Alcohol intervention strategy among tuberculosis patients: A pilot study from South India.

Thomas, B .; Watson, B.; Senthil, E.K.; Deepalakshmi, A.; Balaji, G.; Chandra, S.; Manogaran, C.; Nagarajan, K.; Ovung, S.; Jayabal, L.; Swaminathan, S.

International Journal of Tuberculosis and Lung Disease; 2017; 21: 947-952.

Summary: Background: Alcohol dependence has been a major cause of treatment non-adherence in tuberculosis (TB) management. There is an urgent need to develop a feasible, acceptable alcohol intervention programme to ensure treatment completion.

Methodology: Four of the 10 Chennai Corporation zones in Chennai, South India, were randomly selected: two each for the experimental and control arms of the study. TB patients registered from August 2013 to January 2014 with the Revised National Tuberculosis Control Programme were assessed using the Alcohol Use Disorder Identification Test (AUDIT) scale. The intervention consisted of four individual counselling sessions at months 0, 2, 4 and 6 conducted by highly trained interventionists.

Results: Of 872 TB patients, 298 (31%) were found to have alcohol use disorders. The numbers of TB patients in the experimental and control arms were respectively 113 (38%) and 185 (62%). The proportion of patients with favourable treatment outcomes was higher in the intervention than in the control group (87% vs. 62%, P = 0.04). Overall adherence to anti-tuberculosis treatment was significantly higher in the intervention group ( P = 0.02).

Conclusion: Study findings suggest that alcohol interventions could be effective in ensuring favourable TB treatment outcomes and adherence. This calls for a large cluster randomised trial for greater generalisability. Tested alcohol-intervention strategies should be recommended to promote treatment adherence among TB patients who consume alcohol.

Keywords: Alcohol use disorder; treatment adherence; alcohol dependence; TB

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