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Nyame L, Xue H, Yu J, Fiagbey EDK, Thomford KP, Du W. Characteristics and trends in adverse drug reactions in Ghana-evidence of spontaneous reports, 2005-2021. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03302-5. [PMID: 39043880 DOI: 10.1007/s00210-024-03302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Adverse drug reaction (ADR) monitoring is crucial in ensuring patient and pharmaceutical safety. However, there is a lack of evidence regarding ADR reporting trend pattern in Ghana. This study, therefore, aimed to analyse and characterise trends in ADRs reported in Ghana over 16 years. METHODS We retrospectively analysed individual case safety retorts (ICSRs) received by the Ghana National Pharmacovigilance Centre from 2005 to 2021. Jointpoint regression was used to estimate age-adjusted ADR rates, stratified by sex and patient characteristics, suspected medication groups, clinical indications, and the manifestation of ADRs. To evaluate trends over time, the percentage annualised estimator was used. RESULTS We identified a total of 6853 ICSRs from 2005 to 2021. The age-adjusted ICSR rates increased significantly from 2005 to 2019, with an annual increase of 18.6%; however, there was a downward trend from 2019 to 2021, although not statistically significant. Males accounted for the majority (64.3%) of ICSRs compared to females (35.7%). The suspected medication group most frequently associated with ADRs were antiprotozoals accounting for 35.6% of all ICSRs, while vascular disorders (21.0%) were the most commonly observed clinical indication in relation to ADRs. An increase in ICSR rates was noted for gastrointestinal disorders with an annual increase of 32.5% (95% CI, 20.6-45.6%; p < 0.001). Amodiaquine was the most commonly suspected medication (8.9%) associated with ADRs, while pruritus (7.2%) was the most frequently reported preferred term. CONCLUSION The study provides a detailed overview of ICSRs received by the Ghana National Pharmacovigilance Centre over the past 16 years and demonstrates an increasing trend of ADR-related medication use as well as clinical indications over time. The findings of this study call for multifaceted strategies aimed at reducing the risks associated with inappropriate drug use, and enhancing knowledge of medication safety, thus improving healthcare service delivery and patient safety.
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Affiliation(s)
- Linda Nyame
- School of Public Health, Southeast University, Nanjing, China.
| | - Hui Xue
- School of Public Health, Southeast University, Nanjing, China
| | - Jinxia Yu
- School of Public Health, Southeast University, Nanjing, China
| | - Emmanuel D K Fiagbey
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Kwesi Prah Thomford
- Department of Pharmacognosy and Herbal Medicine, University of Cape Coast, Cape Coast, Ghana
| | - Wei Du
- School of Public Health, Southeast University, Nanjing, China.
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Bhat AA, Afzal O, Agrawal N, Thapa R, Almalki WH, Kazmi I, Alzarea SI, Altamimi ASA, Kukreti N, Chakraborty A, Singh SK, Dua K, Gupta G. A comprehensive review on the emerging role of long non-coding RNAs in the regulation of NF-κB signaling in inflammatory lung diseases. Int J Biol Macromol 2023; 253:126951. [PMID: 37734525 DOI: 10.1016/j.ijbiomac.2023.126951] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/30/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
Public health globally faces significant risks from conditions like acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD), and various inflammatory lung disorders. The NF-κB signaling system partially controls lung inflammation, immunological responses, and remodeling. Non-coding RNAs (lncRNAs) are crucial in regulating gene expression. They are increasingly recognized for their involvement in NF-κB signaling and the development of inflammatory lung diseases. Disruption of lncRNA-NF-κB interactions is a potential cause and resolution factor for inflammatory respiratory conditions. This study explores the therapeutic potential of targeting lncRNAs and NF-κB signaling to alleviate inflammation and restore lung function. Understanding the intricate relationship between lncRNAs and NF-κB signaling could offer novel insights into disease mechanisms and identify therapeutic targets. Regulation of lncRNAs and NF-κB signaling holds promise as an effective approach for managing inflammatory lung disorders. This review aims to comprehensively analyze the interaction between lncRNAs and the NF-κB signaling pathway in the context of inflammatory lung diseases. It investigates the functional roles of lncRNAs in modulating NF-κB activity and the resulting inflammatory responses in lung cells, focusing on molecular mechanisms involving upstream regulators, inhibitory proteins, and downstream effectors.
