Alcohol use disorders (AUD) among tuberculosis patients: a study from Chennai, South India.

Mohanarani Suhadev,Raja Sakthivel M,Beena E Thomas,Auxilia M,Fraser Wares,Murugesan P,Chandrasekaran V,Niruparani Charles,Durga R,Trini A Mathew,Pere-Joan Cardona

doi:10.1371/journal.pone.0019485

Abstract

BackgroundAlcohol Use Disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. Studies from Tuberculosis Research Centre (TRC), Chennai have reported that alcoholism has been one of the major reasons for default and mortality in under the DOTS programme in South India. Hence, it is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India.MethodologyThis is a cross-sectional cohort study covering 10 corporation zones at Chennai and it included situational assessment followed by screening of TB patients by a WHO developed Alcohol Use Disorders Identification Test AUDIT scale. Four zones were randomly selected and all TB patients treated during July to September 2009 were screened with AUDIT scale for alcohol consumption.ResultsOut of 490 patients, 66% were males, 66% were 35 years and above, 57% were married, 58% were from the low monthly income group of <Rs 5000 per month. No females reported alcohol use. Overall, out of 490 TB pts, 29% (141) were found to consume alcohol. Among 141 current drinkers 52% (73) had an AUDIT score of >8. Age (>35 years), education (less educated), income (<Rs 5000 per month), marital status (separated/divorced) and treatment category (Category 2) were statistically significant for TB patients with alcohol use than those TB patients without alcohol use.ConclusionsAUD among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care.

Highlights

Tuberculosis (TB) remains a major global public health problem [1]
Alcohol Use Disorders (AUDs) among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care
A recent systematic review by Lonnrot et al [7] showed that the risk of active TB is substantially elevated in people who drink more than 40 g alcohol per day, and/or have an alcohol use disorder (AUD)

Summary

Introduction

Tuberculosis (TB) remains a major global public health problem [1]. TB is one of the most important problems in India, with 1.98 million new cases per year, comprising over 20% of the global totalfor incident cases [2]. India’s Revised National Tuberculosis Control Programme (RNTCP), an adoption of the internationally recommended Directly Observed Treatment Short course (DOTS) strategy, focuses on providing free quality sputum smear microscopy for diagnosis as well as quality drugs for treatment free of cost. This strategy provides decentralized treatment services close to patients’ residence under direct observation with the help of government health workers and community volunteers [3]. A recent systematic review by Lonnrot et al [7] showed that the risk of active TB is substantially elevated in people who drink more than 40 g alcohol per day, and/or have an alcohol use disorder (AUD). It is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India

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