Table 1: Characteristics of studies included on the meta-analysis of Alcohol use disorder in tuberculosis patients
Author
|
Year
|
Region
|
design
|
Setting
|
Study population
|
Tool
|
Mean/
media age(year)
|
Phase of Rt
|
AUD by sex/n (%)
|
Outcome
|
Male
n(%)
|
Female n(%)
|
AUD
n(%)
|
Abuse n(%)
|
Dependence n(%)
|
Fiske et al.(1)
|
2009
|
US
|
CS
|
All settings
|
5556
|
NA
|
NA
|
All phases
|
1130 (30.6)
|
196 (10.5)
|
1326(23.8)
|
NA
|
NA
|
Hayes-larson et al(2)
|
2017
|
US
|
RCT
|
Hospital
|
371
|
AUDIT
|
35
|
DOT phase
|
NA
|
NA
|
(24.7)
|
NA
|
NA
|
Fleming et al(3)
|
2006
|
Russia
|
CS
|
Hospital
|
200
|
DSM-IV
|
41
|
DOT phase
|
NA
|
NA
|
125 (62.5)
|
40(20)
|
85(42.5)
|
Mathew et al(4)
|
2009
|
Russia
|
CS
|
PHCU
|
851
|
AUDIT
|
NA
|
Continuation
|
NA
|
NA
|
469
(55.1)
|
NA
|
NA
|
Miller et al(5)
|
2016
|
Russia
|
RCT
|
Hospital
|
196
|
AUDIT
|
NA
|
Continuation
|
NA
|
NA
|
22(11.2)
|
NA
|
NA
|
Shin et al(6)
|
2010
|
Russia
|
Cohort
|
Hospital
|
374
|
AUDIT
|
41.1
|
Continuation
|
112(39.7)
|
16(17.4)
|
128(57.1)
|
45(21.1)
|
83(36.0)
|
Gelmanova et al(7)
|
2007
|
Russia
|
Cohort
|
Hospital
|
237
|
NA
|
40
|
DOT phase
|
NA
|
NA
|
57(24)
|
NA
|
NA
|
Cavanaugh et al(8)
|
2012
|
Russia
|
Cohort
|
Hospital
|
200
|
NA
|
42
|
DOT phase
|
NA
|
NA
|
103(51.5)
|
NA
|
NA
|
Laprawat et al(9)
|
2017
|
Thailand
|
Cohort
|
Hospital
|
295
|
AUDIT
|
NA
|
DOT phase
|
NA
|
NA
|
72(24)
|
NA
|
NA
|
Thomas et al(10)
|
2019
|
India
|
Cohort
|
Hospital
|
455
|
AUDIT
|
38
|
DOT phase
|
NA
|
NA
|
45(10)
|
NA
|
NA
|
Suhadev et al (11)
|
2011
|
India
|
CS
|
Hospital
|
490
|
AUDIT
|
NA
|
DOT phase
|
NA
|
NA
|
63(12.8)
|
41(8.4)
|
22(4.5)
|
Kulkarni et al(12)
|
2013
|
India
|
CS
|
Hospital
|
156
|
NA
|
33
|
DOT phase
|
NA
|
NA
|
54(34.6)
|
NA
|
NA
|
Thummar 2020 (13)
|
2020
|
India
|
CS
|
NA
|
200
|
AUDIT
|
NA
|
NA
|
NA
|
NA
|
NA
|
40(20%)
|
Hazardous drinking
|
Kliman et al (14)
|
2010
|
Estonia
|
CS
|
Hospital
|
1163
|
NA
|
45.3
|
NA
|
NA
|
NA
|
462(39.7)
|
NA
|
NA
|
Kliman et al (15)
|
2009
|
Estonia
|
CC
|
All settings
|
1109
|
NA
|
43.2
|
Completed treatment
|
NA
|
NA
|
469(42.3)
|
NA
|
NA
|
Table 1: Characteristics of studies included on the meta-analysis of Alcohol use disorder in tuberculosis patients (continued).
