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Wolde A. Alcohol Use Disorder and Associated Factors Among Elderly in Ethiopia. Subst Abuse 2023; 17:11782218231158031. [PMID: 36875744 PMCID: PMC9983104 DOI: 10.1177/11782218231158031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023]
Abstract
Background The aim of this study was to investigate the magnitude and associated factors of alcohol use disorder among the elderly living in 3 towns in South West Ethiopia. Method Cross-sectional community-based study was done among 382 elderly people aged 60 or more from February to March 2022 in South West Ethiopia. The participants were selected by a systematic random sampling method. Alcohol use disorder, quality of sleep, cognitive impairment, and depression were assessed by using AUDIT, Pittsburgh Sleep Quality Index, Standardized Mini Mental State Examination, and geriatric depression scale, respectively. Also, suicidal behavior, elder abuse, and other clinical and environmental factors were assessed. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a P-value less than .05 in the final fitting model were stated as independent predictors of alcohol use disorder (AUD). Result The magnitude of alcohol use disorder, current alcohol use, and life-time alcohol use among the elderly was 27.5%, 52.4%, and 89.3%, respectively. Also, 7%, 23%, 8.9%, and none of the elderly had nicotine, khat, inhalants, and cannabis use disorder, respectively. Furthermore, AUD was associated with cognitive impairment (AOR, 95% CI; 2.79 (1.47-5.30)), poor sleep quality (AOR, 95% CI; 3.27 (1.23-8.69)), chronic medical illness (AOR, 95% CI; 2.12 (1.20-3.74)), and suicidal ideation (AOR, 95% CI; 5.27 (2.21-12.60)). Conclusion Problematic alcohol use was higher among the elderly, and cognitive impairment, poor sleep quality, having chronic medical illness, and suicidal ideation were risk factors for AUD. Therefore, community level screening for AUD and comorbid risk factors among this particular age group and managing them is crucial to prevent further complications due to AUD.
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Affiliation(s)
- Asrat Wolde
- Department of Psychiatry, School of Medicine, Mizan Tepi University, Mizan Aman, Ethiopia
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Diriba K, Awulachew E. Associated risk factor of tuberculosis infection among adult patients in Gedeo Zone, Southern Ethiopia. SAGE Open Med 2022; 10:20503121221086725. [PMID: 35356810 PMCID: PMC8958711 DOI: 10.1177/20503121221086725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Tuberculosis remains a major global health problem causing death among millions of people each year. Even though many of the World Health Organization recommended tuberculosis control strategies were implemented, there is still a major gap in tuberculosis case detection and treatment which resulted in rapid transmission of the cases in high burden countries. This study aimed to provide updated information on the contributing factors for the development of tuberculosis. Methods: A case–control study was carried out in Gedeo Zone from February to July 2021 to assess the risk factors of tuberculosis. Cases were confirmed pulmonary tuberculosis patients with age ⩾18 years, while controls were participants who were confirmed to be pulmonary tuberculosis negative with the same age. Multivariate logistic regression models were used to assess the associated risk factor. Results: A total of 368 individuals (173 cases and 173 controls) were included in this study. Based on the multivariable logistic regression analysis, we identified six variables as independent risk factors for the development of tuberculosis after controlling possible confounders. Those were patients with income <1500 Ethiopian birr per month (adjusted odds ratio = 2.35; 95% confidence interval: 1.22–3.97), patients with no educational background (illiterate) (adjusted odds ratio = 2.10; 95% confidence interval: 1.17–2.51), patients smoking cigarette (adjusted odds ratio = 2.89; 95% confidence interval: 2.10–3.82), patients chewing khat (adjusted odds ratio = 2.86; 95% confidence interval: 1.28–3.79), patients in close contact with known tuberculosis cases (adjusted odds ratio = 3.63; 95% confidence interval: 2.24–4.46), and patients being positive for HIV (adjusted odds ratio = 3.01; 95% confidence interval: 1.07–3.52) who were found to be significantly associated with tuberculosis development, while Bacille Calmette-Guérin vaccination had a protective effect against the development of tuberculosis (adjusted odds ratio = 0.52; 95% confidence interval: 0.21–0.88). Conclusion: The priority should be given to the identified contributing factors through application of coordinated efforts on screening of patients suspected for pulmonary tuberculosis and all contacts of pulmonary tuberculosis patients and treatment of known tuberculosis cases, and appropriate control methods to reduce Mycobacterium tuberculosis cases.
