Study of treatment outcomes in tuberculosis patients on DOTS therapy at five centres in Goa (original) (raw)
Related papers
Alcohol Use Disorders (AUD) among Tuberculosis Patients: A Study from Chennai, South India
PLoS ONE, 2011
Background: Alcohol 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. Methodology: This 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. Results: Out 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. Conclusions: AUD among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care.
The International Journal of Tuberculosis and Lung Disease, 2021
BACKGROUND: Approximately 10% of incident TB cases worldwide are attributable to alcohol. However, evidence associating alcohol with unfavorable TB treatment outcomes is weak.METHODS: We prospectively evaluated men (≥18 years) with pulmonary TB in India for up to 24 months to investigate the association between alcohol use and treatment outcomes. Unhealthy alcohol use was defined as a score of ≥4 on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scale at entry. Unfavorable TB treatment outcomes included failure, recurrence, and all-cause mortality, analyzed as composite and independent endpoints.RESULTS: Among 751 men, we identified unhealthy alcohol use in 302 (40%). Median age was 39 years (IQR 28–50); 415 (55%) were underweight (defined as a body mass index [BMI] <18.5 kg/m2); and 198 (26%) experienced an unfavorable outcome. Unhealthy alcohol use was an independent risk factor for the composite unfavorable outcome (adjusted incidence rate ratio [aIRR] 1.47, 9...
Journal of Nepal Health Research Council
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Global studies on alcoholism among tuberculosis patients have found alcoholism to alter pharmacokinetics of medicines used in the treatment of tuberculosis (TB), higher rate of defaults during the treatment and development of drugresistant forms of TB. 1-7 Studies carried out in India have found alcoholism to be a risk factor for TB mortality, factor for default in TB and reason for non-compliance under RNTCP. 8-10 These findings are corroborated by research from The Tuberculosis Research Centre (TRC) in India, who report alcoholism as a major underlying factor associated with default and mortality among TB patients. 11,12 Prevalence of current use of alcohol among the general population was 13% in Udupi taluk in 2011. 13 There is paucity of documented evidence on the prevalence of alcohol use among tuberculosis patients. The present study was carried out to assess the prevalence, patterns and associated factors of alcoholism among tuberculosis patients in Udupi taluk. Background: Tuberculosis (TB) is a major public health problem in India. Several studies carried out in India have shown alcoholism as a risk factor for tuberculosis mortality, factor for default in TB and reason for non-compliance under the Revised National Tuberculosis Control Program (RNTCP). The aim of this study was to assess the prevalence, pattern and associated factors of alcohol use among tuberculosis patients in Udupi taluk, Karnataka, India. Methods: A cross-sectional study was conducted with the complete enumeration of all the cases undergoing Directly Observed Treatment Short-course (DOTS) treatment in Primary Health Centre and Community Health Centre of Udupi taluk from March to April 2013. Interview was conducted to obtain the socio-demographic and health information and participants were screened using WHO developed Alcohol Use Disorders Identification Test (AUDIT) for alcohol use. Results: Out of 123 participants, 78% were males, 86.2% were Hindu, 79.7% were married and 88.6% were from low socioeconomic status. About 20.3% (n=25) participants were alcoholic. Among them, 44% were low risk drinkers, 32% were hazardous drinkers, 4% were harmful drinkers and 20% were alcohol dependent. Age, sex, occupation, tobacco use, perceived health status and discrimination due to tuberculosis positive status were significantly associated with alcohol use. On logistic regression sex, tobacco use, perceived health status and facing discrimination due infection with tuberculosis were found to be factors associated with alcohol use. Conclusions: This study found a high prevalence of alcoholism among tuberculosis patients which is of concern and has to be addressed.
Alcoholism: Clinical and Experimental Research, 2010
Background: While the integration of alcohol screening, treatment, and referral in primary care and other medical settings in the U.S. and worldwide has been recognized as a key health care priority, it is not routinely done. In spite of the high co-occurrence and excess mortality associated with alcohol use disorders (AUDs) among individuals with tuberculosis (TB), there are no studies evaluating effectiveness of integrating alcohol care into routine treatment for this disorder.