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Affiliation(s)
- Asif Ahmad Bhat
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Mahal Road, Jaipur, India
| | - Obaid Afzal
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Neetu Agrawal
- Institute of Pharmaceutical Research, GLA University, Mathura, UP, India
| | - Riya Thapa
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Mahal Road, Jaipur, India
| | - Waleed Hassan Almalki
- Department of Pharmacology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | | | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Amlan Chakraborty
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK; Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology, Monash University, Clayton, VIC 3800, Australia
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo 2007, Australia
| | - Kamal Dua
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo 2007, Australia; Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, NSW 2007, Australia.
| | - Gaurav Gupta
- Center for Global Health research (CGHR), Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, India
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Conteh TA, Thomas F, Abiri OT, Komeh JP, Kanu A, Kanu JS, Fofanah BD, Thekkur P, Zachariah R. Quality of Reporting of Adverse Drug Reactions to Antimicrobials Improved Following Operational Research: A before-and-after Study in Sierra Leone (2017-2023). Trop Med Infect Dis 2023; 8:470. [PMID: 37888598 PMCID: PMC10610728 DOI: 10.3390/tropicalmed8100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/28/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
Background: The quality of pharmacovigilance data is important for guiding medicine safety and clinical practice. In baseline and follow-up studies after introducing interventions to improve the quality of reporting of Individual Case Safety Reports (ICSRs) in Sierra Leone, we compared (a) timeliness and completeness of reporting and (b) patient outcomes classified as 'recovering'. Methods: Baseline (January 2017-December 2021) and follow-up (June 2022-April 2023) studies of ICSRs in the national pharmacovigilance database. Interventions introduced following recommendations from the baseline study included: updating standard operating procedures and guidelines, setting performance targets follow-up of patient outcomes, and training. Results: There were 566 ICSRs in the baseline study and 59 in the follow-up study. Timelines (reporting < 30 days) improved by five-fold (10% at baseline to 47% in follow-up). For the completeness of variables in ICSRs (desired threshold ≥ 90%),this was 44% at baseline and increased to 80% in the follow-up study. 'Recovering' outcomes reduced from 36% (baseline study) to 3% (follow-up study, p < 0.001). Conclusions: Significant improvements in timeliness, completeness, and validation of ICSRs were observed following operational research in Sierra Leone. While enhancing pharmacovigilance and patient safety, this study highlights the important synergistic role operational research can play in improving monitoring and evaluation systems.
