Abstract
BackgroundThe negative influences of alcohol on TB management with regard to delays in seeking care as well as non compliance for treatment has been well documented. This study is part of a larger study on the prevalence of AUD (Alcohol Use Disorder) among TB patients which revealed that almost a quarter of TB patients who consumed alcohol could be classified as those who had AUD. However there is dearth of any effective alcohol intervention programme for TB patients with Alcohol Use Disorder (AUD).MethodologyThis qualitative study using the ecological system model was done to gain insights into the perceived effect of alcohol use on TB treatment and perceived necessity of an intervention programme for TB patients with AUD. We used purposive sampling to select 44 men from 73 TB patients with an AUDIT score >8. Focus group discussions (FGDs) and interviews were conducted with TB patients with AUD, their family members and health providers.ResultsTB patients with AUD report excessive alcohol intake as one of the reasons for their vulnerability for TB. Peer pressure has been reported by many as the main reason for alcohol consumption. The influences of alcohol use on TB treatment has been elaborated especially with regard to the fears around the adverse effects of alcohol on TB drugs and the fear of being reprimanded by health providers. The need for alcohol intervention programs was expressed by the TB patients, their families and health providers. Suggestions for the intervention programmes included individual and group sessions, involvement of family members, audiovisual aids and the importance of sensitization by health staff.ConclusionsThe findings call for urgent need based interventions which need to be pilot tested with a randomized control trial to bring out a model intervention programme for TB patients with AUD.
Highlights
Alcohol use- disorders (AUD) has been reported as a risk factor for an impaired immune system, and increases a person’s susceptibility to active TB infection as well as to the reactivation of latent disease [1,2,3,4,5,6,7,8]
The need for alcohol intervention programs was expressed by the TB patients, their families and health providers
The findings call for urgent need based interventions which need to be pilot tested with a randomized control trial to bring out a model intervention programme for TB patients with Alcohol Use Disorder (AUD)
Summary
Alcohol use- disorders (AUD) has been reported as a risk factor for an impaired immune system, and increases a person’s susceptibility to active TB infection as well as to the reactivation of latent disease [1,2,3,4,5,6,7,8]. India is no exception with the challenge of poverty, high rates of alcohol use and hazardous drinking among men [10] This increases vulnerability to TB but there are other issues of concern which vary from delays in diagnosis [11] to default for treatment and mortality [12,13]. Treatment failures were 43% in the low risk group with AUDIT score ,8 against 57% in group of TB patients with AUDIT score .8 This qualitative study was done to describe the reasons for excessive alcohol intake, the problems associated with alcohol abuse, the perceived effect of alcohol use on TB treatment and the perceived necessity of an intervention programme for TB patients with AUD. There is dearth of any effective alcohol intervention programme for TB patients with Alcohol Use Disorder (AUD)
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