Symptom experience of adverse drug reaction among male and female patients with newly diagnosed pulmonary tuberculosis in Thailand


adverse drug reaction
pulmonary tuberculosis
symptom experiences
quality of life
drug-related side effects

How to Cite

Thontham, A., & Polsook, R. (2021). Symptom experience of adverse drug reaction among male and female patients with newly diagnosed pulmonary tuberculosis in Thailand. Belitung Nursing Journal, 7(3), 195–202.
Share |

Funder Registry Funding data - Crosreff


Background: Patients with newly diagnosed pulmonary tuberculosis often suffer from adverse drug reaction symptoms, which leads to the automatic discontinuation of anti-tuberculosis drugs. Thus, understanding symptom experience of adverse drug reactions is necessary.

Objective: This study aimed to examine differences in symptoms experienced in four dimensions: presence, frequency, severity, and distress of adverse drug reactions, between male and female patients.

Methods: This was a quantitative survey with a cross-sectional design, with data collected between January and April 2020. A total of 394 patients with newly diagnosed pulmonary tuberculosis was selected through a purposive sampling technique. The symptom experiences of adverse drug reactions were measured using a validated instrument. Data were analyzed using mean, standard deviation, and independent t-test.

Results: The most commonly reported symptom was itchiness (24.1% in males and 34.9% in females). Vomiting occurred as the most frequent symptom among males (x̅ ± SD = 2.73 ± .88), and fatigue was found to be the most severe and distressing symptom across male patients (x̅ ± SD = 2.50 ± 1.61 and 2.06 ± 1.30, respectively). In contrast, yellowing of the eyes and skin was most frequent and severe among females (x̅ ± SD = 3.17 ± .75 and 3.83 ± 1.47, respectively). In addition, flu-like symptoms were evaluated as the most distressing symptom for female patients (x̅ ± SD = 2.80 ± 1.09). The symptom burdens of the females ranged significantly and reached higher than those of the male patients at a p-value of .05 (t = 3.33).

Conclusion: Females taking anti-tuberculosis drugs should be carefully monitored to deal with adverse drug reaction symptoms. This finding would help to decrease the severity of disease and improve their quality of life.

Supporting Agencies

Ratchadaphiseksomphot Endowment Fund, Chulalongkorn University, Bangkok, Thailand (GCUGR1125633058M)


Copyright (c) 2021 Apichaya Thontham, Rapin Polsook

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Abstract views: 670 | PDF views: 421


Download data is not yet available.

PlumX Metrics


Almutary, Hayfa, Bonner, Ann, & Douglas, Clint. (2015). Arabic translation, adaptation and modification of the dialysis symptom index for chronic kidney disease stages four and five. BMC Nephrology, 16(1), 1-8.

Armstrong, Terri S. (2003). Symptoms experience: A concept analysis. Oncology Nursing Forum, 30(4), 601-612.

Dodd, Marylin, Janson, Susan, Facione, Noreen, Faucett, Julia, Froelicher, Erika S., Humphreys, Janice, . . . Rankin, Sally. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33(5), 668-676.

Fang, Yong, Xiao, Heping, Tang, Shenjie, Liang, Li, Sha, Wei, & Fang, Yuanyuan. (2016). Clinical features and treatment of drug fever caused by anti‐tuberculosis drugs. The Clinical Respiratory Journal, 10(4), 449-454.

Fei, Cheah Meng, Zainal, Hadzliana, & Ali, Irfhan Ali Hyder. (2018). Evaluation of adverse reactions Induced by anti-tuberculosis drugs in Hospital Pulau Pinang. The Malaysian Journal of Medical Sciences: MJMS, 25(5), 103-114.

Grove, S. K., & Gray, J. . (2018). Understanding nursing research: Building an evidence‐based practice. St. Louis, Missouri: Elsevier.

Health Data Center. (2020). Report of age and gender of Thais new tuberculosis. Retrieved from

Imam, Faisal, Sharma, Manju, Khayyam, Khalid Umer, Al-Harbi, Naif O., Rashid, Mohd Khan, Ali, Mohammad Daud, . . . Qamar, Wajhul. (2020). Adverse drug reaction prevalence and mechanisms of action of first-line anti-tubercular drugs. Saudi Pharmaceutical Journal, 28(3), 316-324.

Iranpour, Abedin, & Nakhaee, Nouzar. (2019). A review of alcohol-related harms: A recent update. Addiction & Health, 11(2), 129-137.