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Affiliation(s)
- Thomas A. Conteh
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Ministry of Health, Freetown 047235, Sierra Leone; (F.T.); (O.T.A.); (J.P.K.); (A.K.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 047235, Sierra Leone
| | - Fawzi Thomas
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Ministry of Health, Freetown 047235, Sierra Leone; (F.T.); (O.T.A.); (J.P.K.); (A.K.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 047235, Sierra Leone
| | - Onome T. Abiri
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Ministry of Health, Freetown 047235, Sierra Leone; (F.T.); (O.T.A.); (J.P.K.); (A.K.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 047235, Sierra Leone
| | - James P. Komeh
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Ministry of Health, Freetown 047235, Sierra Leone; (F.T.); (O.T.A.); (J.P.K.); (A.K.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 047235, Sierra Leone
| | - Abdulai Kanu
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Ministry of Health, Freetown 047235, Sierra Leone; (F.T.); (O.T.A.); (J.P.K.); (A.K.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 047235, Sierra Leone
| | - Joseph Sam Kanu
- National Disease Surveillance Program, Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 047235, Sierra Leone;
| | | | - Pruthu Thekkur
- Centre for Operational Research, International Union against Tuberculosis and Lung Disease, 75001 Paris, France;
| | - Rony Zachariah
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland;
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Thomas F, Abiri OT, Komeh JP, Conteh TA, Bah AJ, Kanu JS, Terry R, Abrahamyan A, Thekkur P, Zachariah R. Inconsistent Country-Wide Reporting of Adverse Drug Reactions to Antimicrobials in Sierra Leone (2017-2021): A Wake-Up Call to Improve Reporting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063264. [PMID: 35328953 PMCID: PMC8952810 DOI: 10.3390/ijerph19063264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 01/25/2023]
Abstract
Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they can cause life-threatening illness, permanent disabilities, and death. We assessed country-wide ADR reporting on antimicrobials and their outcomes. Methods: A cross-sectional study was conducted using individual case safety reports (ICSRs) entered into the national pharmacovigilance database (VigiFlow) during 2017−2021. Results: Of 566 ICSRs, inconsistent reporting was seen, with the highest reporting in 2017 and 2019 (mass drug campaigns for deworming), zero reporting in 2018 (reasons unknown), and only a handful in 2020 and 2021 (since COVID-19). Of 566 ICSRs, 90% were for antiparasitics (actively reported during mass campaigns), while the rest (passive reporting from health facilities) included 8% antibiotics, 7% antivirals, and 0.2% antifungals. In total, 90% of the reports took >30 days to be entered (median = 165; range 2−420 days), while 44% had <75% of all variables filled in (desired target = 100%). There were 10 serious ADRs, 18 drug withdrawals, and 60% of ADRs affected the gastrointestinal system. The patient outcomes (N-566) were: recovered (59.5%), recovering (35.5%), not recovered (1.4%), death (0.2%), and unknown (3.4%). There was no final ascertainment of ‘recovering’ outcomes. Conclusions: ADR reporting is inconsistent, with delays and incomplete data. This is a wake-up call for introducing active reporting and setting performance targets.
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Affiliation(s)
- Fawzi Thomas
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
- Correspondence: ; Tel.: +23-27946-0264
| | - Onome T. Abiri
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
| | - James P. Komeh
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
| | - Thomas A. Conteh
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
| | - Abdulai Jawo Bah
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
- Institute of Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Joseph Sam Kanu
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
- National Disease Surveillance Program, Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 02717, Sierra Leone
| | - Robert Terry
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland; (R.T.); (R.Z.)
| | - Arpine Abrahamyan
- Tuberculosis Research and Prevention NGO (TB-RPC), Yerevan 0014, Armenia;
| | - Pruthu Thekkur
- Centre for Operational Research, International Union against Tuberculosis and Lung Disease, 75001 Paris, France;
| | - Rony Zachariah
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland; (R.T.); (R.Z.)
