Open AccessAlcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India
Author(s) -
Carolyn Kan,
Elizabeth J. Ragan,
Sonali Sarkar,
Selby Knudsen,
Megan Forsyth,
Muthusivaramapandian Muthuraj,
K. Yaragudri Vinod,
Helen E. Jenkins,
C. Robert Horsburgh,
Padmini Salgame,
Gautam Roy,
Jerrold J. Ellner,
Karen R Jacobson,
Swaroop Kumar Sahu,
Natasha S. Hochberg
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0240595
Subject(s) - medicine , tuberculosis , chest radiograph , alcohol , alcohol use disorder , surgery , lung , pathology , biochemistry , chemistry
Setting Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. Objective To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. Design Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. Results Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7–1.4), cavitation (aOR 0.8, 95%CI 0.4–1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. Conclusions A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.