title: Alcohol use and abuse among patients with multidrug-resistant tuberculosis in Botswana.
abstract: BACKGROUND
  Data on alcohol abuse as a risk factor for the development of multidrug-resistant tuberculosis (MDR-TB) are scarce.
  
  
  OBJECTIVE
  To describe the patterns of alcohol use in MDR-TB patients and to determine whether alcohol use is associated with the development of MDR-TB  in Botswana.
  
  
  METHODS
  We compared the level of alcohol use among MDR-TB patients against three control groups: 1) non-MDR-TB patients, 2) human immunodeficiency virus (HIV) infected patients without a history of TB, and 3) the general population. Alcohol use and abuse was measured with  the Alcohol Use Disorders Identification Test 10 (AUDIT) questionnaire.
  
  
  RESULTS
  Of a total national population of 164 MDR-TB cases, 114 (70%) were interviewed. MDR-TB cases had a lifetime prevalence of alcohol use of 35.1%, which was lower than that of all control groups (P <  0.001). MDR-TB cases had higher 1-month prevalence of alcohol dependence symptoms and a lower 1-year period prevalence of alcohol dependence symptoms (P < 0.01 and P = 0.01 respectively). Among patients with TB, alcohol abuse was found to be a risk factor for the development  of MDR-TB.
  
  
  CONCLUSIONS
  MDR-TB patients in Botswana have high rates of alcohol use and abuse. Among TB patients, alcohol abuse is associated with the diagnosis of MDR-TB, and could be an important modifiable factor.
authors.affiliation: Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA. nzetola@hotmail.com
authors.forename: N M
authors.initials: NM
authors.lastname: Zetola
authors.forename: C
authors.initials: C
authors.lastname: Modongo
authors.forename: E C
authors.initials: EC
authors.lastname: Kip
authors.forename: R
authors.initials: R
authors.lastname: Gross
authors.forename: G P
authors.initials: GP
authors.lastname: Bisson
authors.forename: R G
authors.initials: RG
authors.lastname: Collman
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D001902:Botswana / Q000453:epidemiology; D016022:Case-Control Studies; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000453:epidemiology* / Q000209:etiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult