The impact of alcohol use on tuberculosis treatment outcomes : a systematic review and meta-analysis
Date
2020-01
Journal Title
Journal ISSN
Volume Title
Publisher
International Union Against Tuberculosis and Lung Disease
Abstract
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.
Description
CITATION: Ragan, E. J. et al. 2020. The impact of alcohol use on tuberculosis treatment outcomes: a systematic review and meta-analysis. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 24(1):73–82. doi:10.5588/ijtld.19.0080
The original publication is available at https://www.ingentaconnect.com/content/iuatld/ijtld
The original publication is available at https://www.ingentaconnect.com/content/iuatld/ijtld
Keywords
Alcoholism, Tuberculosis -- Treatment, Multidrug-resistant tuberculosis, Drug resistance
Citation
Ragan, E. J. et al. 2020. The impact of alcohol use on tuberculosis treatment outcomes: a systematic review and meta-analysis. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 24(1):73–82. doi:10.5588/ijtld.19.0080