A Score to Predict the Risk of Major Adverse Drug Reactions Among Multi-Drug Resistant Tuberculosis Patients in Southern Ethiopia, 2014–2019

Abstract

Lemlem Bogale,1 Denekew Tenaw,2 Tewodros Tsegaye,1 Mohamed Abdulkadir,1 Temesgen Yihunie Akalu3 1Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Temesgen Yihunie Akalu, Tel [phone], Email [email protected]: Adverse events (AE) contribute to poor drug adherence and withdrawal, which contribute to a low treatment success rate. AE are commonly reported among multi-drug resistance tuberculosis (MDR-TB) patients in Ethiopia. However, predictors of AE among MDR-TB patients were limited in Ethiopia. Thus, the current study aimed to develop and validate a score to predict the risks of major AE among MDR-TB patients in Southern Ethiopia.Methods: A retrospective follow-up study design was employed among MDR-TB patients from 2014– 2019 in southern Ethiopia at selected hospitals. A least absolute shrinkage and selection operator algorithm was used to select the most potent predictors of the outcome. The adverse event risk score was built based on the multivariable logistic regression analysis. Discriminatory power and calibration were checked to evaluate the performance of the model. Bootstrapping method with 100 repetitions was used for internal model validation.Results: History of baseline khat use, long-term drug regimen use, and having coexisting disorders (co-morbidity) were predictors of AEs. The score has a satisfactory discriminatory power (AUC = 0.77, 95% CI: 0.68, 0.82) and a modest calibration (Prob > chi2 = 0.2043). It was found to have the same c-statistics after validation by bootstrapping method of 100 repetitions with replacement.Conclusion: A history of baseline khat use, co-morbidity, and long-term drug regimen use are helpful to predict individual risk of major adverse events in MDR-TB patients with a satisfactory degree of accuracy (AUC = 0.77).Keywords: prediction, multi-drug resistant tuberculosis, major adverse events, Southern Ethiopia

Keywords

• prediction
• multi-drug resistant tuberculosis
• major adverse events
• southern ethiopia