Socio-demographic and economic characteristics
A total of 409 participants were interviewed, of whom 252 (61.6%) were males. More than fifty percent of the participants resided in rural areas. Of the participants, 66.5 % were engaged in government work and private business. One-third of the participants were aged below
24 years and more than 50 % were married. Regarding literacy, 22.5% had not attended formal education, 40.3 % had primary education, and more than one-third, 37.2 % had secondary and above education. The majority of the participants had a monthly income of <1539 and 21.8 % had >= 1539 ETB per month (Table 1).
Table 1- Distribution of patients with tuberculosis attending the tuberculosis unit of public healthcare facilities, Gedeo zone, South Ethiopia, 2018 (n = 409)
Variables
|
Categories
|
Frequency
|
Percent (%)
|
Sex
|
Male
|
252
|
61.6
|
Female
|
157
|
38.4
|
|
|
|
|
Age in years
|
18-24
|
135
|
33
|
29-34
|
122
|
29.8
|
35-44
|
85
|
20.8
|
45 and above
|
67
|
16.4
|
|
|
|
|
Marital status
|
Married
|
217
|
53.1
|
Single
|
157
|
38.3
|
Divorced/Single/divorced
|
35
|
8.6
|
|
|
|
|
Level of education
|
No formal education
|
92
|
22.5
|
Primary education
|
165
|
40.3
|
Secondary education
|
152
|
37.2
|
|
|
|
|
Occupational status
|
Employed
|
272
|
66.5
|
Unemployed
|
137
|
33.5
|
|
|
|
|
Place of residence
|
Rural
|
217
|
53.1
|
Urban
|
192
|
46.9
|
Psychosocial and clinical characteristics of the respondents
One-third of the participants with harmful alcohol use 139 (34 %) had poor social support, 177 (43.1%) had intermediate social support. Regarding perceived TB stigma, more than one-third of the participants (159 (38.9%) had perceived TB stigma, and a greater proportion (61.6 %, n = 250) of participants had not perceived TB related stigma.
A greater proportion (73.8 %, n = 302) of participants were pulmonary TB patients, and (61.6 %, n = 250) of the participants were in the intensive phase of treatment (the first two months of treatment).
A large proportion of the participants (77 %, n = 315) were medium adherent to TB treatment. Majority of the participants were new TB patients and 15.2 % were retreatment cases.
In addition to TB, 71 (17.4%) had HIV, and 22 participants reported having other comorbid chronic illnesses: hypertension (n = 6), cardiac illness (n = 10), diabetes mellitus (n = 2), and kidney disease (n = 4). Only 5.1% had a family history of mental illness. Two hundred thirty-six (57.7 %) were interviewed within 6–12 months of their illness. Nearly half of the participants had depressive symptoms (Table 2).
Table 2- Description of psychosocial and clinical characteristics of patients with tuberculosis attending the tuberculosis unit of public healthcare facilities, Gedeo zone, South Ethiopia, 2018 (n = 409)
Variables
|
Categories
|
Number (%)
|
Perceived TB stigma
|
No
|
132 (32.3)
|
Yes
|
277 (67.7)
|
Adherence to TB medication
|
High adherence
|
41 (10.0)
|
Medium adherence
|
315 (77.0)
|
Low adherence
|
53 (13.0)
|
Perceived social support
|
Poor social support
|
139 (34.0)
|
Intermediate social support
|
177 (43.1)
|
Strong social support
|
93 (22.9)
|
Classification of TB
|
Pulmonary
|
302 (73.8)
|
Extra-pulmonary
|
107 (26.2)
|
Phase of treatment
|
Intensive phase
|
250 (61.1)
|
Continuation phase
|
159 (38.9)
|
Treatment category
|
New case
|
347 (84.8)
|
Re-treatment case
|
62 (15.2)
|
Comorbidity
|
TB/HIV comorbidity
|
71 (17.4)
|
Other comorbid condition
|
22 (5.4)
|
No comorbidity
|
316 (77.2)
|
Depressive symptoms
|
No
|
223 (54.5)
|
Yes
|
186 (45.5)
|
Prevalence of hazardous alcohol drinking
The 10-items of the Alcohol Disorder Identification Test (AUDIT) were summed and a single variable was generated (18). A score of 8 and above indicates a tendency to hazardous alcohol drinking. A total of 82 (20%) patients with tuberculosis were hazardous alcohol drinkers.