Author
|
Year
|
Region
|
design
|
Setting
|
Study population
|
Tool
|
Mean/media age
|
Phase of Rt
|
AUD by sex/n (%)
|
Outcome
|
Male
|
Female
|
AUD
n (%)
|
Abuse
|
Dependence
|
Louw et al(16)
|
2012
|
SA
|
CS
|
PHCU
|
4900
|
AUDIT
|
36.2
|
DOT phase
|
NA
|
NA
|
1142(23.3)
|
NA
|
NA
|
Peltzer et al(17)
|
2014
|
SA
|
CS
|
PHCU
|
4900
|
AUDIT
|
36.2
|
DOT phase
|
820(31.8)
|
280(13)
|
NA
|
NA
|
NA
|
Kedall et al(18)
|
2013
|
SA
|
Cohort
|
Hospital
|
225
|
NA
|
37.5
|
DOT phase
|
NA
|
NA
|
134(63)
|
NA
|
NA
|
Peltzer et al(19)
|
2014
|
SA
|
Cohort
|
PHCU
|
1196
|
AUDIT
|
NA
|
DOT phase
|
NA
|
NA
|
321(26.8)
|
NA
|
NA
|
O,connel et al(20)
|
2013
|
Zambia
|
CS
|
PHCU
|
649
|
MINI
|
NA
|
NA
|
127(32.3)
|
15(5.8)
|
142 (21.8)
|
25(3.8)
|
117(18)
|
Tola et al(21)
|
2015
|
Ethiopia
|
Cohort
|
All setting
|
330
|
AUDIT
|
32.21
|
DOT phases
|
NA
|
NA
|
62 (18.8)
|
NA
|
NA
|
Ayana et al(22)
|
2019
|
Ethiopia
|
CS
|
All setting
|
365
|
AUDIT
|
35.5
|
All phases
|
NA
|
NA
|
16 (4.4)
|
NA
|
NA
|
Tesfahugn et al(23)
|
2015
|
Ethiopia
|
CS
|
All setting
|
200
|
NA
|
34.9
|
All phases
|
NA
|
NA
|
36 (18)
|
NA
|
NA
|
Tesfaye et al(24)
|
2019
|
Ethiopia
|
Cohort
|
All setting
|
268
|
AUDIT
|
NA
|
DOT phases
|
NA
|
NA
|
29 (10.8)
|
NA
|
NA
|
Ambaw et al (25)
|
2017
|
Ethiopia
|
CS
|
PHCU
|
657
|
ASSIST
|
30
|
DOT phases
|
NA
|
NA
|
89 (9.3)
|
NA
|
NA
|
Key: AUD: Alcohol Use Disorder, AUDIT: Alcohol Use Disorder Identification Test, ASSIST: Alcohol Smoking and Substance Involvement Screening Test, CC: Case control, CS: Cross-sectional, DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, DOT: Directly Observed Therapy, MINI: Mini-international Neuropsychiatric Interview, NA: Not Reported, PHCU: Primary Health Care Unit, RCT: Randomized Controlled Trial, SA: South Africa, US: United States
Table 2: A subgroup analysis of the prealence of alcohol use disorder among tuberculosis patients
Subgroup
|
Number of studies
|
Estimates
|
Heterogeneity
|
|
Prevalence
|
95% CI
|
I2
|
P-value
|
Mean age
|
Not reported
|
10
|
0.27
|
0.19, 0.34
|
57.3%
|
P =0.012
|
Below 40 years age
|
9
|
0.24
|
0.14, 0.33
|
35%
|
P =0.135
|
40 years and above
|
7
|
0.42
|
0.43, 0.50
|
8.2%
|
P =0.37
|
Continent
|
US
|
2
|
0.24
|
0.18, 0.30
|
0%
|
P =0.936
|
Asia and Europe
|
12
|
0.37
|
0.28, 0.47
|
54.3%
|
P =0.012
|
Africa
|
12
|
0.24
|
0.19, 0.29
|
7.5%
|
P =0.372
|
Study design
|
Cross-sectional
|
11
|
0.3
|
0.21, 0.39
|
70.4%
|
P ≤ 0.01
|
Cohort
|
10
|
0.3
|
0.21, 0. 40
|
48%
|
P ≤ 0.01
|
Case control
|
3
|
0.39
|
0.28, 0.51
|
0%
|
P =0.43
|
RCT
|
2
|
0.2
|
0.01, 0.38
|
0%
|
P =0.47
|
Assessment tool
|
AUDIT
|
14
|
0.26
|
0.19, 0.34
|
54%
|
P =0.008
|
MINI, DSM-IV&ASSIST
|
4
|
0.28
|
0.08,0.51
|
66.1%
|
P =0.0031
|
Not reported
|
8
|
0.36
|
0.26, 0.46
|
62%
|
P =0.01
|
Key: AUDIT: Alcohol Use Disorder Identification Test, ASSIST: Alcohol Smoking and Substance Involvement Screening Test, CS: Cross-sectional, DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, MINI: Mini-international Neuropsychiatric Interview, RCT: Randomized Controlled Trial, US: United States
Table 3: A sensitivity analysis of the prevalence of alcohol use disorder among tuberculosis patients
No
|
Study excluded from the analysis
|
Average prevalence of AUD
|
95% confidence interval
|
1
|
Fiske et al.
