A retrospective cohort analysis of treatment outcomes of patients with tuberculosis who used substances in Tel Aviv, Israel.

IF 2.1 4区医学 Q3 SUBSTANCE ABUSE

Alcohol and alcoholism Pub Date : 2024-01-17 DOI:10.1093/alcalc/agad073

Ehud Kaliner, Sandy Bornstein, Doaa Kabha, Moshe Lidji, Rivka Sheffer, Zohar Mor

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Abstract

Aims: To outline the demographic, clinical, laboratory characteristics, and treatment outcomes of tuberculosis (TB) patients who used substances.

Methods: This retrospective cohort study compared 50 TB patients who used substances with a matched random sample of 100 TB patients who did not use substances between 2007 and 2017. Treatment failure was defined as a sputum smear or culture that tested positive after 5 months of treatment, loss to follow-up, unevaluated patients, or death.

Results: TB patients who used substances were typically younger, experienced homelessness, smokers, and had fewer chronic diseases than those who did not use substances. They also were hospitalized for longer periods, their treatment durations were longer, had higher rates of multidrug resistant strains, increased rates of treatment failure, and higher mortality. Individuals whose treatment failed predominantly originated from the former Soviet Union, experienced homelessness, and had chronic diseases compared with those whose treatment was successful. In the multivariate analysis, homelessness [odds ratios (OR) = 6.7], chronic diseases (OR = 12.4), and substance use (OR = 4.0) were predictors of treatment failures.

Conclusions: TB patients who used substances were more likely to have treatment failure. Targeted interventions, including early diagnosis and enhanced support during treatment, are essential to achieve treatment success in this vulnerable population, in addition to TB-alcohol/drug collaborative activities.

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对以色列特拉维夫使用药物的肺结核患者的治疗结果进行回顾性队列分析。

目的:概述使用药物的结核病(TB)患者的人口学、临床、实验室特征和治疗结果。方法:这项回顾性队列研究比较了50名使用药物的结核病患者与2007年至2017年期间未使用药物的100名结核病患者的匹配随机样本。治疗失败的定义为:治疗5个月后痰涂片或培养呈阳性、随访失败、未评估患者或死亡。结果:与不使用药物的结核病患者相比，使用药物的结核病患者通常更年轻、无家可归、吸烟，并且患有更少的慢性疾病。他们住院时间更长，治疗持续时间更长，耐多药菌株率更高，治疗失败率更高，死亡率更高。治疗失败的人主要来自前苏联，他们无家可归，与治疗成功的人相比，他们患有慢性病。在多变量分析中，无家可归[比值比(OR) = 6.7]、慢性病(OR = 12.4)和药物使用(OR = 4.0)是治疗失败的预测因素。结论:使用药物的结核病患者更容易出现治疗失败。除了结核病-酒精/药物合作活动外，有针对性的干预措施，包括早期诊断和在治疗期间加强支持，对于在这一脆弱人群中取得治疗成功至关重要。

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

Alcohol and alcoholism 医学-药物滥用

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

4-8 weeks

期刊介绍： About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.