Reni,1,2 Tri Yunis Miko Wahyono,1 Yulismar3
1Fakultas Kesehatan Masyarakat, Universitas Indonesia
2Badan Pengawas Obat dan Makanan
3Perkumpulan Pemberantasan Tuberkulosis Indonesia Wilayah DKI Jakarta
Abstract
Background: In 2015, Indonesia was ranked 2nd out of 20 countries with the highest tuberculosis patients in the world. Long term exposure to anti-tuberculosis medication and polypharmacy increase risk of ADR and which might determine adherence and therefore therapy success. This study aimed to determine factors associated with anti-tuberculosis ADR.
Methods: A case control study was performed between January 2014 to March 2016 in PPTI lung clinic of Jakarta. Controls were defined as not having reported as side effect, receiving anti-TB during the same time that the case had appeared. A total of 342 patients (171 cases and 171 controls) were analyzed.
Results: Multivariate analysis model proved that 4 factors (age, gender, acid-fast staining(+) and previous anti-Tb therapy) associated with ADR in different role. In multivariate model, age especially those over 40 years (OR=2.17; 95% CI 1.60 – 4.75), gender (OR= 4.67; 95% CI 1.26 – 17.33) were independently associated with mild-ADR and age over 40 years (OR= 3.22; 95% CI 1.73 – 5.96), gender (OR=2.92; 95% CI: 1.07 – 7.97), acid-fast staining(+) (OR= 0.59; 95% CI 0.35 – 0.98) and previous anti-Tb therapy (OR= 3.19; 95% CI: 1.16 – 8.74) were independently associated with severe ADR.
Conclusion: Age, gender, acid-resistant bacteria and previous TB therapy were factors associated with mild ADR and severe ADR. Patients with such risk factors should be given special attention by providing counseling or information related to TB ADR and monitoring strictly on the side effects of using anti tuberculosis drugs. (J Respir Indo. 2016; 36: 222-30)
Keywords: Mild ADR and severe ADR, risk factor, anti-TB drugs