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BMC Public Health
Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review

Authors: Jürgen Rehm, Andriy V Samokhvalov, Manuela G Neuman, Robin Room, Charles Parry, Knut Lönnroth, Jayadeep Patra, Vladimir Poznyak, Svetlana Popova

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

In 2004, tuberculosis (TB) was responsible for 2.5% of global mortality (among men 3.1%; among women 1.8%) and 2.2% of global burden of disease (men 2.7%; women 1.7%). The present work portrays accumulated evidence on the association between alcohol consumption and TB with the aim to clarify the nature of the relationship.

Methods

A systematic review of existing scientific data on the association between alcohol consumption and TB, and on studies relevant for clarification of causality was undertaken.

Results

There is a strong association between heavy alcohol use/alcohol use disorders (AUD) and TB. A meta-analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 (95% CI: 1.89-4.59). Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition, there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB, social marginalization and drift, higher rate of re-infection, higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data, about 10% of the TB cases globally were estimated to be attributable to alcohol.

Conclusion

The epidemiological and other evidence presented indicates that heavy alcohol use/AUD constitute a risk factor for incidence and re-infection of TB. Consequences for prevention and clinical interventions are discussed.
Appendix
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Metadata
Title
The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review
Authors
Jürgen Rehm
Andriy V Samokhvalov
Manuela G Neuman
Robin Room
Charles Parry
Knut Lönnroth
Jayadeep Patra
Vladimir Poznyak
Svetlana Popova
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-450

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