Alcohol use disorder among people diagnosed with tuberculosis in a large urban case-finding project in central Uganda: prevalence, associated factors and challenges to treatment adherence.

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Substance Abuse Treatment, Prevention, and Policy Pub Date : 2025-03-05 DOI:10.1186/s13011-024-00629-3

Josephine Bayigga, Ilona Kakai, Eva Agnes Laker Odongpiny, Ahmed Ddungu, Lynn Semakula, Martha Nansereko, Christine Sekaggya Wiltshire, Turyahabwe Stavia, Stella Zawedde-Muyanja

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引用次数: 0

Abstract

Background: Heavy consumption of alcohol increases the risk of developing active tuberculosis (TB), contributes to delayed diagnosis and affects adherence to treatment. Within a large urban case-finding project, we aimed to determine the prevalence of and factors associated with alcohol use disorder (AUD) and to understand the challenges that people with AUD face while seeking for TB services and adhering to TB treatment.

Methods: We carried out an explanatory sequential study in two large urban districts in Uganda. We collected quantitative data on the prevalence of alcohol use disorder using the Cut, Annoyed, Guilty, Eye opener (CAGE) tool. We used a Poisson regression model with robust variance to examine factors associated with AUD. Both the crude and adjusted prevalence risk ratios with 95% confidence intervals were presented. We then conducted two focus group discussions with persons diagnosed with both TB and AUD. Focus group discussions (FGDs) were transcribed, data were analysed inductively and coded into themes using NVIVO version 12 software.

Results: Out of 325 people with TB people interviewed, 62 (18.7% 95% confidence interval [CI] 18-31%) screened positive for AUD. Majority 82.3% (51/62) were male. Being male aPR 2.32 (95% CI 1.19, 4.49) and living in an urban area aOR 1.79 (95% CI: 1.10, 2.92) were significantly associated with a positive screen. Among people who screened positive for AUD, there was a tendency towards suboptimal TB treatment outcomes, although this did not reach significance aPR 1.65 (95% CI: 0.95, 2.85). Fourteen people (eight male and six female) who screened positive for AUD attended two FGDs. These respondents often did not disclose alcohol use during TB treatment and missed clinic refill appointments due to lack of transport fares to the clinic.

Conclusion: A significant proportion of people with TB screened positive for AUD but did not disclose alcohol use to their healthcare workers. These patients experienced several challenges while on TB treatment. Therefore, TB care programs need to design interventions that actively assess for AUD and in order to address related challenges.

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乌干达中部一个大型城市病例发现项目中被诊断患有结核病的人的酒精使用障碍：流行情况、相关因素和坚持治疗的挑战。

背景：大量饮酒会增加活动性结核病（TB）的发病风险，导致诊断延迟，并影响治疗的坚持性。在一个大型城市病例调查项目中，我们旨在确定酒精使用障碍（AUD）的患病率及其相关因素，并了解AUD患者在寻求结核病服务和坚持结核病治疗时面临的挑战。方法：我们在乌干达的两个大城市地区进行了一项解释性顺序研究。我们使用割伤、烦恼、内疚、开眼（CAGE）工具收集了有关酒精使用障碍患病率的定量数据。我们使用具有稳健方差的泊松回归模型来检查与AUD相关的因素。给出了粗糙和调整后的患病率风险比（95%置信区间）。然后，我们与诊断为结核病和AUD的人进行了两次焦点小组讨论。对焦点小组讨论（fgd）进行转录，使用NVIVO version 12软件对数据进行归纳分析并编码为主题。结果：在325名受访的结核病患者中，62人（18.7%，95%置信区间[CI] 18-31%）筛查出AUD阳性。男性占82.3%（51/62）。男性aPR为2.32 (95% CI为1.19,4.49)，居住在城市地区aOR为1.79 （95% CI为1.10,2.92）与筛查阳性显著相关。在AUD筛查呈阳性的人群中，有次优结核病治疗结果的趋势，尽管这没有达到显著的aPR 1.65 （95% CI: 0.95, 2.85）。AUD筛查阳性的14人（8男6女）参加了两次fgd。这些答复者往往没有披露在结核病治疗期间饮酒情况，并且由于缺乏前往诊所的交通费而错过了诊所重新预约。结论：很大比例的结核病患者AUD筛查呈阳性，但没有向其医护人员透露饮酒情况。这些患者在接受结核病治疗期间经历了一些挑战。因此，结核病治疗项目需要设计干预措施，积极评估AUD，以应对相关挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Substance Abuse Treatment, Prevention, and Policy Medicine-Health Policy

CiteScore

5.20

自引率

0.00%

发文量

审稿时长

19 weeks

期刊介绍： Substance Abuse Treatment, Prevention, and Policy is an open access, peer-reviewed journal that encompasses research concerning substance abuse, with a focus on policy issues. The journal aims to provide an environment for the exchange of ideas, new research, consensus papers, and critical reviews, to bridge the established fields that share a mutual goal of reducing the harms from substance use. These fields include: legislation pertaining to substance use; correctional supervision of people with substance use disorder; medical treatment and screening; mental health services; research; and evaluation of substance use disorder programs.