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Orkin C, Ajana F, Kityo C, Koenig E, Natukunda E, Gandhi-Patel B, Wang H, Liu Y, Wei X, White K, Makadzange T, Pikora C, McNicholl I, Collins SE, Brainard D, Chuck SK. Brief Report: Efficacy and Safety of Bictegravir/Emtricitabine/Tenofovir Alafenamide in Females Living With HIV: An Integrated Analysis of 5 Trials. J Acquir Immune Defic Syndr 2021; 88:393-398. [PMID: 34506342 PMCID: PMC8547745 DOI: 10.1097/qai.0000000000002789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND We characterized the efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in a broad population of pediatric/adolescent/adult/elderly females living with HIV (FWH). SETTING Integrated analysis. METHODS Available data from 5 trials were integrated. Week 48 virologic suppression (HIV-1 RNA <50 copies/mL), resistance, adverse events (AEs), and laboratory parameters were assessed. RESULTS Three hundred and seventy-three FWH [304 virologically suppressed; 69 antiretroviral therapy (ART)-naive] received B/F/TAF [data from comparator regimens available for 306 individuals (236 virologically suppressed and 70 ART-naive participants)]. Virologic suppression rates with B/F/TAF at week 48 were high regardless of age in participants virologically suppressed at baseline (≥95%) and in ART-naive participants (≥87%). Virologic suppression rates were similar in B/F/TAF and comparator regimens (both virologically suppressed and ART-naive groups). Treatment-emergent resistance was not detected in the B/F/TAF group. AEs considered related to study drugs were experienced by 9.2% (B/F/TAF) and 5.5% (comparator regimen) of virologically suppressed participants and 15.9% (B/F/TAF) and 31.4% (comparator regimen) of ART-naive participants. For virologically suppressed and ART-naive FWH combined, only 1 of the 373 B/F/TAF-treated and 2 of the 306 comparator-regimen participants discontinued because of AEs (none were bone/renal/hepatic AEs); grade 3/4 AEs were experienced by 5.1% (B/F/TAF) and 7.8% (comparator regimen); and grade 3/4 elevation of low-density lipoprotein/total cholesterol occurred in 2.7%/0.3% (B/F/TAF) and 5.9%/2.0% (comparator regimen). At week 48, median changes from baseline estimated glomerular filtration rate in adults were <5 mL/min; results were similar in B/F/TAF and comparator-regimen groups. CONCLUSION B/F/TAF treatment was effective and well tolerated over 48 weeks, confirming B/F/TAF as an option for a broad population of FWH.
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Affiliation(s)
- Chloe Orkin
- Ambrose King Centre, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Faiza Ajana
- Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Cissy Kityo
- Joint Clinical Research Centre, Kampala, Uganda
| | - Ellen Koenig
- Instituto Dominicano de Estudios Virologicos (IDEV), Santo Domingo, Dominican Republic; and
| | | | | | - Hui Wang
- Gilead Sciences, Foster City, CA
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Incidence and predictors of Adverse Drug Reaction (ADR) among adult HIV positive patients on anti-retroviral treatment in Arba Minch town public health facilities, southern Ethiopia: A retrospective cohort study, 2020. PLoS One 2021; 16:e0251763. [PMID: 34043687 PMCID: PMC8158905 DOI: 10.1371/journal.pone.0251763] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/30/2021] [Indexed: 12/01/2022] Open
Abstract
Background Besides its contribution in the treatment of Human Immunodeficiency Virus-infected patients, anti-retroviral drugs may also cause mild to serious adverse effects. It is the main causes for poor drug adherence, treatment discontinuation and changes in Anti-Retroviral Treatment (ART) regimens. Thus, the aim of this study was to assess the incidence and predictors of adverse drug reaction among adult Human Immunodeficiency Virus positive patients on anti-retroviral treatment from January 1, 2013 up to December 30, 2018 at Arba Minch town public health facilities, Southern Ethiopia. Methods An institution based retrospective cohort study was conducted on 456 charts. Secondary data was collected by structured questionnaire. Data were entered in Epi-data version 4.4.2 software and exported to STATA Version 14 for analysis. The Kaplan-Meier survival curve with Log-rank was used to estimate survival time. Bi-variable and multivariable Cox proportional hazard regression models were fitted to identify predictors of adverse drug reaction. In the bi-variable analysis, the variables with p-value < 0.25 were eligible for multivariable analysis. Finally, variables with p-values less than 0.05 in the multivariable Cox regression were considered as independent predictors. The statistical significance was declared at p-value<0.05. Results Out of 456 patients observed for 14,903 person-months (pm), 79 experienced adverse drug reactions and the overall incidence density rate was 0.53/100 pm, CI: 0.42–0.66/100 person’s month or 6.36 per 100 Pearson year of observation. Females were at higher risk of experiencing adverse drug reactions (ADRs) compared to males [AHR = 2.35; CI (1.18, 4.69)]. The risk of experiencing ADRs among patient with advanced WHO clinical stage (stage III and IV) was higher compared to stage I and II [AHR = 3.0, CI (1.22, 7.37)]. The risk of experiencing an ADR was at any given time higher among AZT and NVP containing regimens compared to TDF and EFV containing regimens. Finally, the risk of ADR among those patients from the health center was reduced by 59% compared to hospital patients, [AHR = 0.41, CI (0.17, 0.97)]. Conclusion and recommendation The incidence rate of ADRs was reduced among patients on ARVs compared to previous studies and it was high during the early years of ART initiation. HIV patients should be closely followed in the early years of ART initiation, since this is the time of highest risk ADRs and emphasis should be given for female and clinically advanced patients.
