen produces many ... -
Cardiovascular risk among patients with drug-resistant tuberculosis and HIV in South Africa
Whitehouse, Erin Rachel (2018-05-10)Problem Statement: South Africa has the highest incidence of drug resistant-tuberculosis (DR-TB) in sub-Saharan Africa and outcomes are poor. Only 54% of patients successfully complete treatment. The prevalence of ... -
Age appropriate treatment of drug-resistant tuberculosis in South Africa
Sullivan, Brittney Jayne (2017-07-19)The purpose of this study was to describe the time from DR-TB diagnosis to treatment initiation for people in South Africa with DR-TB with and without HIV and to evaluate the influence of age on the timing of treatment ... -
Reach, implementation, and effectiveness of a tuberculosis preventive therapy intervention in rural South Africa
van de Water, Brittney; Fulcher, Isabel; le Roux, KarlIn this study, we will assess the reach, implementation, and effectiveness of a nurse-led home based intervention designed to deliver tuberculosis (TB) preventive therapy. -
Validation of a counseling guide for adherence to antiretroviral therapy using implementation science
Musayón-Oblitas, Yesenia; Carcamo, Cesar; Gimbel, Sarah; Echevarria, Juan; Grana, AnaParticipants will learn about the process of developing and validating a nursing counseling guide to improve adherence to Antiretroviral Treatment to HIV patients using the implementation science. They will know the guide ...