Does Alcohol Consumption during Multidrug-resistant Tuberculosis Treatment Affect Outcome?. A Population-based Study in Kerala, India

Duraisamy, Karthickeyan; Mrithyunjayan, Sunilkumar; Ghosh, Smita; Nair, Sreenivas Achuthan; Balakrishnan, Shibu; Subramoniapillai, Jayasankar; Oeltmann, John E.; Moonan, Patrick K.; Kumar, Ajay M. V.

doi:10.1513/annalsats.201312-447oc

Cited by 50 publications

(45 citation statements)

References 24 publications

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“…1 Smoking and alcohol consumption are known to worsen the outcomes in pulmonary tuberculosis. 7,8 However, in our current, we could not see any significant effect of smoking and alcohol consumption. Of note, 9 out of 11 patients who died were alcoholics.…”

Section: Discussioncontrasting

confidence: 81%

Treatment outcome in new smear positive pulmonary tuberculosis patients with and without immunosuppression on RNTCP regimen: a comparative observational study

2017

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Background: Immune status of a patient influences the susceptibility, clinical presentation of tuberculosis and its treatment outcome. Some of the most common conditions associated with immune deficiency includes, human immunodeficiency virus (HIV) infection, diabetes and chronic steroid therapy for any underlying diseases.Methods: A cohort study, enrolled patients with tuberculosis alone (n=51) and those with tuberculosis and immunosuppressed state (patients with HIV, diabetes and those on steroid therapy, n=97).Results: All patients received Directly Observed Treatment Short course (DOTS) regimen implemented through RNTCP. Among the immunosuppressed patients, 32 were HIV patients, 45 of them were diabetic and 20 received chronic steroid therapy. All immunocompetent patients (control) were totally cured but 62.5% and 88.9% of HIV and diabetic patients in the immunosuppressed group were cured. Mortality was high in the immunosuppressed group (18.75% in HIV, and 11.11% in diabetic group). The grade of sputum smear had significant influence on the treatment outcome after adjusting for death and default (p>0.05). After intensive phase, the smear conversion rate were 86.27% in the control group,37.5% in the HIV patients, 22.22% in diabetics and 55% among chronic steroid use. The mortality and cure rate among those who received treatment for diabetes mellitus is comparable with that of immunocompetent group. Treatment prolongation was required for patients in the immunosuppressed group (62.5% in HIV group, 77.7% in diabetes group and 45% in chronic steroid users group).Conclusions: Immunosuppression was a risk factor for increased morbidity and mortality among new smear positive pulmonary tuberculosis patients. Prolonged DOTS regimen requires long-term close follow-up of patients who are immunocompromised.

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Section: Discussioncontrasting

confidence: 81%

Treatment outcome in new smear positive pulmonary tuberculosis patients with and without immunosuppression on RNTCP regimen: a comparative observational study

2017

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“…More recent research revealed a surprising association with infectious diseases such as tuberculosis and HIV/AIDS. [3][4][5] College students are within the high-risk age range to consume alcohol. During these years, many of the them would experience the first encounter with alcohol, and this behavior can be sustained into adulthood.…”

mentioning

confidence: 99%

Alcohol consumption among college students in Minahasa, Indonesia: a cross-sectional study towards the formulation of intervention strategies

Supit¹,

Mamuaja²,

Pissu³

2017

Int J Community Med Public Health

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Background: College students are within the high-risk group to experience the full spectrum of alcohol-related psychopathologies, ranging from initial contact with alcohol to the severe problematic drinking. The prevalence, degree of severity, reasons of drinking, among other variables, however, have been inconsistent across studies. Therefore, it is crucial to replicate such studies in different socio-cultural settings to synthesize a broader understanding about alcohol-consuming behavior and formulating intervention strategies. This research aims to describe the pattern of alcohol drinking behavior among college students in Minahasa, Indonesia, and to analyze its correlation with academic performance. Methods: We conducted a questionnaire-based cross-sectional study to investigate the alcohol-consumption pattern and examined its association with the students' academic performance obtained from the campus database. A total-sampling technique was applied to draw the samples. Chi-square and Kendall's tau analyses were employed accordingly to measure the relationship significance. Results: From 417 samples (338 samples were females), 70.98% of them reported never had consumed alcohol of any amount. Male sex and local ethnicity are positively associated with consuming behavior. We found an association between alcohol consumption status with cumulative GPA but not with current GPA. Although alcohol consumers considered GPA as less important, the self-insight about their academic performance is intact. The consumed beverages were mostly beers, followed by traditional liquor and winepalms. Most of them consumed alcohol to "warm-up the body"—a common practice in this area, followed by social reasons. Only small number of them identified themselves as being addicted. Majority of the consumers realized the importance to reduce or quit consuming alcohol. The implications of these findings are then discussed. Conclusions: This study showed that most of the students have never consumed alcohol. However, among the consumers, male sex and local ethnicity are more prone to become alcohol users. The academic performance is also affected, and since most of the consumers consider to reduce their drinking behavior, professional interventions are necessary to facilitate recovery attempts.

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“…Introduction of a system of TB case notification among the private practitioners in Pune City: Is it operationally feasible?Yes [54]24. Treatment outcomes of MDR-TB patients in Kerala, IndiaYes [55]25. A comparative study on same day sputum smear microscopy with the conventional method in the diagnosis of sputum positive pulmonary TBYes [66]26.…”

Section: Implementation Of Operational Research Training Coursesmentioning

confidence: 99%

“…These included: the status of screening household contacts of sputum smear positive pulmonary TB patients [48,49] and malnourished children attending nutritional rehabilitation centers [50], delays in the initiation of TB treatment after diagnosis [51], whether all TB patients diagnosed in the hospitals attached to medical college were being referred and initiated on treatment under RNTCP [52], reasons for poor uptake of HIV counselling and testing [53], status of notification of TB cases by private health care providers [54], TB treatment outcomes of MDR-TB patients [55], detection of TB cases by mobile medical units [56], innovatively addressing the challenges of routine servicing of binocular microscopes [23] and compliance to infection control practices at health facilities [57]. One study assessed innovative ways of improving programme processes such as use of photo-voice for enhancing patient adherence to therapy [58].…”

Section: Contribution Of or To Policy And Practicementioning

confidence: 99%

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

Sagili¹,

Satyanarayana

Chadha³

et al. 2018

Global Health Action

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Background: The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. Objectives: To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. Methods: From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project’s core activities and outcomes. Results: In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. Conclusions: OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.

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Does Alcohol Consumption during Multidrug-resistant Tuberculosis Treatment Affect Outcome?. A Population-based Study in Kerala, India

Cited by 50 publications

References 24 publications

Treatment outcome in new smear positive pulmonary tuberculosis patients with and without immunosuppression on RNTCP regimen: a comparative observational study

Treatment outcome in new smear positive pulmonary tuberculosis patients with and without immunosuppression on RNTCP regimen: a comparative observational study

Alcohol consumption among college students in Minahasa, Indonesia: a cross-sectional study towards the formulation of intervention strategies

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

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