Does Alcohol Consumption during Multidrug-resistant Tuberculosis Treatment Affect Outcome?

Details

• Alternative Title:
  Ann Am Thorac Soc
• Personal Author:
  Duraisamy, Karthickeyan ; Mrithyunjayan, Sunilkumar ; Ghosh, Smita ; Nair, Sreenivas Achuthan ; Balakrishnan, Shibu ; Subramoniapillai, Jayasankar ; Oeltmann, John E. ; Moonan, Patrick K. ; Kumar, Ajay M. V.
• Description:
  Rationale ; India reports the largest number of multidrug-resistant tuberculosis cases in the world; yet, no longitudinal study has assessed factors related to treatment outcomes under programmatic conditions in the public sector. ; Objectives ; To describe demographic, clinical, and risk characteristics associated with treatment outcomes for all patients with multidrug-resistant tuberculosis registered in the Revised National Tuberculosis Control Programme, Kerala State, India from January 1, 2009 to June 30, 2010. ; Methods ; Cox regression methods were used to calculate adjusted hazard ratios with 95% confidence intervals (CIs) to assess factors associated with an unsuccessful treatment outcome. ; Measurements and Main Results ; Of 179 patients with multidrug-resistant tuberculosis registered, 112 (63%) had successful treatment outcomes (77 bacteriologically cured, 35 treatment completed) and 67 (37%) had unsuccessful treatment outcomes (30 died, 26 defaulted, 9 failed treatment, 1 stopped treatment because of drug-related adverse events, and 1 developed extensively drug-resistant tuberculosis). The hazard for unsuccessful outcome was significantly higher among patients who consumed alcohol during treatment (adjusted hazard ratio, 4.3; 95% CI, 1.1–17.6) than those who did not. Persons who consumed alcohol during treatment, on average, missed 18 more intensive-phase doses (95% CI, 13–22) than those who did not. Although many patients had diabetes (33%), were ever smokers (39%), or had low body mass index (47%), these factors were not associated with outcome. ; Conclusion ; Overall treatment success was greater than global and national averages; however, outcomes among patients consuming alcohol remained poor. Integration of care for multidrug-resistant tuberculosis and alcoholism should be considered to improve treatment adherence and outcomes.
• Keywords:
  • multidrug-resistant tuberculosis treatment outcome
  • multidrug-resistant tuberculosis
  • alcohol
  • tuberculosis
  • India
  • Adult
  • Alcohol Drinking
  • Antitubercular Agents
  • Female
  • Follow-Up Studies
  More +
• Source:
  Ann Am Thorac Soc. 11(5):712-718
• Pubmed ID:
  24735096
• Pubmed Central ID:
  PMC4631605
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/Intramural CDC HHSUnited States/
• Volume:
  11
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/36398/cdc_36398_DS1.pdf
• File Type:
  [PDF - 282.96 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:325d3884f865c46ca5fd31ab83fa446a65f1bb4a20190f0afa3af90c1a8beb37