Alcohol use and abuse among patients with multidrug-resistant tuberculosis in Botswana
OBJECTIVE: To describe the patterns of alcohol use in MDR-TB patients and to determine whether alcohol use is associated with the development of MDR-TB in Botswana.
METHODS: We compared the level of alcohol use among MDR-TB patients against three control groups: 1) non-MDR-TB patients, 2) human immunodeficiency virus (HIV) infected patients without a history of TB, and 3) the general population. Alcohol use and abuse was measured with the Alcohol Use Disorders Identification Test 10 (AUDIT) questionnaire.
RESULTS: Of a total national population of 164 MDR-TB cases, 114 (70%) were interviewed. MDR-TB cases had a lifetime prevalence of alcohol use of 35.1%, which was lower than that of all control groups (P < 0.001). MDR-TB cases had higher 1-month prevalence of alcohol dependence symptoms and a lower 1-year period prevalence of alcohol dependence symptoms (P < 0.01 and P = 0.01 respectively). Among patients with TB, alcohol abuse was found to be a risk factor for the development of MDR-TB.
CONCLUSION: MDR-TB patients in Botswana have high rates of alcohol use and abuse. Among TB patients, alcohol abuse is associated with the diagnosis of MDR-TB, and could be an important modifiable factor.
Keywords: alcohol; case control; multidrug resistance; tuberculosis
Document Type: Research Article
Affiliations: 1: Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Botswana–University of Pennsylvania Partnership, Gaborone, Botswana; Department of Medicine, University of Botswana, Gaborone, Botswana 2: Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Botswana–University of Pennsylvania Partnership, Gaborone, Botswana 3: Ministry of Health, Government of Botswana, Gaborone, Botswana 4: Division of Infectious Diseases, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA 5: Division of Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Publication date: 01 November 2012
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