Abstract
Introduction: MDR-TB, caused by Koch bacillus which is resistant to at least isoniazid and rifampicin, is a dangerous form of tuberculosis. In Tunisia, the national TB control program joined the fight against MDR-TB in its priority activities since 2004 with acquisition of second-line drugs, which are expensive and often poorly tolerated.
Aim: Describe the side effects of second-line drugs occurred during the treatment of MDR-TB.
Methods: Retrospective study (2009 – 2013)conducted in two referral centers for the treatment of MDR-TB in Tunisia, including patients with confirmed MDR-TB and treated according to national guidelines and WHO recommendations.
Results: Fifty-four patients (mean age: 38±13 years; sex ratio= 3.15) were enrolled. It was a primary MDR-TB in 17% of cases,retreatment after interruption of treatment in 15% of cases,failure of treatment and relapse in 26% and 42% of cases. Side effects due to TB treatment were reported in 48 patients: gastrointestinal disorder (78 %),joint pain (42%),otologic manifestations (38%),dermatologic abnormalities (31%),ocular manifestations (14%),peripheral nervous system abnormalities (11%),psychiatric disorders (8%),hypothyroidism (4%) and abscesses at the injection site in buttock (2%). The involved treatment was changed in 14.5% of cases and its dose was reduced in 23% of cases. These side effects were responsible for 81% of non-compliance to treatment. Healing was reported in 32 cases, 5 patients died, 3 have a therapeutic failure and 14 are being processed.
Conclusion: In Tunisia, the MDR-TB remains a public health problem. The side effects commonly encountered in the use of second-line drugs encourage regular and rigorous monitoring to detect and treat them early.
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