Factors associated with hazardous alcohol drinking
Socio-demographic factors, clinical factors, and psychosocial factors were used to identify statistically significant factors. Among all covariates, age, gender, marital status, depression, medical comorbidity, duration of illness, social support, and category of TB treatment were found to have p-value less than 0.2 in invariable logistic regression and considered for the multiple logistic regression model. The model goodness of fit was tested using Hosmer and Lemeshow test and the p-value was found to be 0.64, which revealed as the model is good.
The odds of hazardous alcohol drinking increased by 2.10 times (95% CI: 1.17, 3.77) for males than females. Not having medical comorbidities has reduced the risk of hazardous alcohol drinking. Those TB patients who had comorbid medical conditions were about more than two times (AOR = 2.44, 95 % CI: 1.29–4.62) more at risk of hazardous alcohol drinking than patients who had no medical comorbidity.
The duration of illness was associated with hazardous alcohol drinking among TB patients. The odds of hazardous alcohol drinking increased by 2.88 times (95 % CI: 1.03–3.04) for patients who had a longer duration of illness compared to patients who had a shorter period of illness (<6 months) (Table 3).
Table 3 Bivariate and multivariable analysis of factors associated with hazardous alcohol drinking among patients with tuberculosis attending the tuberculosis unit of healthcare facilities, Gedeo Zone, South Ethiopia, 2018 (n = 409)
VARIABLES
|
CATEGORIES
|
Hazardous alcohol drinking
|
COR (95 % CI)
|
AOR (95 % CI)
|
Yes
|
No
|
Sex of the participants
|
Male
|
57
|
195
|
1.54 (0.91, 2.59)
|
2.10 (1.17, 3.77) *
|
Female
|
25
|
132
|
1
|
1
|
|
|
|
|
|
|
Marital status
|
Married
|
46
|
171
|
1
|
1
|
Single
|
24
|
133
|
0.67 (0.39, 1.15)
|
1.04 (0.54, 2.03)
|
Widow/ Divorced/ Separated
|
12
|
23
|
1.94 (0.89, 4.18)
|
0.87 (0.34,2.21)
|
|
|
|
|
|
|
Age of participants
|
18- 24 years
|
13
|
122
|
0.34 (0.15, 0.75)
|
0.38 (0.14, 1.01)
|
25-34 years
|
27
|
95
|
0.90 (0.44, 1.83)
|
0.83 (0.37,1.88)
|
35-44 years
|
26
|
59
|
1.40 (0.67, 2.90)
|
1.17 (0.52, 2.64)
|
45 years and above
|
16
|
51
|
1
|
1
|
|
|
|
|
|
|
Depression
|
Yes
|
55
|
131
|
3.04 (1.82, 5.08)
|
1.54 (0.84, 2.83)
|
No
|
27
|
196
|
1
|
1
|
|
|
|
|
|
|
Medical
Comorbidity
|
Yes
|
34
|
59
|
3.21 (1.90, 5.42)
|
2.44 (1.29, 4.62) **
|
No
|
48
|
268
|
1
|
1
|
|
|
|
|
|
|
Duration of illness
|
< 6 months
|
6
|
72
|
1
|
1
|
6 -12 months
|
47
|
189
|
2.98 (1.22, 7.29)
|
2.47 (0.96, 6.35)
|
>=12 months
|
29
|
66
|
5.27 (2.05, 13.5)
|
2.88 (1.03, 8.04) *
|
|
|
|
|
|
|
Social support
|
Poor social support
|
42
|
97
|
2.49 (1.52, 4.07)
|
1.36 (0.75, 2.48)
|
Good social support
|
40
|
230
|
1
|
1
|
Category of TB treatment
|
New case
|
58
|
289
|
1
|
1
|
Re-treatment case
|
24
|
38
|
3.14 (1.75, 5.64)
|
1.66 (0.80, 3.43)
|
Key: * = p-value less than 0.05; COR crude odds ratio, AOR adjusted odds ratio, CI confidence interval