Alcohol use and clinical manifestations of tuberculosis.
OBJECTIVE
Excess alcohol use represents a significant challenge in tuberculosis control. Whether alcohol use enhances transmission of Mycobacterium tuberculosis is not known.


METHODS
We analyzed North Carolina, USA surveillance data for all adult (>14 years) tuberculosis cases reported 1994-2006 (N = 5556).


RESULTS
The prevalence of excess alcohol use among tuberculosis cases declined from 27.3% in 1994 to 17.9% in 2006. Cases with excess alcohol use were more likely to have pulmonary tuberculosis compared with cases without excess alcohol use (92.5% vs. 77.2%, p < 0.0001). Among pulmonary cases, excess alcohol use was associated with cavities on chest radiograph (36.8% vs. 28.2%, p < 0.0001) and positive acid-fast sputum smears (65.9% vs. 45.8%, p < 0.0001).


CONCLUSIONS
Although excess alcohol use is becoming less prevalent among tuberculosis cases in North Carolina, cases who use excess alcohol had clinical features associated with greater infectiousness, and represent a significant public health problem.
Fiske
Christina T
CT
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Hamilton
Carol D
CD
Stout
Jason E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology*; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents