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Eur Respir J. 2017 Jul 13;50(1). pii: 1700216. doi: 10.1183/13993003.00216-2017. Print 2017 Jul.

Alcohol consumption as a risk factor for tuberculosis: meta-analyses and burden of disease.

Author information

1
Institute of Medical Science, University of Toronto, Toronto, ON, Canada sameer.imtiaz@gmail.com.
2
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
3
Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
4
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
5
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
6
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
7
Global TB Programme, World Health Organization, Geneva, Switzerland.
8
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
9
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
10
Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.

Abstract

Meta-analyses of alcohol use, alcohol dosage and alcohol-related problems as risk factors for tuberculosis incidence were undertaken. The global alcohol-attributable tuberculosis burden of disease was also re-estimated.Systematic searches were conducted, reference lists were reviewed and expert consultations were held to identify studies. Cohort and case-control studies were included if there were no temporal violations of exposure and outcome. Risk relations (RRs) were pooled by using categorical and dose-response meta-analyses. The alcohol-attributable tuberculosis burden of disease was estimated by using alcohol-attributable fractions.36 of 1108 studies were included. RRs for alcohol use and alcohol-related problems were 1.35 (95% CI 1.09-1.68; I2: 83%) and 3.33 (95% CI 2.14-5.19; 87%), respectively. Concerning alcohol dosage, tuberculosis risk rose as ethanol intake increased, with evidence of a threshold effect. Alcohol consumption caused 22.02 incident cases (95% CI 19.70-40.77) and 2.35 deaths (95% CI 2.05-4.79) per 100 000 people from tuberculosis in 2014. Alcohol-attributable tuberculosis incidence increased between 2000 and 2014 in most high tuberculosis burden countries, whereas mortality decreased.Alcohol consumption was associated with an increased risk of tuberculosis in all meta-analyses. It was consequently a major contributor to the tuberculosis burden of disease.

PMID:
28705945
PMCID:
PMC5540679
DOI:
10.1183/13993003.00216-2017
[Indexed for MEDLINE]
Free PMC Article

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