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Affiliation(s)
- Kuma Diriba
- Department of Medical Laboratory Sciences, Health Science and Medical College, Dilla University, Dilla, Ethiopia
| | - Ephrem Awulachew
- Department of Medical Laboratory Sciences, Health Science and Medical College, Dilla University, Dilla, Ethiopia
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Diriba K, Churiso G. The prevalence of Mycobacterium tuberculosis using Gene Xpert among tuberculosis suspected patients in Gedeo Zone, Southern Ethiopia. Eur J Med Res 2022; 27:24. [PMID: 35151350 PMCID: PMC8840317 DOI: 10.1186/s40001-022-00650-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Tuberculosis (TB) is a communicable disease remains a major global health problem and the leading cause of death from a single infectious agent. Even though many of the WHO recommended TB control strategies were implemented; there is still a major gap in TB case detection and treatment. This study aimed to determine the prevalence of Mycobacterium tuberculosis among presumptive TB patients in Gedeo Zone, Southern Ethiopia. Methods A cross-sectional study was conducted on 384 TB suspected patients in Gedeo Zone from February to July 2021. Data were collected using a pretested structured questionnaire. Laboratory examination was processed using Xpert-MTB/RIF assay. Data entry was made using Epi info version 7 and analyzed by SPSS version 24. Logistic regression models were used to determine the risk factors. Results Out of 384 study participants suspected with TB, M. tuberculosis was isolated from 103 giving an overall prevalence of 26.8%. Males (AOR) = 1.95; 95% CI 1.56–2.65, P = 0.01) were more likely to develop TB than females. Study participants who were illiterate (AOR 2.10; 95% CI 1.17–2.51, P = 0.014) were more likely to develop TB than the educated ones. Cigarette smokers (AOR 2.89; 95% CI 2.10–3.84, P = 0.01), khat chewers (AOR 2.86; 95% CI 1.28–3.79, P = 0.01), vaccination (AOR 0.52; 95% CI 0.21–0.88, P = 0.02), close contact (AOR 3.42; 95% CI 2.24–4.50, P = 0.01) and being positive for HIV (AOR 2.01; 95% CI 1.07–3.52, 0.01) were more likely to develop TB. Conclusion Despite implementation of national and international TB control strategies, TB still remains one of the major public health problems in the country especially in the study area. The high prevalence of MTB was reported different risk groups. Early case detection and management of TB should be given special attention to strengthen and an appropriate control and prevention methods to reduce the emergence and increasing of MTB cases.
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Soboka M, Tesfaye M, Adorjan K, Krahl W, Tesfaye E, Yitayih Y, Strobl R, Grill E. Substance use disorders and adherence to antituberculosis medications in Southwest Ethiopia: a prospective cohort study. BMJ Open 2021; 11:e043050. [PMID: 34226210 PMCID: PMC8258551 DOI: 10.1136/bmjopen-2020-043050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES In Ethiopia, little is known about the association between substance use disorders and adherence to antituberculosis (anti-TB) medications. Therefore, the objective of this study was to assess the effect of substance use disorders on adherence to anti-TB medications in Southwest Ethiopia. DESIGN Prospective cohort study. SETTINGS Patients were recruited from 22 health centres and four hospitals in Southwest Ethiopia. PARTICIPANTS This study was conducted among 268 patients with TB, aged 18-80 in Southwest Ethiopia between October 2017 and October 2018. At baseline, patients who were exposed substance use disorders (134 patients) and unexposed to substance use disorders (134 patients) were recruited. Patients were followed for 6 months, and data were collected on three occasions. MAIN OUTCOME MEASURE Adherence to anti-TB medications. RESULTS Patients with substance use disorders had consistently higher prevalence of non-adherence than those without, 16.4% versus 3.0% at baseline, 41.7% versus 14.4% at 2-month follow-up and 45.7% versus 10.8% at 6-month follow-up assessments. Patients with khat use disorder were 3.8 times more likely to be non-adherent to anti-TB medications than patients without khat use disorder (Adjusted odds ratio (aOR)=3.8, 95% CI 1.8 to 8.0). Patients who had alcohol use disorder (AUD) were also 3.2 times likely to have poor adherence compared with their counterparts (aOR=3.2, 95% CI 1.6 to 6.6). In addition, being educated (aOR=4.4, 95% CI 1.7 to 11.3), and being merchant (aOR=6.1, 95% CI 1.2 to 30.8) were associated with non-adherence to anti-TB medications. CONCLUSION Khat and AUDs predict greater likelihood of non-adherence to anti-TB medication. This implies the need to integrate the management for substance use disorders into the existing TB treatment services.
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Affiliation(s)
- Matiwos Soboka
- Department of Psychiatry, Medical Faculty, Jimma University, Jimma, Ethiopia
- Center for International Health, Ludwig Maxmilians University, Munich, Germany
| | - Markos Tesfaye
- Center for International Health, Ludwig Maxmilians University, Munich, Germany
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Kristina Adorjan
- Center for International Health, Ludwig Maxmilians University, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU Munich, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Krahl
- Center for International Health, Ludwig Maxmilians University, Munich, Germany
- Department of Forensic Psychiatry, Isar Amper Klinikum, Munich, Germany
| | - Elias Tesfaye
- Department of Psychiatry, Medical Faculty, Jimma University, Jimma, Ethiopia
| | - Yimenu Yitayih
- Department of Psychiatry, Medical Faculty, Jimma University, Jimma, Ethiopia
| | - Ralf Strobl
- Institute for Medical Information Processing, Biometry and Epidemiology,Ludwig Maximilians University Muenchen, Munich, Germany
- German Center for Vertigo and Balance Disorders, University Hospital LMU Muenchen, Munich, Germany
| | - Eva Grill
- Center for International Health, Ludwig Maxmilians University, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology,Ludwig Maximilians University Muenchen, Munich, Germany
- German Center for Vertigo and Balance Disorders, University Hospital LMU Muenchen, Munich, Germany
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Belew H, Wubie M, Tizazu G, Bitew A, Birlew T. Predictors of tuberculosis infection among adults visiting anti-retroviral treatment center at east and west Gojjam, northwest, Ethiopia, 2017. BMC Infect Dis 2020; 20:593. [PMID: 32787798 PMCID: PMC7422613 DOI: 10.1186/s12879-020-05290-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 07/26/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Tuberculosis is a serious health risk, for people living with human immune deficiency virus worldwide, and the burden of TB/HIV infection is still high in Ethiopia in particular. Therefore, the aim of this study was to determine the predictors of tuberculosis infection among adults visiting anti-retroviral treatment center in East and West Gojjam, northwest, Ethiopia. METHODS Institution based unmatched case-control study was employed to determine the predictors of tuberculosis infection among adults visiting anti-retroviral treatment center in east and west Gojjam, Northwest, Ethiopia from March 7-April 15, 2017. Just about 552 participants were participated in the study (139 Cases and 413 controls). Cases were confirmed with active TB and infected with HIV, and controls were HIV positive adults with non-TB. All cases in each health facility who confirmed by acid-fast bacilli, culture and gene expert were considered as TB positive. However, controls were selected by using simple random sampling technique through the above diagnostic criteria and the data were collected with Face to face interview as well as patient medical record were utilized, and the quality of the data were assured, checked, coded, cleaned and entered in EPI-Data version 3.1 and exported to SPSS version 20 for the analysis. RESULT Of the total sample (556), just about 552(99.2%) were participated in the study. 47.5% were females and 58.9% were rural dweller. Behavioral and modifiable biological risk factors: alcohol users (AOR = 2.33; 95%CI:1.34,4.07), BMI < 18.5 kg/m2 (AOR = 3.03;95%CI:1.79,5.14), CD4 count ≤200 cells/μl (AOR = 2.34;95%CI:1.89,2.79) and between 201 and 499 cells/μl (AOR = 2.63; 95%CI: 1.01,6.84), bedridden and ambulatory (AOR = 3.3;95%CI:1.70,6.29 and AOR = 8.2;95%CI:4.34,15.64), respectively. TB history in the family (AOR = 3.00; 95%CI: 1.57, 5.74) were predictors for TB infection. Taking CPT (AOR = 0.36; 95%CI: 0.21, 0.62) and having early WHO clinical stage I or II (AOR = 0.34; 95%CI: 0.20, 0.56) had protective effect against TB infection. CONCLUSION From this study, it has been concluded that alcohol users, BMI < 18.5 kg/m2, CD4 count < 499 cells/μl, bedridden and ambulatory and TB history were predictors for TB-HIV co-infected adults. Strengthen screening more frequently, CPT Prophlaxysis and treated promptly important to reduce TB co-morbidity.
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Affiliation(s)
- Habtamu Belew
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia
| | - Moges Wubie
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia
| | - Getaye Tizazu
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia
| | - Abebaw Bitew
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia
| | - Tesfa Birlew
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia
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Magnitude and predictors of khat use among patients with tuberculosis in Southwest Ethiopia: A longitudinal study. PLoS One 2020; 15:e0236154. [PMID: 32730258 PMCID: PMC7392297 DOI: 10.1371/journal.pone.0236154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 06/30/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Tuberculosis (TB) is a leading cause of morbidity and mortality in low and middle-income countries. Substance use negatively affects TB treatment outcomes. Our recent study has found that khat use predicted poorer adherence to anti-TB medications. However, there is scarce longitudinal study on predictors of khat use among outpatients with TB, and this study aimed at addressing this research gap. METHODS From October 2017 to October 2018, 268 outpatients with tuberculosis on DOTs were enrolled in a longitudinal study from 26 health institutions in Southwest Ethiopia. Structured questionnaires translated into local languages (Afaan Oromoo and Amharic) were used to assess khat use. Patients were followed for six months, and data were collected on three occasions during the follow-up. A generalized linear mixed model was used to identify the relation between khat use and predictors. Model fitness was checked using the Bayesian Information Criterion (BIC). Odds ratio (OR) and 95% CI were used to describe the strength of association between the outcome variable and predictors. RESULTS The overall prevalence of khat use at baseline and first follow up was 39.2% while it was 37.3% at second follow up. Of this, 77.1% and 96.2% of them believed that khat use reduces the side effects of anti-TB medications and symptoms of tuberculosis respectively. In the final model, being male (aOR = 7.0, p-value = 0.001), being government employee (aOR = 0.03, p-value≤0.001) and presence of alcohol use disorders (AUD) (aOR = 2.0, p-value≤0.001) predicted khat use among outpatients with tuberculosis. CONCLUSION A considerable proportion of patients with TB used khat throughout DOTs and wrongly perceived that it had health benefits. The finding implies that all patients diagnosed with TB should be screened for khat use, and a particular emphasis should be given to males and individuals with a history of alcohol use. Moreover, further studies are needed to assess patients' beliefs regarding the benefits of khat use so that interventions can be developed.
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Chekesa B, Gumi B, Chanyalew M, Zewude A, Ameni G. Prevalence of latent tuberculosis infection and associated risk factors in prison in East Wollega Zone of western Ethiopia. PLoS One 2020; 15:e0233314. [PMID: 32428042 PMCID: PMC7237014 DOI: 10.1371/journal.pone.0233314] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/01/2020] [Indexed: 01/07/2023] Open
Abstract
Background Latent tuberculosis infection (LTBI) is the major source of active TB and is an obstacle to the strategy of World Health Organization to end TB by 2035. In Ethiopia, there are hundreds of prisons and they are conducive settings for the transmission of TB and could serve as the sources of infection to the general public. However, there is little data on the epidemiology of TB in prisons in Ethiopia. The objective of the present study was to estimate the prevalence of LTBI and evaluate associated risk factors in prisons in East Wollega Zone in western Ethiopia. Methods A cross-sectional design and systematic sampling technique were used to select 352 prisoners from a total of 2620 prisoners during the two months (May and June, 2019). The selected inmates were consented for their willingness to participate in the study. Thereafter, they were interviewed and 2ml of blood sample was collected from each prisoner and screened for LTBI using interferon-gamma release assay (IGRA). The data were analyzed using SPSS version 25 and logistic regression was used to model the likelihood of LTBI occurrence and to identify risk factors associated with LTBI. Results The prevalence of LTBI was 51.2% (95% CI: 46.45–57%) and higher prevalence was recorded in males (53%) than in females (43.5%) although the difference was not significant. Prisoners whose age ≥45 years (AOR = 2.48, 95%CI, 1.04–5.9), who chewed khat (AOR = 2.27; 95% CI, 1.27–4.19), who were prisoned over a year (AOR = 1.81, 95%CI, 1.04–3.18) and who were in overcrowded pens (AOR = 1.91, 95% CI, 1.002–3.65) were at higher risk of LTBI. Conclusions The prevalence of LTBI in prisoners in West Wollega Zone of western Ethiopia was high and could serve as sources of infection to the public. Hence optimum handling of prisoners, and regular follow up and treatment of TB cases in prisons were recommended to minimize the burden of TB in the Zone.
