Background
Screening and brief interventions for alcohol use disorders
Aim of the study
Methods
Setting
Design
Principles for recruitment
Inclusion criteria
Public primary health care clinics
Patients with active TB
Randomisation
Blinding
Procedure
Screening and baseline assessment
Socioeconomic characteristics
Tobacco use
Interventions
Health education leaflet
Brief counselling
Counsellor training and intervention quality assurance
Outcome evaluation
Sample size calculation
Data management and analyses
Intention to treat
Clinic level
Patient level
Analysis approach
Results
Screening and randomization
Brief intervention implementation fidelity analysis
Participant characteristics
Variables | Control | Intervention |
---|---|---|
N = 455 (%) | N = 741 (%) | |
Socio-demographic variables
| ||
Gender (N,% male) | 328 (73.4) | 545 (74.9) |
Age (M, SD) | 35.9 (10.8) | 37.2 (11.0) |
Education
| ||
Grade 7 or less | 134 (29.9) | 251 (34.5) |
Grade 8-11 | 237 (52.5) | 329 (45.2) |
Grade 12 or more | 79 (17.5) | 148 (20.3) |
Poverty index (5–20)
| ||
Low (5) | 134 (31.0) | 191 (28.2) |
Medium (6–12) | 235 (54.4) | 307 (45.3) |
High (13–20) | 63 (14.6) | 179 (26.4) |
Health variables
| ||
Perceived health status
| ||
Excellent | 47 (10.4) | 55 (7.5) |
Very good | 68 (15.0) | 60 (8.2) |
Good | 133 (29.4) | 282 (38.4) |
Fair | 130 (28.8) | 254 (34.6) |
Poor | 74 (16.4) | 83 (11.3) |
AUDIT total (M,SD) | 14.2 (6.0) | 16.5 (6.5) |
AUDIT (7–19) | 369 (80.7) | 507 (68.6) |
AUDIT (20–40) | 88 (19.3) | 232 (31.4) |
New TB patient | 344 (78.0) | 592 (81.3) |
Retreatment TB patient | 97 (22.0) | 136 (18.7) |
Daily or almost daily tobacco use | 171 (38.1) | 267 (39.8) |
HIV positive | 210 (46.5) | 435 (59.0) |
HIV negative | 215 (47.6) | 245 (33.2) |
HIV unknown | 27 (6.0) | 56 (7.6) |
On antiretroviral therapy | 91 (29.8) | 142 (32.3) |
Drinking and TB treatment outcomes
Variables | Time | Control | Intervention | OR* (95% CI) | P-value | ICC (SE) |
---|---|---|---|---|---|---|
Adjusted for cluster | ||||||
AUDIT total (M,SD) | Baseline | 14.2 (6.1) | 16.5 (6.5) | 0.91 (0.78-1.07) | 0.264 | 0.13 (0.04) |
3 months | 4.0 (5.9) | 5.0 (6.1) | ||||
6 months | 3.6 (6.2) | 2.4 (4.8) | ||||
AUDIT (7–40) High risk or alcohol dependence | Baseline | 455 (100) | 741 (100) | 0.70 (0.41-1.19) | 0.186 | 0.11 (0.03) |
3 months | 37 (21.0) | 139 (34.8) | ||||
6 months | 57 (21.2) | 98 (16.8) | ||||
AUDIT (7–19) High risk (N,%) | Baseline | 367 (80.7) | 507 (68.4) | 0.64 (0.43-0.97) | 0.035 | 0.07 (0.02) |
3 months | 33 (18.8) | 126 (31.5) | ||||
6 months | 45 (16.7) | 91 (15.6) | ||||
AUDIT (20–40) Alcohol dependence (N,%) | Baseline | 88 (19.3) | 233 (31.4) | 1.39 (0.75-2.56) | 0.296 | 0.09 (0.03) |
3 months | 4 (2.3) | 13 (3.2) | ||||
6 months | 12 (4.5) | 7 (1.2) | ||||
Heavy episodic drinking1 (weekly+) (N,%) | Baseline | 131 (29.0) | 331 (45.2) | 0.96 (0.46-2.02) | 0.921 | 0.22 (0.06) |
3 months | 11 (9.6) | 23 (10.4) | ||||
6 months | 13 (11.6) | 16 (10.6) | ||||
Daily or almost daily tobacco use (N,%) | Baseline | 171 (39.0) | 278 (40.8) | 1.12 (0.67-1.89) | 0.662 | 0.09 (0.03) |
6 months | 71 (31.8) | 93 (18.6) | ||||
TB treatment outcomes (N,%)
2
| 6 months | 195 (53.6) | 289 (45.9) | |||
Cure | 76 (20.9) | 135 (21.5) | ||||
Complete | 22 (6.0) | 29 (4.6) | ||||
Failure | 65 (17.9) | 155 (24.6) | ||||
Default | 6 (1.6) | 21 (3.3) | ||||
Died | 12 (3.2) | 44 (6.5) | ||||
Transfer out | ||||||
TB treatment cure or completion | 6 months | 271 (74.5) | 424 (67.4) | 0.93 (0.46-1.88) | 0.840 | 0.15 (0.5) |