title: Alcohol use and the management of multidrug-resistant tuberculosis in Tomsk, Russian Federation.
abstract: METHODS
  Alcohol use increases the risk of multidrug-resistant tuberculosis (MDR-TB) and poses challenges for successful MDR-TB treatment, including the potential for additional adverse events.
  
  
  OBJECTIVE
  To investigate the association between alcohol consumption during MDR-TB treatment  and adverse events and treatment outcomes in a cohort of patients in Tomsk, Russia.
  
  
  METHODS
  From 2000 to 2004, retrospective data were collected on 407 MDR-TB patients in Tomsk. Factors associated with treatment outcomes were assessed using logistic regression.
  
  
  RESULTS
  Of the 407 patients,  253 (62.2%) consumed alcohol during treatment ('drinkers'), and 367 (90.2%) had at least one documented adverse advent. No significant differences were noted in frequency of adverse events in drinkers vs. non-drinkers. Drinkers had less favourable treatment outcomes (OR 0.28, 95%CI  0.18-0.45). Among drinkers, favourable treatment outcome was associated with adherence to at least 80% of prescribed doses (OR 2.89, 95%CI 1.30-6.43) and the occurrence of an adverse event requiring treatment interruption (OR 2.49, 95%CI 1.11-5.59).
  
  
  CONCLUSIONS
  Alcohol  use did not appear to increase the risk of adverse events during MDR-TB treatment; however, alcohol consumption was associated with poor outcome. Our findings suggest that individuals who drink alcohol should receive aggressive attention to optimise treatment adherence and manage adverse events.
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA. ann_miller@hms.harvard.edu
authors.forename: A C
authors.initials: AC
authors.lastname: Miller
authors.forename: I Y
authors.initials: IY
authors.lastname: Gelmanova
authors.forename: S
authors.initials: S
authors.lastname: Keshavjee
authors.forename: S
authors.initials: S
authors.lastname: Atwood
authors.forename: G
authors.initials: G
authors.lastname: Yanova
authors.forename: S
authors.initials: S
authors.lastname: Mishustin
authors.forename: J J
authors.initials: JJ
authors.lastname: Furin
authors.forename: S S
authors.initials: SS
authors.lastname: Shin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012426:Russia; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy*; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents