Prevalence and Associated Factors for Alcohol Use Disorder Among Tuberculosis Patients: A Systematic Review and Meta-analysis.

Abstract

Background: Alcohol use disorders (AUD) in tuberculosis patients are complicated with the poor compliance to anti-tuberculosis treatment and poor tuberculosis treatment outcomes. However, aggregate data concerning this problem is not available. Therefore, this study aimed at its inception to fill the above gap by generating an average prevalence of AUD and associated factors in tuberculosis patients.Method: Our electronic search was conducted in the databases of Scopus, PubMed, and EMBASE, African Index Medicus, and psych-info. Besides, the reference list of selected articles was looked manually to have further eligible articles. The random-effects model was employed during the analysis. MS-Excel was used to extract data and stata-11 to determine the average prevalence of AUD among tuberculosis patients. A sub-group analysis and sensitivity analysis were also run. A visual inspection of the funnel plots and an Eggers publication bias plot test were checked for the presence of publication bias.Result: A search of the electronic and manual system resulted in 1965 articles. However, after the massive screening, only 27 articles that studied 30654 tuberculosis patients met the inclusion criteria. The average estimated prevalence of AUD in tuberculosis patients was 30% (95% CI: 24.00, 35.00). This was with a slight heterogeneity (I2 = 57%, p-value = 0.000). The prevalence of AUD in tuberculosis patients was higher in Asia and Europe; 37% than the prevalence in the US and Africa; 24%. Besides, the average prevalence of AUD was 39%, 30%, 30%, and 20% in studies with case-control, cohort, cross-sectional and experimental in design respectively. Also, the prevalence of AUD was higher studies with the assessment tool not reported (36%) than studies assessed with AUDIT. AUD was also relatively higher in studies with a mean age of ≥ 40 years (42%) than studies with a mean age < 40 years (24%) and mean age not reported (27%).Conclusion: There existed a high prevalence of AUD in tuberculosis patients and this varies across continents, design of studies, mean age of the participants, and assessment tool used. This will be of paramount importance for public health intervention in the area.