Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study
Abstract Background Alcohol and illicit drugs are associated with the discontinuation of tuberculosis (TB) treatment and can compromise the immune system. We estimated the impact of alcohol disorder and the use of illicit drug on TB treatment outcomes, considering the interaction of both substances...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | Archives of Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s13690-018-0287-z |
| _version_ | 1819037670676889600 |
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| author | Daniele M. Pelissari Fredi A. Diaz-Quijano |
| author_facet | Daniele M. Pelissari Fredi A. Diaz-Quijano |
| author_sort | Daniele M. Pelissari |
| collection | DOAJ |
| description | Abstract Background Alcohol and illicit drugs are associated with the discontinuation of tuberculosis (TB) treatment and can compromise the immune system. We estimated the impact of alcohol disorder and the use of illicit drug on TB treatment outcomes, considering the interaction of both substances in patients from São Paulo state, Brazil. Methods This is a retrospective cohort of patients diagnosed with TB from 2011 to 2015. We estimated the relative risk (RR) of an unsuccessful outcome associated with alcohol disorder, use of illicit drugs and their interaction using a multiple regression model. We used the adjusted RR to estimate the population attributable fraction. Results Out of a total 77,212 TB patients, 22.2% used at least one of the substances of interest during treatment, while 17% presented an unsuccessful outcome of TB treatment. Compared with no exposure to any substance, alcohol disorder alone (adjusted RR: 1.48; 95% CI: 1.4–1.56), drug use alone (adjusted RR: 2.1; 95% CI: 1.98–2.21) and exposure to both substances (adjusted RR: 2.09; 95% CI: 1.97–2.21) were all associated with a higher risk of an unsuccessful outcome. The adjusted RR of an unsuccessful outcome for people exposed to both substances was 32.7% (95% CI: 26.8–38.2%) and 15.8% (95% CI: 11.5–20.1%) lower than expected on the multiplicative and additive scales respectively. Among all TB patients, 15.8% (95% CI: 15–16.5%) of unsuccessful outcomes was attributable to those exposures. Conclusions We identified a negative interaction between alcohol disorder and the use of illicit drugs on TB treatment outcomes. Despite this, interventions to reduce substance use in TB patients could have a meaningful contribution to preventing unsuccessful treatment outcomes. |
| first_indexed | 2024-12-21T08:25:07Z |
| format | Article |
| id | doaj.art-4803c2d6e0244471988f209b0901014c |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-12-21T08:25:07Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj.art-4803c2d6e0244471988f209b0901014c2022-12-21T19:10:21ZengBMCArchives of Public Health2049-32582018-07-017611710.1186/s13690-018-0287-zImpact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort studyDaniele M. Pelissari0Fredi A. Diaz-Quijano1Department of Epidemiology, School of Public Health, University of São PauloDepartment of Epidemiology, School of Public Health, University of São PauloAbstract Background Alcohol and illicit drugs are associated with the discontinuation of tuberculosis (TB) treatment and can compromise the immune system. We estimated the impact of alcohol disorder and the use of illicit drug on TB treatment outcomes, considering the interaction of both substances in patients from São Paulo state, Brazil. Methods This is a retrospective cohort of patients diagnosed with TB from 2011 to 2015. We estimated the relative risk (RR) of an unsuccessful outcome associated with alcohol disorder, use of illicit drugs and their interaction using a multiple regression model. We used the adjusted RR to estimate the population attributable fraction. Results Out of a total 77,212 TB patients, 22.2% used at least one of the substances of interest during treatment, while 17% presented an unsuccessful outcome of TB treatment. Compared with no exposure to any substance, alcohol disorder alone (adjusted RR: 1.48; 95% CI: 1.4–1.56), drug use alone (adjusted RR: 2.1; 95% CI: 1.98–2.21) and exposure to both substances (adjusted RR: 2.09; 95% CI: 1.97–2.21) were all associated with a higher risk of an unsuccessful outcome. The adjusted RR of an unsuccessful outcome for people exposed to both substances was 32.7% (95% CI: 26.8–38.2%) and 15.8% (95% CI: 11.5–20.1%) lower than expected on the multiplicative and additive scales respectively. Among all TB patients, 15.8% (95% CI: 15–16.5%) of unsuccessful outcomes was attributable to those exposures. Conclusions We identified a negative interaction between alcohol disorder and the use of illicit drugs on TB treatment outcomes. Despite this, interventions to reduce substance use in TB patients could have a meaningful contribution to preventing unsuccessful treatment outcomes.http://link.springer.com/article/10.1186/s13690-018-0287-zTuberculosisIllicit drugs useAlcohol disorderOutcomeInteraction |
| spellingShingle | Daniele M. Pelissari Fredi A. Diaz-Quijano Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study Archives of Public Health Tuberculosis Illicit drugs use Alcohol disorder Outcome Interaction |
| title | Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study |
| title_full | Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study |
| title_fullStr | Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study |
| title_full_unstemmed | Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study |
| title_short | Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study |
| title_sort | impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes a retrospective cohort study |
| topic | Tuberculosis Illicit drugs use Alcohol disorder Outcome Interaction |
| url | http://link.springer.com/article/10.1186/s13690-018-0287-z |
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