Section of Infectious Diseases, Department of Medicine, Boston University Chobanian Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America.
Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa.
BMC Public Health. 2024 Aug 14;24(1):2216. doi: 10.1186/s12889-024-19570-y.
Unhealthy alcohol use is widespread in South Africa and has been linked to tuberculosis (TB) disease and poor treatment outcomes. This study used qualitative methods to explore the relationship between TB and alcohol use during TB treatment.
Focus group discussions (FGDs) were conducted with 34 participants who had previous or current drug-susceptible TB and self-reported current alcohol use. Eight interviews were conducted with healthcare workers who provide TB services in Worcester, South Africa.
In this rural setting, heavy episodic drinking is normalized and perceived to be related to TB transmission and decreased adherence to TB medication. Both healthcare workers and FGD participants recommended the introduction of universal screening, brief interventions, and referral to specialized care for unhealthy alcohol use. However, participants also discussed barriers to the provision of these services, such as limited awareness of the link between alcohol and TB. Healthcare workers also specified resource constraints, while FGD participants or patients mentioned widespread stigma towards people with alcohol concerns. Both FGD participants and health providers would benefit from education on the relationship between TB and unhealthy alcohol use and had specific recommendations about interventions for alcohol use reduction. Healthcare workers also suggested that community health worker-delivered interventions could support access to and engagement in both TB and alcohol-related services.
Findings support strengthening accessible, specialized services for the identification and provision of interventions and psychosocial services for unhealthy alcohol use among those with TB.
在南非，不健康的饮酒行为普遍存在，并与结核病（TB）疾病和治疗效果不佳有关。本研究采用定性方法探讨了结核病治疗期间结核病与饮酒之间的关系。
对 34 名曾患有或目前患有药物敏感性结核病且自我报告目前有饮酒行为的参与者进行了焦点小组讨论（FGD）。对在南非伍斯特提供结核病服务的 8 名医护人员进行了访谈。
在这个农村地区，重度间歇性饮酒被视为正常行为，被认为与结核病传播和减少结核病药物治疗的依从性有关。医护人员和 FGD 参与者都建议对所有患者进行普遍性筛查、简短干预和转介到专门的酗酒治疗服务。然而，参与者还讨论了提供这些服务的障碍，例如对酒精和结核病之间联系的认识有限。医护人员还指出了资源限制，而 FGD 参与者或患者则提到了对有酒精问题的人的广泛污名化。FGD 参与者和卫生服务提供者都需要接受关于结核病和不健康饮酒之间关系的教育，并对减少饮酒的干预措施提出了具体建议。医护人员还建议，由社区卫生工作者提供的干预措施可以支持接触和参与结核病和与酒精相关的服务。
研究结果支持加强针对结核病患者的酗酒问题的可及性、专门服务，以识别和提供干预措施以及心理社会服务。