BMC Health Services Research, 2019
Background: Tobacco use and alcohol abuse are associated with higher risk of tuberculosis (TB) infection, progression to active TB and adverse treatment outcomes among patients with TB. Revised National Tuberculosis Control Programme (RNTCP) treatment guidelines (2016) require the documentation of tobacco and alcohol use among patients with TB and their linkage to tobacco and alcohol abuse treatment services. This study aimed to assess the extent of documentation of tobacco and alcohol usage data in the TB treatment card and to explore indepth, the operational issues involved in linkage. Methods: A convergent parallel mixed methods study was conducted. All new TB treatment cards of adult patients registered under RNTCP between January and June 2017 in Dakshina Kannada district were reviewed to assess documentation. Document review was done to understand the process of linkage (directing patients to tobacco and alcohol abuse treatment services). In-depth interview of health care providers (n = 7) and patients with TB (n = 5) explored into their perspectives on linkage. Results: Among 413 treatment cards reviewed, tobacco use was documented in 322 (78%), of whom 86 (21%) were documented as current tobacco users. Sixteen (19%) out of these 86 patients were linked to tobacco cessation services. Alcohol usage status was documented in 319 (77%) cards of whom 71(17%) were documented as alcohol users. Eleven (16%) out of these 71 patients were linked to alcohol abuse treatment services. The questions in the treatment card lacked clarity. Guidelines on eliciting history of substance abuse and criteria for linkage were not detailed. Perceived enablers for linkage included family support, will power of the patients and fear of complications. Challenges included patient's lack of motivation, financial and time constraints, inadequate guidelines and lack of coordination mechanisms between TB programme and tobacco/alcohol abuse treatment services. Conclusion: Documentation was good but not universally done. Clear operational guidelines on linkage and treatment guidelines for health care providers to appropriately manage the patients with comorbidities are lacking. Lack of coordination between the TB treatment programme and tobacco cessation as well as alcohol treatment services was considered a major challenge in effective implementation of the linkage services.
Alcohol use disorders among pulmonary tuberculosis patients under RNTCP in urban Pondicherry, India
Indian Journal of Tuberculosis, 2015
Background: Alcohol use is implicated in a wide variety of diseases and disorders including TB. Objectives: To study the prevalence and pattern of alcohol use among the PTB patients registered under RNTCP in urban Pondicherry and the association of various socio-demographic variables with alcohol drinking during treatment. Methods: A cross-sectional study was conducted among 235 PTB patients from 6 randomly selected urban PHCs of Pondicherry from Jan 2013 to March 2014. Alcohol Use Disorder Identification Test (AUDIT) was used for screening the PTB patients for their severity of alcohol use. Data were entered in Epi-data v3.1 and was analyzed by SPSS v20. Chi-square test and multiple-logistic regression were used. Results: Prevalence of alcohol use among PTB patients at the time of diagnosis was 59% and during treatment was 31.5%. Around 54% PTB patients had alcohol use disorders (AUD) during diagnosis, whereas the same during treatment was 26.4%. Among drinkers at the time of diagnosis (n = 139), 80% modified and 20% did not modify their alcohol use even after TB diagnosis. Male gender was significantly associated with alcohol use (p ≤ 0.001). Univariate analysis showed that lower level of education, lower SES, unemployed/unskilled/semiskilled/ skilled occupational group, and Category II were significantly associated with alcohol use among male patients (p < 0.05). Multivariate analysis showed that none of the variables were associated. Conclusions: One-third of PTB patients were drinking alcohol during the treatment. Though 80% modified alcohol use after TB diagnosis, the rest 20% did not modify. Necessary interventions need to be planned to screen for alcohol use.
