Comparative Analysis of The Frequency of Adverse Events in Children and Adolescents with Sensitive and Resistant Forms of Tuberculosis

Аннотация

The study examined adverse events (AE) in 182 children and adolescents receiving anti-tuberculosis treatment. AE were detected in 103 (56.6%) patients. The most common were toxic reactions (79.6%), less common were toxic-allergic (12.6%) and allergic (7.8%) reactions. In adolescents, allergic (11.1% vs 6.0%) and toxic-allergic (19.4% vs 9.1%) reactions were significantly more common than in children (P<0.05). In adolescents, allergic (11.1% vs 6.0%) and toxic-allergic (19.4% vs 9.1%) reactions were significantly more common than in children (P<0.05). In patients with drug-resistant TB, AEs were observed 1.7 times more often than in patients with sensitive TB (81.6% vs 47.4%, P<0.05). Keywords: Tuberculosis, children, adolescents, anti-tuberculosis therapy, adverse events, toxic reactions, allergic conditions, toxic-allergic reactions, drug resistance, chemotherapy, Xpert MTB/Rif, HAIN TEST, MGIT. treating children and adolescents with tuberculosis Introduction: The problem of tuberculosis (TB) in [7,14]. The frequency of adverse events in anti-TB drugs children and adolescents has always been of interest, tends to increase [2,8,10,11,12,13]. The increase in the in modern conditions it is more acute and relevant frequency of adverse events in children and [1,17]. The decisive factor determining the occurrence adolescents, the expansion of their spectrum, and the of TB in children is their cohabitation with a bacteria growth in the number of cases of severe drug excretor in a tuberculosis infection site (TIS) [9,17]. complications require a revision of approaches to their In modern conditions, the drug load on the child's body prevention and elimination. In this regard, it seems has increased during the treatment of TB, which has relevant to study the frequency of adverse events in contributed to the development of adverse reactions to anti-TB drugs in different categories of tuberculosis anti-tuberculosis drugs (ATD) in most children [2,4,6]. patients. Polychemotherapy of TB, including various According to literary data, half of children and combinations of ATD, has a negative effect on many of adolescents with TB have concomitant diseases: liver, its organs and systems. Thus, according to the stomach, nasopharynx pathology, diabetes mellitus, literature, as a result of intensive chemotherapy in neuropsychiatric disorders, iron deficiency anemia, and hospital, patients developed some adverse reactions in others. This complicates diagnosis and leads to late 60-80% of cases. However, adverse reactions in this age initiation of treatment, development of adverse events group require an individual approach to the sick child, (AE) to anti-tuberculosis chemotherapy (ATC) and a clear organization of the chemotherapy regimen, and prevents optimal chemotherapy [3,5]. the selection of various types of pathogenetic treatment [6,15]. Indications and principles of correction of standard chemotherapy in children and adolescents with AE Adverse reactions to anti-tuberculosis drugs that occur have not been widely covered in the printed literature during chemotherapy significantly limit the possibility [14,15,17,18]. In the literature of recent years, we have of its implementation and reduce the effectiveness of not found any works devoted to the assessment of the International Journal of Medical Sciences And Clinical Research 37 https://theusajournals.com/index.php/ijmscr International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265) effectiveness of chemotherapy in children and were observed and treated at the Republican adolescents with AE on ATC, carried out according to Specialized Scientific and Practical Medical Center of standardized schemes. A literature search did not Phthisiology and Pulmonology (RSSPMCPh&P) named reveal any published studies in Uzbekistan on reported after Sh. Alimov, and 153 patients were treated at the adverse drug reactions in children and adolescents Tashkent Regional Children's Phthisiology Hospital treated for tuberculosis. during 2018–2019. Among the examined patients, 133 were found to have drug-sensitive forms of The problem of treating tuberculosis in children and tuberculosis and 49 were found to have drug-resistant adolescents with the development of AE on ATC is still forms of TB. A mandatory condition for selection in the relevant and requires further improvement. The study groups was the presence of active tuberculosis. literature of recent years does not cover an individual To solve the tasks set in the study, the clinical material approach to a sick child, a chemotherapy regimen, or was analyzed in a blinded manner: medical histories, the selection of various types of pathogenetic outpatient observation cards of children and treatment in children and adolescents with the adolescents with tuberculosis. The main outcome of development of AE on ATC. The issues of treatment the study was the analysis of the incidence of adverse correction were also not reflected in