title: Hazardous and harmful alcohol use and associated factors in tuberculosis public primary care patients in South Africa.
abstract: The aim of this study was to assess the prevalence of hazardous and harmful alcohol use and associated factors among patients with tuberculosis in South Africa. In a cross-sectional survey new tuberculosis (TB) and TB retreatment patients were consecutively screened using the Alcohol Use Disorder Identification Test (AUDIT) within one month of anti-tuberculosis treatment. The sample included 4,900 (54.5% men and women 45.5%) tuberculosis patients from 42 primary care clinics in three districts. Results indicate that, overall 23.2% of the patients were hazardous or harmful alcohol drinkers, 31.8% of men and 13.0% of women were found to be hazardous drinkers, and 9.3% of men and 3.4% of women meet criteria for probable alcohol dependence (harmful drinking) as defined by the AUDIT. Men had significantly higher AUDIT scores than women. In multivariable analyses it was found that among men poor perceived health status, tobacco use, psychological distress, being a TB retreatment patient and not being on antiretroviral therapy (ART), and among women lower education, tobacco use and being a TB retreatment patient were associated with hazardous or harmful alcohol use. The study found a high prevalence of hazardous or harmful alcohol use among tuberculosis primary care patients. This calls for screening and brief intervention and a comprehensive alcohol treatment programme as a key component of TB management in South Africa.
authors.affiliation: HIV/STI and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, Durban and Cape Town 8000, South Africa. kpeltzer@hsrc.ac.za
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.forename: Julia
authors.initials: J
authors.lastname: Louw
authors.forename: Gugu
authors.initials: G
authors.lastname: McHunu
authors.forename: Pamela
authors.initials: P
authors.lastname: Naidoo
authors.forename: Gladys
authors.initials: G
authors.lastname: Matseke
authors.forename: Bomkazi
authors.initials: B
authors.lastname: Tutshana
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology; D000995:Antitubercular Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011320:Primary Health Care; D019233:Retreatment; D012307:Risk Factors; D057566:Self Report; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents