SUBSTANCE ABUSE AMONG PULMONARY TUBERCULOSIS PATIENTS AT TERTIARY CARE HOSPITALS OF PESHAWAR, PAKISTAN
Article Sidebar
Main Article Content
Abstract
OBJECTIVES: To determine the frequency of substance abuse among pulmonary tuberculosis (PTB) patients and to assess the association of socioeconomic factors associated with substance abuse among PTB attending tuberculosis clinics at tertiary hospitals in Peshawar, Pakistan.
METHODS: This descriptive cross-sectional study was conducted from 1st May 2019 to 31st October 2019 at three tertiary care hospitals (Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex) in Peshawar, Pakistan. Sample size was calculated by using OpenEpi software, taking prevalence of substance abuse as 50%. PTB patients (n=423) aged 17-60 years were recruited through convenient sampling technique. Data was collected from tuberculosis patients through validated questionnaires: Alcohol, Smoking & Substance Involvement Screening Test & Poverty Score Card.
RESULTS: Out of 423 patients, 264 (62.4%) were males. Majority (n=331;78.3%) of the participants belonged to ‘middle-income group. Mean age of the participants was 39.33±13.76 years. Frequency of substance abuse amongst sampled tuberculosis population was 54.9% (n=232/423). The most common substance abuse included tobacco products (22.7%), sleeping pills (6.6%), opioids (6.1%) and cannabis (5.7%). A significant association was detected between substance abuse and income of participants- low and high income group had higher reported substance abuse than middle income group (p<0.001). Our study found a statistically significant association between gender and substance abuse (p-value <0.01) with more females (63.63%) than males (50.38%) reported being involved in substance abuse.
CONCLUSION: More than half of PTB patients, substance abuses. Gender and socioeconomic factors have significant association with substance abuse.
Article Details
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online
(e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Wang XB, Li XL, Zhang Q, Zhang J, Chen HY, Xu WY, et al. A survey of anxiety and depressive symptoms in pulmonary tuberculosis patients with and without tracheobronchial tuberculosis. Front Psychiatry 2018;9:308. https://doi.org/10.3389/fpsyt.2018.00308
World Health Organization, Global TB Programme. Global Tuberculosis Report 2017. World Health Organization, Geneva, Switzerland; 2017. ISBN 978-92-4-156551-6. Accessed on: June 23, 2020. Available from URL: https://www.who.int/teams/global-tuberculosis-programme/tb-reports
World Health Organization (WHO). World Health Day 2017 - Depression: let's talk. April 07, 2017. Accessed on: June 23, 2020. Available from URL: https://www.who.int/news-room/events/detail/2017/04/07/default-calendar/world-health-day-2017
Macintyre K, Bloss E. Alcohol brewing and the African tuberculosis epidemic. Med Anthropol 2011;30(2):126-35. https://doi.org/10.1080/01459740.2011.552457
Deiss RG, Rodwell TC, Garfein RS. Tuberculosis and Illicit Drug Use: Review and Update. Clin Infect Dis 2009;48(1):72-82. https://doi.org/10.1086/594126
Ambaw F, Mayston R, Hanlon C, Alem A. Burden and presentation of depression among newly diagnosed individuals with TB in primary care settings in Ethiopia. BMC Psychiatry 2017;17(1):57. https://doi.org/10.1186/s12888-017-1231-4
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16(9):606-13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Rachel H, Henry-Edwards S, Ali R, Vladimir P. Maristela GM, World Health Organization (WHO). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Manual for use in primary care. World Health Organization, Geneva, Switzerland, 2010. ISBN 978 92 4 159938 2
Gong Y, Yan S, Qiu L, Zhang S, Lu Z, Tong Y, et al. Prevalence of depressive symptoms and related risk factors among patients with tuberculosis in China: A multistage cross-sectional study. Am J Trop Med Hyg 2018;98(6):1624-8. https://doi.org/10.4269/ajtmh.17-0840
Galea S, Vlahov D. Social determinants and the health of drug users: socioeconomic status, homelessness, and incarceration. Public Health Rep 2002;117(Suppl 1):S135-S145.
Pelissari DM, Diaz-Quijano FA. Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study. Arch Public Health 2018;76:45. https://doi.org/10.1186/s13690-018-0287-z
Henkel D. Unemployment and substance use: a review of the literature (1990-2010). Curr Drug Abuse Rev 2011;4(1):4-27. https://doi.org/10.2174/1874473711104010004
Azagba S, Shan L, Qeadan F, Wolfson M. Unemployment rate, opioids misuse and other substance abuse: quasi-experimental evidence from treatment admissions data. BMC Psychiatry 2021;21(1):22. https://doi.org/10.1186/s12888-020-02981-7
Djibuti M., Mirvelashvili E, Makharashvili N, Magee MJ, et al. Household income and poor treatment outcome among patients with tuberculosis in Georgia: a cohort study. BMC Public Health 2014;14:88. https://doi.org/10.1186/1471-2458-14-88
Nelliyanil M, Sharada MP, Joseph N, Basagoudar SS, Jayaram S, Patil DC. A study of the socio-demographic profile and treatment outcome of paediatric tuberculosis patients in Bangalore Mahanagar Palike area. Indian J Tuberc 2012;59(4):207-13.
European Centre for Disease Prevention and Control. Social determinants and risk factors in tuberculosis surveillance in the EU/EEA. Stockholm: ECDC;2018:1-32. ISBN 978-92-9498-184-4. https://doi.org/10.2900/463341
Bates MN, Khalakdina A, Pai M, Chang L, Lessa F, Smith KR, et al. Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Arch Intern Med 2007;167(4):335-42. https://doi.org/10.1001/archinte.167.4.335
Silva MR, Pereira JC, Costa RR, Dias JA, Guimarães MDC, Leite ICG. Drug addiction and alcoholism as predictors for tuberculosis treatment default in Brazil: a prospective. Epidemiol Infect 2017;145(16):3516-24. https://doi/1017/s0950268817002631
Lonnroth K, Williams BG, Stadlin S, Jaramillo E, Dye C. Alcohol use as a risk factor for tuberculosis systematic review. BMC Public Health 2008; 8:289. https://doi.org/10.1186/1471-2458-8-289
World Health Organization, Global TB Programme. Global Tuberculosis Report 2019. World Health Organization, Geneva, Switzerland; 2019. ISBN 978-92-4-156571-4. Accessed on: June 23, 2020. Available from URL: https://www.who.int/teams/global-tuberculosis-programme/tb-reports.
World Health Organization, Global TB Programme. Global Tuberculosis Report 2018. World Health Organization, Geneva, Switzerland; 2018. ISBN 978-92-4-156564-6. Accessed on: June 23, 2020. Available from URL: https://www.who.int/teams/global-tuberculosis-programme/tb-reports
World Health Organization (WHO). WHO Expert Committee on Drug Dependence, fortieth report. World Health Organization, Geneva, Switzerland; 2018. ISBN 978-92-4-121022-5. Accessed on: June 23, 2020. Available from URL: https://apps.who.int/iris/bitstream/handle/10665/279948/9789241210225-eng.pdf
Pittalis S, Piselli P, Contini S, Gualano G, Alma MG, Tadolini M, et al. Socioeconomic status and biomedical risk factors in migrants and native tuberculosis patients in Italy. PLoS One 2017;12(12):e0189425. https://doi.org/10.1371/journal.pone.0189425
Oeltmann JE, Kammerer JS, Pevzner ES, Moonan PK. Tuberculosis and Substance Abuse in the United States, 1997-2006. Arch Intern Med 2009;169(2):189-97. https://doi.org/10.1001/archinternmed.2008.535
Mohamed S, Kanagasabapathy S, Kalifulla S. Socio-economic profile and risk factors among pulmonary tuberculosis patients in Madurai, India: a cross sectional study. International Journal of Res Med Sci 2015;3(12)3490-8. https://doi.org/10.18203/2320-6012.ijrms20151230
French CE, Coope CM, McGuinness LA, Beck CR, Newitt S, Ahyow L, et al. Cannabis use and the risk of tuberculosis: a systematic review. BMC Public Health 2019;19:1006. https://doi.org/10.1186/s12889-019-7127-0
Gupta S, Shenoy VP, Mukhopadhyay C, Bairy I, Muralidharan S. Role of risk factors and socio-economic status in pulmonary tuberculosis: a search for the root cause in patients in a tertiary care hospital, South India. Trop Med Int Health 2011;16(1):74-8. https://doi.org/10.1111/j.1365-3156.2010.02676.x
Khan QH. Epidemiology of pulmonary tuberculosis in rural Aligarh. Indian J Community Med 2006;31(1);39-40. https://doi.org/10.4103/0970-0218.54938