Background: Information about the prevalence of adverse drug reactions (ADRs) among HIV infected and HIV uninfected patients receiving anti-tuberculous therapy in Africa is limited due to unavailability of local data or publications and hence the basis of this study.
Objective: To determine the prevalence of adverse drug reactions among HIV infected and HIV uninfected adult patients on anti-TB therapy.
Design: A retrospective cohort study.
Setting: Kenyatta National Hospital, Kenya.
Subjects: HIV infected and HIV uninfected patients receiving anti-TB therapy between January 2006 to December 2007
Main Outcome Measures:Documented adverse drug reactions.
Results: Three hundred and fourteen records were reviewed, 157 for both HIV infected and HIV uninfected. Of the 314 patient files, 96 (30.5%) had ADRs; 70 (44.6%) verses 26 (16.6%) for HIV infected and HIV uninfected respectively. Overall, the most frequent ADR among the two groups was gastrointestinal disturbances (21.7%) verses (10.2%) for HIV infected and uninfected respectively, (RR=2.44 [1.28-4.63], P=0.006). This was followed by peripheral neuropathy (16.6%) verses (4.5%) for HIV infected and uninfected respectively, (RR=4.25 [1.79-10.12], P=0.005). 73(46.49%) of the HIV infected patients were also receiving anti-retroviral therapy, of
which 36(49.31 %) of them had ADRs documented. Twenty five (29.8%) of the HIV infected who were not taking anti-retroviral therapy, had ADRs documented.
Conclusions: Gastrointestinal disturbances and peripheral neuropathy were the most common ADRs in both groups. Surveillance systems should be established in hospitals for ADRs monitoring and control.
A retrospective study of poisoned patients admitted at Kenyatta National Hospital (KNH) over the period January 2002 to June 2003 was carried out. KNH is a national referral and university teaching hospital and patients are admitted from all parts of Kenya. The results of the study are therefore expected to mirror closely the situation in the rest of the country. Data analysis showed that 58.9% of poisoned patients were males. Pesticides and household/industrial chemicals, the two most important poisoning agents, accounted for 43% and 24% of poisoning, respectively. Organophosphates and rodenticides were the two most common pesticides accounting for 57.4% and 31% of poisoning, respectively. Kerosene accounted for 66% of poisoning with household agents. Self-poisoning was prevalent in the age bracket 21-30 years (70.7%)while accidental poisoning, mostly with kerosene,was prevalent in the age group 0-5 years (83.9%). The overall mortality rate from poisoning was 7.0%.
Antiretrovirals have been associated with serious adverse drug reactions. Several factors have been suggested as independent risk factors for their development. Identification of these factors may help in prevention and management of the adverse drug reactions.Current standard regimens in resource-limited countries are associated with an increased risk of adverse drug reactions. Almost half of adverse reactions are managed by addition of a non-anti-retroviral drug alone but 41% necessitated a change of anti-retrovirals.
There has been an increased access to anti-retrovirals in resource constrained settings. However, few studies have addressed the area of adverse drug reactions in these settings.This study indicates a high prevalence of adverse drug reactions among HIV/AIDS patients on anti-retroviral therapy at Kenyatta National Hospital, Comprehensive Care Centre.