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The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review
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BACKGROUND: In 2004, tuberculosis (TB) was responsible for 2.5% of global mortality (among men 3.1%; among women 1.8%) and 2.2% of global burden of disease (men 2.7%; women 1.7%). The present work portrays accumulated evidence on the association between alcohol consumption and TB with the aim to clarify the nature of the relationship. METHODS: A systematic review of existing scientific data on the association between alcohol consumption and TB, and on studies relevant for clarification of causality was undertaken. RESULTS: There is a strong association between heavy alcohol use/alcohol use disorders (AUD) and TB. A meta-analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 (95% CI: 1.89-4.59). Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition, there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB, social marginalization and drift, higher rate of re-infection, higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data, about 10% of the TB cases globally were estimated to be attributable to alcohol. CONCLUSION: The epidemiological and other evidence presented indicates that heavy alcohol use/AUD constitute a risk factor for incidence and re-infection of TB. Consequences for prevention and clinical interventions are discussed.
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“As a second important pathway, alcohol use may lead to a presence in social environments that facilitate the spread of tuberculosis infection 85.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [85]
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“Accordingly, a weakened immune system is critical for increasing susceptibility to TB infection, or for reactivation of latent TB, and alcohol plays a prominent role here 85.”
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Metadata
- Authors
- Rehm, J., Samokhvalov, A. V., Neuman, M. G., Room, R., Parry, C., Lönnroth, K., Patra, J., Poznyak, V., & Popova, S.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Toronto (CA)
- The University of Melbourne (AU)
- South African Medical Research Council (ZA)
- World Health Organization (CH)
- Corresponding author
- Rehm, Jürgen
- ORCID
- Venue
- BMC Public Health
- Published
- 2009-12
- Volume
- 9
- Issue
- 1
- Pages
- 450-450
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC2796667
- OpenAlex
- W2126451218
- Cited by
- 458
- References
- 168
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 28 · 2023: 37 · 2022: 30 · 2021: 44 · 2020: 40 · 2019: 25 · 2018: 35 · 2017: 46 · 2016: 23 · 2015: 20 · 2014: 21 · 2013: 25 · 2012: 25
- FWCI
- 2.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- World Health Organization
- U.S. President’s Emergency Plan for AIDS Relief
- Centre for Addiction and Mental Health
- Centers for Disease Control and Prevention (1u51ps000729-01)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcohol consumption, alcoholism, tuberculosis, heavy drinking, tuberculosis risk factors, tuberculosis treatment outcomes, drug-resistant tuberculosis, social determinants of health, tuberculosis prevention
- MeSH terms
- Alcohol Drinking, Female, Humans, Male, Mycobacterium tuberculosis, Risk Factors, Russia, Tuberculosis, Ukraine, Prevalence, Alcohol-Related Disorders
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