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Affiliation(s)
- Basha Chekesa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Collage of Natura and Computational Science, Wollega University, Nekemte, Ethiopia
- * E-mail:
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mahlet Chanyalew
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aboma Zewude
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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Ahmed A, Mekonnen D, Shiferaw AM, Belayneh F, Yenit MK. Incidence and determinants of tuberculosis infection among adult patients with HIV attending HIV care in north-east Ethiopia: a retrospective cohort study. BMJ Open 2018; 8:e016961. [PMID: 29437750 PMCID: PMC5829770 DOI: 10.1136/bmjopen-2017-016961] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 11/13/2017] [Accepted: 12/19/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study assessed the incidence of tuberculosis (TB) and its predictors among adults living with HIV/AIDS in government health facilities in north-east Ethiopia. SETTING A 5-year retrospective cohort study was conducted from May to June 2015 on 451 adult HIV/AIDS-infected individuals who enrolled in the HIV care clinics of government health facilities in north-east Ethiopia. PARTICIPANTS A total of 451 HIV-infected adults who newly enrolled in the adult HIV care clinic from 1 July 2010 with complete information were followed until May 2015. PRIMARY OUTCOME MEASURE The primary outcome was the proportion of patients diagnosed with TB or the TB incidence rate. SECONDARY OUTCOME MEASURE The incidence of TB was investigated in relation to years of follow-up. RESULTS A total of 451 charts with complete information were followed for 1377.41 person-years (PY) of observation. The overall incidence density of TB was 8.6 per 100 PYof observation. Previous TB disease (adjusted HR (AHR) 3.65, 95% CI 1.97 to 6.73), being bedridden (AHR 5.45, 95% CI 1.16 to 25.49), being underweight (body mass index (BMI) <18.5 kg/m2) (AHR 2.53, 95 % CI 1.27 to 5.05), taking isoniazid preventive therapy (IPT) (AHR 0.14, 95% CI 0.05 to 0.39), haemoglobin below 11 g/dL (AHR 2.31, 95% CI 1.35 to 3.93), and being in WHO clinical stages III and IV (AHR 2.84, 95% CI 1.11 to 7.27; AHR 3.07, 95% CI 1.08 to 8.75, respectively) were significant for the incidence of TB. CONCLUSION The incidence of TB among adults living with HIV/AIDS in the first 3 years of follow-up was higher compared with that of subsequent years. Previous TB disease, no IPT, low BMI and haemoglobin level, advanced WHO clinical stage, and bedridden condition were the determinants of the incidence of TB. Therefore, addressing the significant predictors and improving TB/HIV collaborative activities should be strengthened in the study setting.
