ADVERSE CUTANEOUS REACTIONS TO THIACETAZONE FOR TUBERCULOSIS TREATMENT IN TANZANIA

Because thiacetazone has been linked with serious adverse cutaneous re actions, we undertook 1 year of systematic surveillance for cutaneous thiacetazone-associated adverse reactions within the national tubercul osis programme of Tanzania, For individual cases, we collected informa tion on age, sex, interval between commencing thiacetazone-containing treatment and occurrence of adverse reaction, most severe clinical pre sentation (toxic epidermal necrolysis, rash without necrolysis, itchin g without rash), and outcome (dead or alive) within 2 weeks of onset, Univariate and multivariate analyses were done of variables relevant t o outcome. 1273 patients with adverse reactions were reported, The fre quency of fatal outcome from any cutaneous reaction was 3.1 per 1000 a mong all tuberculosis patients, and 19.1% among patients with toxic ep idermal necrolysis. About 60% of all adverse reactions and deaths occu rred within 20 days of starling thiacetazone. Case fatality from adver se cutaneous reactions was considerably less frequent than reported pr eviously, suggesting that improved management might allow retention of thiacetazone in the armamentarium of national tuberculosis programmes even where infection with HIV is prevalent,