Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India

Abstract

Setting Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. Objective To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. Design Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. Results Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7–1.4), cavitation (aOR 0.8, 95%CI 0.4–1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. Conclusions A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.

Prevalence and risk factors associated with latent tuberculosis infection among household contacts of smear positive pulmonary tuberculosis patients in South India

“…However, the impact of alcohol use among TB patients, on their infectiousness and transmission to HHCs, is still not known [30]. Previously, we found that alcohol consumers had prominent chest X-ray findings compared to nonconsumers (adjusted mean difference 10.8%, p < 0.0001) but their alcohol use was not linked with mycobacterial burden, time to positivity, smear grade, or cavitation on chest X-ray [31]. In the current study, we hypothesised that TB patients who consume high bouts of alcohol would stay away from their home, thereby reducing the risk of exposure among their HHCs, but this was not found to be statistically significant.…”

Assessing Tuberculosis and Risk Factors: Population Study in Rivers State, Nigeria's Niger Delta Region, Nigeria

“…Additionally, family TB, cough 2 weeks, lost weight, contact cough 2 weeks, and alcohol showed insignificant correlations with MTB infection. A finding in sync as reported by Wijayamti [32], Gebrecherkos et al [33] and Melsew et al [34] but in contrast to Kan et al [35] , Jethan et al [36] and Reechaipichitkul et al [30]. This shows that these factors may not be reliable indicators of MTB infection.…”

Differential effects of sex on tuberculosis location and severity across the lifespan

“…Dependence on alcohol and tobacco is generally higher in men, which aggravates the initial clinical presentation at the time of TB diagnosis. Both alcohol abuse 20 and smoking 21 are associated with disease progression, disease severity, and poor treatment outcomes among patients with TB. Therefore, we aimed to adjust for these effects in multivariable analysis in order to exclude the potential influence of men's deleterious health behaviors.…”