Anupa Khatri Chhetri, Archana Saha, Sharat Chandra Verma, Subish Palaian, Pranaya Mishra, Pathiyil Ravi Shankar.
A study of adverse drug reactions caused by first line anti-tubercular drugs used in Directly Observed Treatment, Short course (DOTS) therapy in western Nepal, Pokhara.
J Pak Med Assoc Jan ;58(10):531-7.

Objective: To study the Adverse Drug Reactions occurring during DOTS therapy and to assess their causality, severity and predisposing factors. Method: Patients undergoing DOTS treatment during the 5 month study period (20th January to 20th June, 2005) at the Regional Tuberculosis Center (RTC) in Pokhara, Western Nepal were studied. Patients and/or patient party were interviewed to detect occurrence of any ADRs during their visit to the DOTS center. Causality and severity assessment were carried out as per the `Naranjo scale` and `modified Hartwig and Siegel scale` respectively. Statistical analysis (Chi square test) was done to determine the predisposing factors. Results: Totally 137 patients were studied among whom 54.74% (n=75) reported occurrence of ADRs. Total 29.33% of ADRs were reported by the age group 21- 30 years. Nearly half (49.33%) of the ADRs were reported by men and 33.33% were reported by the ethnic group of `Gurungs`. Half (49.33%) of the patients were illiterate and 70.67% of the ADRs were classified as ADRs `possibly` due to the suspected drugs and 93.33% were classified as `mild (level 1)`. Isoniazid accounted for 49.3% of the ADRs. The most commonly reported ADR was tingling and burning sensation in hands and feet experienced by 32 (11.03%) patients. Conclusion: Occurrence of ADRs from antitubercular drugs was high in the population of Western Nepal. Further studies encompassing a wider population and covering different regions of Nepal are needed (JPMA 58:531; 2008).

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