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Adedapo ADA, Adedeji WA, Adedapo IA, Adedapo KS. Cohort study on adverse drug reactions in adults admitted to the medical wards of a tertiary hospital in Nigeria: Prevalence, incidence, risk factors and fatality. Br J Clin Pharmacol 2020; 87:1878-1889. [PMID: 32991765 DOI: 10.1111/bcp.14577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
AIMS Intensive monitoring of medical patients for adverse drug reactions (ADRs) to assess prevalence, incidence, risk factors and fatality of ADRs leading to hospital admission or occurring in the hospital. METHODS Prospective cohort study on 1280 adult patients admitted to the medical wards of a tertiary institution over 12 months. Patients were assessed for ADRs during and throughout admission; causality and preventability of ADRs were assessed. RESULTS Sixty-seven (5.2%) patients had ADRs, 51 (3.9%) caused hospitalisation while 17(1.3%) occurred during hospitalisation, and 42 (62.7%) of total ADRs were preventable. Nonsteroidal anti-inflammatory drugs, 14 (20.3%), antidiabetics, 12 (17.4%) and antibacterial, 11 (15.8%) were the most implicated drug classes. Gastrointestinal tract (37%), central nervous system (30.2%), and skin (24.7%) were the most affected organ/systems, while upper gastrointestinal bleeding and hypoglycaemia were the most observed ADRs. ADRs led to deaths in 7 (10.4%) patients, with an overall case fatality rate of 0.5%. The highest number of deaths were among patients with Stevens-Johnson syndrome 2/7 (28.6%) and hepatotoxicity 2/7 (28.6%). Risk factors, adjusted odds ratio (AOR [95% confidence interval, CI]) for ADRs leading to hospitalisation was male sex 3.11 (1.11, 8.73) while for ADRs during hospitalisation were number of drugs used before admission (AOR [95% CI] = 6.67 [1.16, 38.47]) and comorbidities (AOR [95% CI] = 3.0 [1.13, 8.01]). Patients admitted with ADRs had prolonged hospital stay (AOR [95% CI] = 3.37 [1.11, 8.71]). CONCLUSION Preventable ADRs are common and important causes of hospitalisation and inpatients' morbidity and mortality among medical patients in Nigeria. Upper gastrointestinal bleeding and hypoglycaemia, resulting from nonsteroidal anti-inflammatory drugs and antidiabetic drugs were the most observed ADRs.