|
0.3
|
0.24, 0.36
|
2
|
Hayes-larson et al
|
0.3
|
0.24, 0.36
|
3
|
Fleming et al
|
0.29
|
0.24, 0.34
|
4
|
Mathew et al
|
0.28
|
0.23, 0.33
|
5
|
Miller et al
|
0.3
|
0.25, 0.36
|
6
|
Shin et al
|
0.3
|
0.24, 0.35
|
7
|
Gelmanova et al
|
0.3
|
0.24, 0.36
|
8
|
Cavanaugh et al
|
0.29
|
0.24, 0.35
|
9
|
Laprawat et al
|
0.28
|
0.25, 0.31
|
10
|
Thomas et al
|
0.3
|
0.24, 035
|
11
|
Suhadev et al
|
0.3
|
0.25, 0.36
|
12
|
Kulkarni et al
|
0.3
|
0.24, 035
|
13
|
Kliman et al
|
0.29
|
0.24, 035
|
14
|
Kliman et al
|
0.29
|
0.23, 0.35
|
15
|
Louw et al
|
0.3
|
0.24, 0.36
|
16
|
Lowa et al
|
0.3
|
0.24, 0.36
|
17
|
Kedall et al
|
0.28
|
0.25, 0.31
|
18
|
Peltzer et al
|
0.3
|
0.24, 0.36
|
19
|
Ige et al
|
0.3
|
0.24, 0.36
|
20
|
Zetola et al
|
0.3
|
0.25, 0.36
|
21
|
O,connel et al
|
0.3
|
0.25, 0.36
|
22
|
Tola et al
|
0.3
|
0.25, 0.36
|
23
|
Ayana et al
|
0.3
|
0.25, 0.36
|
24
|
Tesfahugn et al
|
0.3
|
0.24, 0.36
|
25
|
Tesfaye et al
|
0.3
|
0.25, 0.36
|
26
|
Ambaw et al
|
0.31
|
0.25, 0.36
|
Table 4: Factors that increase the risk of alcohol use disorder in tuberculosis patients
Factors that increase the risk of AUD in tuberculosis patients
|
Factors that are protective of AUD in tuberculosis patients
|
- Socio-demographic factors
- Male gender (1, 2, 6, 11, 17)
- Age older than 35 years(11)
- Being single, divorced or widowed(11, 20)
- Being unemployed (20)
- Being black American(1)
- Coloured ethnicity(17)
- Low level of education (11, 17)
- No educational background(2)
- Low level of income (<70US$ per month) (11) and poverty(17)
|
- Socio-demographic factors
- 41 to 54 years of age (9)
- Higher educational achievement and marital relationship (9, 11)
- Female gender (11)
|
- Clinical and tuberculosis related factors
- Being on category-II tuberculosis treatment(relapse and treatment failure)(11)
- TB retreatment patient status and non-adherence to anti-TB medication(17)
- Patients with chronic/relapsing form of tuberculosis (3)
- Patients with perceived TB stigma(2)
- Patients who feel ashamed of having TB(2)
- People close to you would avoid you because of TB(2)
- HIV-co-infection and low HIV CD4-count(2)
- Having cavitary lesions on chest radiographic examination(1)
- Smear positive and culture positive types of TB(1)
|
- Clinical and tuberculosis related factors
- Tuberculosis treatment category I and III (11)
- Having extra pulmonary TB as compared to Pulmonary of mixed type of TB (1)
- Good tuberculosis medication adherence(17)
|
- Substance related variables
|
|
Key: HIV: Human Immune Virus, TB: Tuberculosis
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