Adverse drug reactions to first-line anti-tuberculosis treatments, associated factors, and treatment outcomes: a retrospective study from Southern Morocco.

Tuberculosis (TB) treatment is often associated with adverse drug reactions (ADRs) of varying severity, which may negatively affect treatment adherence and outcomes. This study aimed to identify ADRs related to first-line anti-TB drugs, determine associated factors, and evaluate treatment outcomes among TB patients in the Laâyoune-Sakia El Hamra region of Morocco. A retrospective study was conducted in southern Morocco from January 1, 2023 to December 31, 2024. Data were collected from clinical charts of TB patients treated at the Center for Tuberculosis and Respiratory Diseases of Laâyoune (CDTMRL). Adverse drug reactions were evaluated by a specialist clinician throughout treatment, and outcomes were assessed according to World Health Organization guidelines. Among 354 TB patients, 26.55% experienced ADRs, most commonly during the intensive treatment phase. ADRs were significantly associated with gender, age, smoking status, and comorbidities, particularly diabetes and HIV infection. The majority of ADRs were hepatic (13.87%) and gastrointestinal (9.83%). Cutaneous (6.36%), articular (6.07%), and renal (5.78%) ADRs occurred at similar frequencies. Neurological, immunoallergic, cardiovascular, and urogenital ADRs were comparatively less frequent. Most reactions were mild to moderate and managed symptomatically, with few requiring treatment modifications and no ADR-related deaths. Treatment success outcomes were achieved in 81.1% of patients and unsuccessful treatment accounted for 10.73%. Adverse reactions to first-line anti-TB medications are relatively common and highlight the need for close clinical monitoring throughout the treatment period. Strengthening pharmacovigilance and improving patient education may help enhance treatment adherence and reduce complications.