The impact of alcohol use on tuberculosis treatment outcomes: a systematic review and meta-analysis

被引:55
作者
Ragan, E. J. [1 ]
Kleinman, M. B. [2 ]
Sweigart, B. [3 ]
Gnatienko, N. [4 ]
Parry, C. D. [5 ,6 ]
Horsburgh, C. R. [1 ,3 ,7 ,8 ]
LaValley, M. P. [3 ]
Myers, B. [5 ,9 ]
Jacobson, K. R. [1 ]
机构
[1] Boston Med Ctr, Sect Infect Dis, 801 Massachusetts Ave, Boston, MA 02118 USA
[2] Univ Maryland, Dept Psychol, College Pk, MD 20742 USA
[3] Boston Univ, Dept Biostat, Boston, MA 02215 USA
[4] Boston Med Ctr, Sect Gen Internal Med, Boston, MA 02118 USA
[5] South African Med Res Council, Alcohol Tobacco & Other Drug Res Unit, Cape Town, South Africa
[6] Stellenbosch Univ, Dept Psychiat, Cape Town, South Africa
[7] Boston Univ, Dept Global Hlth, Boston, MA 02215 USA
[8] Boston Univ, Dept Epidemiol, Boston, MA 02215 USA
[9] Univ Cape Town, Dept Psychiat & Mental Hlth, Cape Town, South Africa
关键词
alcohol use disorder; multidrug-resistant TB; drug-susceptible TB; risk factors; MULTIDRUG-RESISTANT TUBERCULOSIS; TOMSK; HETEROGENEITY; CONSUMPTION; MANAGEMENT; DEFAULT; FOCUS; RISK;
D O I
10.5588/ijtld.19.0080
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Alcohol use is associated with increased risk of developing tuberculosis (TB) disease, yet the impact of alcohol use on TB treatment outcomes has not been summarized. We aimed to quantitatively review evidence of the relationship between alcohol use and poor TB treatment outcomes. We conducted a systematic review of PubMed, EMBASE, and Web of Science (January 1980-May 2018). We categorized studies as having a high- or low-quality alcohol use definition and examined poor treatment outcomes individually and as two aggregated definitions (i.e., including or excluding loss to follow-up [LTFU]). We analyzed drug-susceptible (DS-) and multidrug-resistant (MDR-) TB studies separately. Our systematic review yielded 111 studies reporting alcohol use as a predictor of DS- and MDR-TB treatment outcomes. Alcohol use was associated with increased odds of poor treatment outcomes (i.e., death, treatment failure, and LTFU) in DS (OR 1.99, 95% CI 1.57-2.51) and MDR-TB studies (OR 2.00, 95% CI 1.73-2.32). This association persisted for aggregated poor treatment outcomes excluding LTFU, each individual poor outcome, and across sub-group and sensitivity analyses. Only 19% of studies used high-quality alcohol definitions. Alcohol use significantly increased the risk of poor treatment outcomes in both DS- and MDR-TB patients. This study highlights the need for improved assessment of alcohol use in TB outcomes research and potentially modified treatment guidelines for TB patients who consume alcohol.
引用
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页码:73 / +
页数:11
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