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Affiliation(s)
- Ausman Ahmed
- Department of Public Health, Jigjiga University, Jigjiga, Ethiopia
| | - Desalew Mekonnen
- Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atsede M Shiferaw
- Department of Health Informatics, University of Gondar, Gondar, Ethiopia
| | - Fanuel Belayneh
- School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Melaku K Yenit
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
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Alemu YM, Awoke W, Wilder-Smith A. Determinants for tuberculosis in HIV-infected adults in Northwest Ethiopia: a multicentre case-control study. BMJ Open 2016; 6:e009058. [PMID: 27084271 PMCID: PMC4838743 DOI: 10.1136/bmjopen-2015-009058] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The objective of this study was to identify determinants for tuberculosis (TB) among HIV-infected adults in Northwest Ethiopia. DESIGN Case-control study. SETTING Three hospitals and 10 health centres in Northwest Ethiopia. PARTICIPANTS A total of 446 individuals consented to participate in the study (150 cases and 296 controls). Cases were HIV-infected adults diagnosed with active TB, and controls were HIV-infected adults without active TB. MAIN OUTCOME MEASURE The link between TB and determinants was assessed using logistic regression. Determinants were categorised as sociodemographic, host-related, clinical and environmental. RESULTS Smoking (adjusted OR (AOR) 5.47; 95% CI 2.26 to 13.22), presence of a TB patient in the family (AOR 2.66; 95% CI 1.25 to 5.66), alcohol consumption (AOR 2.49; 95% CI 1.29 to 4.80) and chewing khat (AOR 2.22; 95% CI 1.11 to 4.41) were independent determinants for increased occurrence of TB. Highly active antiretroviral therapy (HAART) (AOR 0.25; 95% CI 0.13 to 0.51), isoniazid preventive therapy (IPT) (AOR 0.22; 95% CI 0.11 to 0.41) and cotrimoxazole preventive therapy (AOR 0.32; 95% CI 0.19 to 0.55) had a protective effect against TB. CONCLUSIONS HIV-infected adults with substance abuse (tobacco smoking, khat chewing and alcohol) should be prioritised for TB screening. This study reaffirmed that HAART and IPT are some of the best strategies for reducing TB occurrence in HIV-infected adults. These findings provide impetus to intensify tracing of TB household contacts.
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Affiliation(s)
- Yihun Mulugeta Alemu
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Worku Awoke
- School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Annalies Wilder-Smith
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Alvi A, Fatima N, Jerah AA, Rizwan M, Hobani YH, Sunosi RA, Taha MMEH, Habiballah EM, Agarwal PK, Abdulwahab SI. Correlation between Resistin, Tuberculosis and Khat Addiction: A Study from South Western Province of Saudi Arabia. PLoS One 2015; 10:e0140245. [PMID: 26448186 PMCID: PMC4598132 DOI: 10.1371/journal.pone.0140245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 09/23/2015] [Indexed: 11/19/2022] Open
Abstract
Tuberculosis(TB) is a disease of global significance, which accounts for a death in every 15 seconds. Recent studies shows TB is rising in certain parts of the world, and Saudi Arabia is one of them. Several factor contribute in predisposing the subjects for infection including but not limited to addiction to various compounds which have immune modulation properties, such as amphetamines and Heroin etc. Khat a plant whose leaves are chewed for its euphoric effect in east Africa and Arabian Peninsula including Saudi Arabia, is considered as mildly addictive, and its principle compound, Cathinone shares structural and functional similarity with amphetamine a known immunomodulator. Tuberculosis being a disease of immune modulation has a varied spectrum of complex interplay of proinflammatory molecules, resistin is one of them. In the present study, we try to explore the trinity of khat addiction, serum resistin level and tuberculosis by correlating the serum resistin level in non khat addicted healthy subjects, khat addicted healthy subjects, and in patients, both khat addicted and non khat addicted, with active tuberculosis. We observed significantly higher resistin level among the apparently healthy khat addicted subjects as compared to non addicted healthy controls. Thereafter, when we compare the resistin levels between khat addicted and non khat addicted TB patients we did not found significant difference between the two groups. However bacillary load was observe to be significantly higher among the khat addicted TB patient as compare to non addicted one. Validation of above results in animal model revealed dose dependant increase in bacillary growth in the Wistar rats treated with khat. Taken together these results suggest the role of khat in immune modulation albeit in the limited frame of resistin level.
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Affiliation(s)
- Ayesha Alvi
- Department of Genetics and Molecular Biology, Faculty of Applied Medical Sciences, Jazan University, Jazan, KSA
- * E-mail:
| | - Nuzhath Fatima
- Department of Microbiology, Faculty of Applied Medical Sciences, Jazan University, Jazan, KSA
| | - Ahmed Ali Jerah
- Department of Biochemistry, Faculty of Applied Medical Sciences, Jazan University, Jazan, KSA
| | - Mohammed Rizwan
- Department of Biochemistry, College of Nursing, Jazan University, Jazan, KSA
| | - Yahya Hasan Hobani
- Department of Genetics and Molecular Biology, Faculty of Applied Medical Sciences, Jazan University, Jazan, KSA
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