Title: Alcohol and Tuberculosis: A Comprehensive Public Health Perspective and Case Series Study at a Tertiary Care Hospital

Authors: Dr Rajendra Tatu Nanavare, Dr Mrs. Namrata Kaur Bhui, Dr Anis Nhavakar

 DOI: https://dx.doi.org/10.18535/jmscr/v11i8.05

Abstract

This study focuses on the intersection of alcoholism and pulmonary tuberculosis (PTB) and its implications for public health. Conducted at a tertiary care hospital in Mumbai, the research aimed to identify the impact of alcohol consumption on PTB incidence, severity, and treatment outcomes among adult male patients. A descriptive case series approach was employed to study patients attending the outpatient department (OPD) and inpatient department (IPD) in May and June 2023.

The findings revealed a significant association between alcoholism and PTB, with chronic alcoholic patients being more susceptible to TB infection and developing severe complications. Comorbidities such as HIV, uncontrolled diabetes, and hemoptysis were commonly observed in these patients, necessitating comprehensive and integrated healthcare services.

Moreover, the study highlighted the psychiatric impact of alcoholism on PTB patients, with many presenting with depression and suicidal ideation. The challenges of early detection and management of PTB were also noted, indicating the need for stronger primary healthcare and community-based interventions.

In conclusion, this study underscores the need for a multidimensional approach to address the complex issues arising from the intersection of alcoholism and PTB. Comprehensive public health strategies encompassing early detection, treatment adherence, mental health support, and targeted preventive measures are crucial to mitigate the impact of alcohol on PTB risk and improve overall health outcomes.

Keywords: Tuberculosis, Alcohol, Alcohol and TB, Alcohol TB and Hepatic comorbidity.

References

  1. Alcohol consumption as a risk factor fortuberculosis: meta-analyses and burden of disease Sameer Imtiaz1,2, Kevin D. Shield3, Michael Roerecke2,4, Andriy V.Samokhvalov1,2,5, Knut Lönnroth6,7 and Jürgen Rehm
  2. World Health Organisation W.H.O. (21-04-2023)
  3. Lönnroth K, Williams B, Stadlin S, et al. Alcohol use as a risk factor for tuberculosis – a systematic review. BMC Public Health 2008; 8: 289.
  4. Rehm J, Samokhvalov AV, Neuman MG, et al. The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health 2009; 9: 450.
  5. Dannenberg AM. Immune mechanisms in the pathogenesis of pulmonary Rev Infect Dis 1989; 11: S369–S378
  6. Rimland K. Mechanisms of ethanol-induced defects of alveolar macrophage function. Alcohol ClinExp Res 1983; 8: 73–76.
  7. Crews FT, Bechara R, Brown LA, et al. Cytokines and alcohol. Alcohol ClinExp Res 2006; 30: 720–730.
  8. Gamble L, Mason CM, Nelson S. The effects of alcohol on immunity and bacterial infection in the lung. Med Mal Infect 2006; 36: 72–77.
  9. Szabo G, Saha B. Alcohol’s effect on host defense. Alcohol Res 2015; 37: 159–170
  10. Lieber CS. Biochemical and molecular basis of alcohol-induced injury to liver and other tissues. N Engl J Med 1988; 319: 1639–1650.
  11. Diel R, Schneider S, Meywald-Walter K, et al. Epidemiology of tuberculosis in Hamburg, Germany: long-term population-based analysis applying classical and molecular epidemiological techniques. J ClinMicrobiol 2002; 4: 532–539
  12. Classen CN, Warren R, Richardson M, et al. Impact of social interactions in the community on the transmission of tuberculosis in a high incidence area. Thorax 1999; 54: 136–140.
  13. Quintero D, Guidot D M. Focus on the lung. Alcohol Res Health 2010; 33(3): 219.
  14. Saukkonen J J, Cohn D L, Jasmer R M, et al. An official ATS statement: hepatotoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006; 174(8): 935–952.
  15. Koriakin V, Sokolova G, Grinchar N, IurchenkoL. Pharmacokinetics of isoniazid in patients with pulmonary tuberculosis and alcoholism. ProblTuberk 1986; 12: 43–46.
  16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Update. Washington (DC): American Psychiatric Association; 2016.
  17. The Impact of Alcohol Use Disorder on Tuberculosis: A Review of the Epidemiology and Potential Immunologic Mechanisms. Gregory W. Wigger 1*, Tara C. Bouton2, Karen R Jacobson2, Sara C. Auld1,3, Samantha M. Yeligar 1,4 and Bashar S. Staitieh1
  18. Friedman LN, Sullivan GM, Bevilaqua RP, Loscos R. Tuberculosis Screening in Alcoholics and Drug Addicts. Am Rev Respir Dis (1987) 136(5):1188–92. doi: 10.1164/ajrccm/136.5.1188
  19. .Ragan EJ, Kleinman MB, Sweigart B, Gnatienko N, Parry CD, Horsburgh CR, et al. The Impact of Alcohol Use on Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis. Int J Tuberc Lung Dis (2020) 24(1):73–82. doi: 10.5588/ijtld.19.008
  20. Przybylski G, Dabrowska A, Trzcinska H. Alcoholism and Other SocioDemographic Risk Factors for Adverse TB-Drug Reactions andUnsuccessful Tuberculosis Treatment - Data From Ten Years' Observation at the Regional Centre of Pulmonology, Bydgoszcz, Poland. Med SciMonit (2014) 20:444–53. doi: 10.12659/MSM.890012

Corresponding Author

Dr Rajendra Tatu Nanavare

Chest Physician (SMC) and Unit head IV Group of T.B. Hospitals, Sewri, Mumbai 15, India