The prevalence of alcohol use disorders among people living with HIV/AIDS: a systematic review and meta-analysis

Tsehay

Seid

et al. 2020

Preprint

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.

“…24.00, 35.00). This result was consistent with the global average prevalence of AUD among individuals living with HIV/AIDS (29.80%) (55).…”

Section: Discussionsupporting

confidence: 91%

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

Tsehay

Seid

et al. 2020

Preprint

“…The average prevalence of alcohol use disorder among tuberculosis patients using the random effect model was found to be 30% (95% CI: 24.00, 35.00). This result was consistent with the global average prevalence of AUD among individuals living with HIV/AIDS (29.80%) (55).…”

Section: Discussionsupporting

confidence: 91%

Prevalence and associated factors for Alcohol Use Disorder among tuberculosis patients: A systematic review and meta-analysis study.

Tsehay

Seid

et al. 2020

Preprint

Background: Alcohol use disorders (AUD) in tuberculosis patients are complicated with poor compliance to anti-tuberculosis treatment and poor tuberculosis treatment outcomes. However, aggregate data concerning this problem is not available. Therefore, this review aimed to fill the above gap by generating an average prevalence of AUD in tuberculosis patients.Method: Our electronic search for original articles 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 at manually to have further eligible articles for the prevalence and associated factors of AUD in tuberculosis patients. 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 1970 articles. However, after removing duplicates and unoriginal articles, only 28 articles that studied 30854 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 < 0.001). 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 in 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%). Based on a qualitative review; the male gender, older age, being single, unemployment, low level of education and income from socio-demographic variables, retreatment and treatment failure patients, stigma, and medication non-adherence from clinical variables were among the associated factors for AUD. Conclusion: This review study obtained a high average prevalence of AUD in tuberculosis patients and this varies across continents, design of studies, mean age of the participants, and assessment tool used. This implied the need for early screening and management of AUD in tuberculosis patients.

“…Considering year of publication, the average prevalence of AUD in studies published before 2011 [9,12,15], 2011-2015 [10,13,14,19,[21][22][23]51], and after 2015 [7,8,11,17,18,20,27,28,49,50,52] Table 1 Characteristics of studies on the 1 year prevalence alcohol use disorders among HIV/AIDS patients on ART which are incorporated in the narrative as well as meta-analysis according to author first name, year of publication, setting of study, design, sample size, assessment instrument, study population and magnitude of alcohol use disorder (Fig. 3) and ( Table 2).…”

Section: The 1 Year Prevalence Of Alcohol Use Disorders Among Hiv/aidmentioning

confidence: 99%

“…The prevalence of AUD in patients with retroviral infection has been evidenced higher than people without retroviral infection or the general public [6]. A systematic review and meta-analysis study by Duko et al 2019 [7] showed that the average worldwide prevalence of AUD among patients with HIV/AIDS was found to be 29.8%. Other earlier studies in Africa reported that the prevalence of AUD ranges from 17 to 39.4% in Nigeria [8][9][10], 1.4 to 33% in Uganda [11][12][13][14], 6.6 to 48.5% in South Africa [15][16][17][18], 5.4 to 33% in Kenya [19][20][21][22], and 14.8% in Zambia [23].…”

Section: Introductionmentioning

confidence: 99%

The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis

Subst Abuse Treat Prev Policy

Belete

Getachew

2020

Background: Alcohol use disorder (AUD) in HIV/AIDS patient's decreases adherence and effectiveness of medications and help-seeking to HIV/AIDS care and treatment. This study, therefore, assessed the average 1 year prevalence and associated factors of alcohol use disorder in HIV/AIDS patients. Methods: We did an electronic data search on PubMed, Scopus, EMBASE, Psych-INFO libraries, African index Medicus and African Journals Online (AJOL). Google scholar was also investigated for non-published articles. The reference lists of published articles were also reviewed. The stata-11meta-prop package was employed. Subgroup and sensitivity analyses were done. Cochran's Q-statistics and the Higgs I 2 test were used to check heterogeneity. Publication bias was evaluated with Egger's test and funnel plots. Results: Of 1362 articles identified using the search strategies; only 22 studies were included in the final analysis. The average 1 year prevalence of AUD was 22.03% (95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). The prevalence of AUD in studies published before 2011, 2011-2015, and after 2015 was found to be 13.47, 24.93, and 22.88% respectively. The average prevalence of AUD among studies with a sample size > 450 was 16.71% whereas it was 26.46% among studies with a sample size < 450. Furthermore, the average prevalence of hazardous, harmful, and dependent drinking was 10.87, 8.1, and 3.12% respectively. Our narrative analysis showed that male sex, cigarette smoking, family history of alcohol use, missing ART medication, mental distress, khat chewing, low CD4 count, and low income were among the associated factors for AUD in people with HIV AIDS. On quantitative meta-analysis for associated factors of AUD, the AOR of being male, Cigarette smoking and khat chewing were 5.5, 3.95, and 3.34 respectively. Conclusion: The average 1 year prevalence of AUD in HIV/AIDs patients was high and qualitatively factors such as being Male, cigarette smoking, and khat chewing were associated with it. Therefore, clinical services for people living with HIV/AIDS should integrate this public health problem. Policymakers should also develop guidelines and implementation strategies for addressing this problem.