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Affiliation(s)
- Aduragbenro D A Adedapo
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Clinical Pharmacology, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Waheed A Adedeji
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Clinical Pharmacology, University College Hospital, Ibadan, Oyo State, Nigeria
| | | | - Kayode S Adedapo
- Department of Chemical Pathology, College of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
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8
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Masuka JT, Khoza S. An analysis of the trends, characteristics, scope, and performance of the Zimbabwean pharmacovigilance reporting scheme. Pharmacol Res Perspect 2020; 8:e00657. [PMID: 32930524 PMCID: PMC7507368 DOI: 10.1002/prp2.657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Abstract
We aimed to determine the reporting trends and characteristics of Individual Case Safety Reports (ICSRs) from the Zimbabwean national pharmacovigilance system. ICSRs submitted to VigiBaseTM, the World Health Organisation's ICSR database between January 1993 and December 2017 were retrospectively reviewed with respect to the suspected medicine, System Organ Class (SOC), adverse drug reaction (ADR) type and seriousness, Anatomic Therapeutic Chemical (ATC) group, age, and gender. In total, 4071 ICSRs were submitted to VigiBaseTM from targeted spontaneous reporting (n = 2909; 71.5%), vaccine surveillance (n = 679; 16.7%), and passive spontaneous reporting (n = 483; 11.9%), respectively. The median age, ICSR completeness score and timeliness of reporting were 34.0 years (IQR: 14.0; 43.0), 0.90 (IQR: 0.70; 1.00), and 548.0 days (IQR: 266:1131), respectively. More than half of the ICRS were from female patients (n = 2233; 54.9%). Antiretrovirals, antibiotics, vaccines, and anti‐tubercular medicines were reported in 62.9%, 27.9%, 16.7%, and 13.3% of submitted ICSRs, respectively. The most frequent ADRs involved the skin and subcutaneous systems (n = 1111; 20.5%), nervous system (n = 733; 13.5%), and gastrointestinal disorders system (n = 654; 12.1%). The number of ADRs reported for each patient was significantly related to the reported medicine's ATC category (P = .001. The number of ADRs was significantly related to the use of antiretroviral agents. In conclusion, Zimbabwe has made significant progress in establishing a functional pharmacovigilance system. However, the present system reports on a limited therapeutic spectrum of medicines and potentially underestimates the national ADR burden. Further work is required to strengthen the more sustainable spontaneous reporting system which potentially captures a variety of therapeutic classes.
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Affiliation(s)
- Josiah Tatenda Masuka
- Harare Central Hospital, Southerton, Harare, Zimbabwe.,Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Congella, Durban, South Africa
| | - Star Khoza
- Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Bellville, South Africa
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9
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Awodele O, Aliu R, Ali I, Oni Y, Adeyeye CM. Patterns of adverse drug reaction signals in NAFDAC pharmacovigilance activities from January to June 2015: safety of drug use in Nigeria. Pharmacol Res Perspect 2019; 6:e00427. [PMID: 30324768 PMCID: PMC6175912 DOI: 10.1002/prp2.427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 11/20/2022] Open
Abstract
Adverse drug reactions (ADRs) are expected to be associated with an economic drain on the healthcare systems. The study was carried out to determine the occurrence of ADRs reported to NAFDAC Pharmacovigilance from January to June 2015, to illustrate the pattern of organ system affected by ADRs, to assess the completeness of ADR report, to determine the relationship between the occurrence of ADRs with suspect drugs and the use of concomitant drugs as well as to generate possible signals from the reported ADRs. A total number of 921 ADR cases reported from January to June 2015 were analyzed using SPSS version 22. A higher percentage of ADR reports were seen in females (65.5%). The highest percentages of reports (45.6%) were from the age range of 21‐40 years, most of the suspected drugs reported had both NAFDAC (50.2%) and batch number identification (65.6%). HIV (56.9%) was the most prevalent indication reported for using the suspected drug; Zidovudine/Lamivudine/Nevirapine combination (16.9%) was reported as the suspected drug with the highest occurrences of ADRs and generalized body itching (6.9%) as the most prevalent ADR. “General disorders” (47.3%) was the most predominant organ system affected by ADRs and Pharmacists were revealed as the highest reporters of ADRs (80.2%). Overall, patients on ARVs should be vigilantly followed up as they are mostly prone to ADRs. Adverse drug reaction reporting systems need to be robust and complete in order to be able to detect new drug alerts, possible signals and improve pharmacovigilance
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Affiliation(s)
- Olufunsho Awodele
- Department of Pharmacology, Therapeutics & Toxicology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Rebecca Aliu
- Department of Pharmacology, Therapeutics & Toxicology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ibrahim Ali
- National Agency for Food and Drug Administration and Control (NAFDAC), Abuja, Nigeria
| | - Yetunde Oni
- National Agency for Food and Drug Administration and Control (NAFDAC), Abuja, Nigeria
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