Title: Alcohol Use in Tuberculosis Patients their Treatment Outcomes: A Cross Sectional Study

Authors: Harshvardhan Singh, Anita Thakur, Salig Ram Mazta, Tripti Chauhan

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.209

Abstract

Background: India has the most number of TB cases among the six countries that account for 60 per cent of total cases worldwide. To progress towards the global goals of elimination, it is vital to understand the factors which can influence the outcome of treatment. The objectives of the present study were to learn about the socio-demographic characteristics of the subjects and to study the factors influencing treatment outcomes in the TB patients.

Methods:  A Cross-sectional study design was employed and all patients (n=117) who were registered for Category I DOTS during the last quarter of 2015 were included after obtaining written informed consent. Patients were visited at their homes for interviews to note socio-demographic and environmental characteristics and secondary data analysis was done to note the outcomes. Univariate and binary logistic regression models were employed.

Results: The overall treatment success rate was 93.2% (Cure rate= 87%, treatment completion rate= 100%). Default, death, failure and lost to follow up rates were 2.6%, 2.6%, 0.8% and 0.8% respectively. Those with a history of alcohol use [OR: 6.13 (1.57-23.93); p=0.01],tobacco smoking [OR: 6 (1.27-28.37) and indoor air pollution [OR: 7.89 (1.10-62.13); p=0.02] and p=0.02]had higher odds of developing unfavourable treatment outcomes.

Conclusion:  The study observed alcohol use, tobacco smoking and indoor air pollution to be associated with adverse outcomes. Health education regarding the ill effects of these with regards to the disease preventability and curability needs to be further intensified to bring a change the firmly embedded social behaviour so that the goals set for global TB control are met.

Keywords: Tuberculosis, Treatment outcomes, alcohol.

References

  1. TB India 2016. Annual status report. New Delhi: Central TB division, Directorate General of Health Services, Ministry of Health and Family Welfare, Govt. of India; 2016: 9.
  2. Lönnroth K, Jaramillo E, Brian G. Williams, Christopher Dye and Raviglione M. Drivers of tuberculosis epidemics: The role of risk factors and social determinants, Social Science & Medicine; 2009: 41-9.
  3. World Health Organisation. TB comorbidities and risk factors. Available from: http://www.who.int/tb/areas-of-work/treatment/risk-factors/en/
  4. Himachal Pradesh Government. Official website of district Shimla administration. Available from: http://hpshimla.nic.in/sml_fact.htm
  5. Government of Himachal Pradesh. Department of Health & Family welfare. Office of the State Tuberculosis Officer.
  6. Horton KC, MacPherson P, Houben RMGJ, White RG and Corbett EL. Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. PLoS Med 2016. 13(9): e1002119.
  7. Parry CDH, Rehm JR, Poznyak V, Room R. Alcohol and infectious diseases: are there causal linkages? Addiction. 2009; 104: 331‐ Jose I Figueroa-Munoz and Pilar Ramon-Pardo. Tuberculosis control in vulnerable groups. Bulletin of the World Health Organization. Available from: http://www.who.int/bulletin/volumes/86/9/06-038737/en/
  8. Rehm J, Samokhvalov AV, Neuman MG, Room R, Parry C, Lönnroth K The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health 2009; 9:450.) Dhanaraj B, Papanna MK, Adinarayanan S, Vedachalam C, Sundaram V, Shanmugam S, et al. Prevalence and Risk Factors for Adult Pulmonary Tuberculosis in a Metropolitan City of South India. PLoS ONE 2015; 10(4): e0124260.
  9. Jakubowiak WM, Bogorodskaya EM, Borisov ES, Danilova DI and Kourbatova EK. Risk factors associated with default among new pulmonary TB patients and social support in six Russian regions. Int J Tuberc Lung Dis. 2007; 11:46–53.
  10. Duraisamy K, Mrithyunjayan S, Ghosh S, Nair SA, Balakrishnan S, Subramoniapillai J, Oeltmann JE, Moonan PK, and Kumar AMV. Does Alcohol Consumption during Multidrug-resistant Tuberculosis Treatm-ent Affect Outcome? Ann Am Thorac Soc. 2014 June; 11(5): 712–718.
  11. Wang J, Shen H. Review of cigarette smoking and tuberculosis in China: intervention is needed for smoking cessation among tuberculosis patients. BMC Public Health 2009; 9: 292.
  12. Kanakia KP, Majella MG, Thekkur P,  Ramaswamy G,  Nair D and Chinnakali P. Osong Public Health Res Perspect 2016; 7(4): 228-32.
  13. Bates MN, Khalakdina A, Pai M, Chang L, Lessa F, Smith K R. Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Arch Intern Med 2007; 167: 335–42.
  14. Lin H H, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLOS Med 2007; 4: e20.

Corresponding Author

Harshvardhan Singh

IGMC, Shimla