Journal of Epidemiology & Community Health, 1995
Objectives-To improve blood pressure control among hypertensive (>140/ 90 mmHg) excessive alcohol drinkers. Design-Fourteen worksite physicians were randomised into an intervention group and a control group. The intervention was based on training the worksite physicians and follow up of those hypertensive subjects defined as excessive drinkers. Follow up was based on self monitoring of alcohol consumption by the subject, in view of the results of their gamma glutamyl transferase (GGT) activity determination. Setting-Fourteen workplaces in Francemainly in the industrial sector. Subjects-Altogether 15 301 subjects were screened by the 14 physicians: 129 of these were included in the study. Main outcome measures-This was the difference between the initial systolic blood pressure (SBP) and the SBP one year later (ABP). Secondary criteria were the difference between the initial and final diastolic blood pressure (ADBP) and ABP at two years; antihypertensive treatment; stated alcohol consumption (AAC); AGGT; and body mass index (ABMI). Results-The decrease in SBP levels was significantly larger in the intervention group than in the control group: at one year, ASBP values were-11.9 (15-6) mmHg and-4-6 (13.8) respectively (p<O0OS). This benefit was still observed after two years of follow up (-13-8 (17.4) numHg v-7 5 (14.2) mmHg (p<0.05)). No difference was observed in DBP. The percentage of treated subjects did not differ between groups. At one year, AAC was larger in the intervention group (-28 (5.2) Uid) than in the control group (-1-6 (3.4) (p<0-1)). AGGT and ABMI did not differ between the two groups. A weak
African Health Sciences, 2014
Background Although there are numerous global efforts to control tuberculosis (TB), it remains a chronic infectious disease with high morbidity and mortality in several parts of the world. 1,2,3 As the world's most frequent contagious disease, TB causes about 2 million deaths a year, with more than 8 million people contractingthe disease every year. 4,5 According to the WHO, 6 an estimated 1.7 million people died from TB in 2009, with the highest number of TB related deaths being in the African region. While modern TB treatment regimens are generally associated with a good prognosis, 7 factors such as bacterium characteristics, heterogeneity of patients' clinical characteristics, patient behaviour, quality of health care, HIV co-infection and multi-drug resistant tuberculosis (MDRTB) are known to influence TB treatment outcomes. 2,8,9,10 A number of factors including age, male gender, delays in diagnosis and treatment, drug resistance, and co-morbid conditions including HIV co-infection, diabetes 1 , alcoholism, smoking, lower educational and income levels, unemployment, treatment for other concomitant diseases, and side effects of anti-TB drugs 11 have been associated with increased risk of death in patients with active tuberculosis. Various studies support a strong association between alcohol use, alcohol use disorders and TB. 12-14 These studies show the pathogenic impact of alcohol on the immune system causing susceptibility to TB among drinkers. 13 People that drink heavily show higher relapse rates, a
PLOS ONE
Background More than 20% of tuberculosis (TB) disease worldwide may be attributable to smoking and alcohol abuse. India is the second largest consumer of tobacco products, a major consumer of alcohol particularly among males, and has the highest burden of TB globally. The impact of increasing tobacco dose, relevance of alcohol misuse and past versus current or never smoking status on TB treatment outcomes remain inadequately defined. Methods We conducted a multi-centric prospective cohort study of newly diagnosed adult pulmonary TB patients initiated on TB treatment and followed for a minimum of 6 months to assess the impact of smoking status with or without alcohol abuse on treatment outcomes. Smokers were defined as never smokers, past smokers or current smokers. Alcohol Use Disorder Identification Test (AUDIT) scores were used to assess alcohol misuse. The association between smoking status and treatment outcomes was assessed in univariate and multivariate random effects poisson regression models. Results Of 455 enrolled, 129 (28%) had a history of smoking with 94 (20%) current smokers and 35 (8%) past smokers. Unfavourable treatment outcomes were significantly higher among past and current smokers as compared to never smokers. Specifically, the risk of treatment