Lin, Wei-Quan, Jing, Meng-Juan, Tang, Jie, Wang, Jia-Ji, Zhang, Hui-Shan, Yuan, Le-Xin, & Wang, Pei-Xi. (2015). Factors associated with fatigue among men aged 45 and older: A cross-sectional study. International Journal of Environmental Research and Public Health, 12(9), 10897-10909.

Marçôa, R., Ribeiro, A. I., Zão, I., & Duarte, R. (2018). Tuberculosis and gender-Factors influencing the risk of tuberculosis among men and women by age group. Pulmonology, 24(3), 199-202.

Mathew, Sowmya, & Joseph, Anoop. (2017). Adverse effects of antituberculosis drugs in patients under dots category – 1. Journal of Evidence Based Medicine and Healthcare, 4(8), 415-422.

Naser, Syed Mohammad, Nandy, Manab, Banu, Parvin, Banerjee, Arghya, Paul, Suhrita, Podder, Indrashis, & Mukherjee, Mayukh. (2016). Adverse drug reaction monitoring through active surveillance of antitubercular therapy in an urban tertiary care center. Community Acquired Infection, 3(2), 51-54.

Nazir, Tauseef, Farhat, Sameena, Adil, Mohd, & Asrafv, Zuryat. (2019). Adverse drug reactions associated with first line anti-tubercular drugs, their prevalence and causality assessment in patients on Directly Observed Treatment Short-course (DOTS) in a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 8(1), 147.

Pal, Shanthi N., Duncombe, Chris, Falzon, Dennis, & Olsson, Sten. (2013). WHO strategy for collecting safety data in public health programmes: Complementing spontaneous reporting systems. Drug Safety, 36(2), 75-81.

Pongcharoen, Padcha, & Fleischer Jr, Alan B. (2016). Itch management: Systemic agents. Itch-Management in Clinical Practice, 50, 46-53.

Qureshi, D., & Kausar, H. (2013). Adverse effects of first line anti-tuberculosis drugs in patients on DOTS CAT1 under revised national tuberculosis control programme (RNTCP). IJBPAS, 2, 2267-2280.

Rademaker, Marius. (2001). Do women have more adverse drug reactions? American Journal of Clinical Dermatology, 2(6), 349-351.

Raftery, Ann, Tudor, Carrie, True, Lisa, & Navarro, Catalina. (2018). Nursing guide for managing side effects to drug-resistant TB treatment. Retrieved from

Ramappa, Vidyasagar, & Aithal, Guruprasad P. (2013). Hepatotoxicity related to anti-tuberculosis drugs: Mechanisms and management. Journal of Clinical and Experimental Hepatology, 3(1), 37-49.

Saputra, Muhammad Reza, Rakhmawati, Windy, Hendrawati, Sri, & Adistie, Fanny. (2020). Knowledge, attitude, and healthcare-seeking behavior among families of children with tuberculosis. Belitung Nursing Journal, 6(4), 127-135.

Singh, Abhijeet, Prasad, Rajendra, Balasubramanian, Viswesvaran, Gupta, Nikhil, & Gupta, Pawan. (2015). Prevalence of adverse drug reaction with first-line drugs among patients treated for pulmonary tuberculosis. Clinical Epidemiology and Global Health, 3, S80-S90.

Singh, Anita, Bhat, Tej K, & Sharma, Om P. (2011). Clinical biochemistry of hepatotoxicity. Journal of Clinical Toxicology, 4(1), 1-19.

Sinha, Kumarjit, Marak, Izora Trudy R., & Singh, W. Asoka. (2013). Adverse drug reactions in tuberculosis patients due to directly observed treatment strategy therapy: Experience at an outpatient clinic of a teaching hospital in the city of Imphal, Manipur, India. The Journal of Association of Chest Physicians, 1(2), 50-53.

Watson, Sarah, Caster, Ola, Rochon, Paula A., & den Ruijter, Hester. (2019). Reported adverse drug reactions in women and men: Aggregated evidence from globally collected individual case reports during half a century. EClinicalMedicine, 17, 100188.

WHO. (2019). Global tuberculosis report 2019. Geneva, Switzerland: World Health Organization.

World Health Organization. (2020). Global tuberculosis report 2020. Retrieved from

Yamane, Taro. (1973). Statistics: An introductory analysis. New York: Harper & Row.

Yee, Daphne, Valiquette, Chantal, Pelletier, Marthe, Parisien, Isabelle, Rocher, Isabelle, & Menzies, Dick. (2003). Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis. American Journal of Respiratory and Critical Care Medicine, 167(11), 1472-1477.

Zucker, Irving, & Prendergast, Brian J. (2020). Sex differences in pharmacokinetics predict adverse drug reactions in women. Biology of Sex Differences, 11, 1-14.