title: Tuberculosis and alcohol misuse in Scotland: a population-based study using enhanced surveillance data.
abstract: OBJECTIVE
  To identify for the first time in Scotland the epidemiological characteristics of tuberculosis (TB) patients who misuse alcohol.
  
  
  METHODS
  A retrospective cohort study using Enhanced Surveillance of Mycobacterial Infections (ESMI) scheme data for adult (aged ≥ 18 years) TB cases notified in Scotland, 2001-2007. Characteristics and treatment outcomes of TB cases with and without recorded alcohol misuse were compared.
  
  
  RESULTS
  Of 2419 adult TB cases, alcohol misuse was recorded in 426 (18%). Alcohol misuse was associated with male sex, White ethnicity, birth in the United Kingdom, unemployment, urban residence and socio-economic deprivation. Alcohol misusers were more likely than other TB cases to have pulmonary TB (92% vs. 61%, P < 0.001), be sputum smear-positive (74% vs. 58%, P < 0.001) and be enrolled on directly observed treatment (30% vs. 3%, P < 0.001). Treatment completion rates were respectively 77% and 79% (P = 0.34) in alcohol misusers and other TB cases.
  
  
  CONCLUSIONS
  We have identified epidemiological characteristics associated with alcohol misuse among TB patients in Scotland, notably socio-economic deprivation. We suggest improvements in data collection to allow more robust findings to inform policy decisions to assist the prevention and management of alcohol misuse and reduce the TB incidence in Scotland.
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK. beth.delahaye@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: de la Haye
authors.forename: S H
authors.initials: SH
authors.lastname: Wild
authors.forename: J
authors.initials: J
authors.lastname: Stevenson
authors.forename: F
authors.initials: F
authors.lastname: Johnston
authors.forename: O
authors.initials: O
authors.lastname: Blatchford
authors.forename: I F
authors.initials: IF
authors.lastname: Laurenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult