Heshmati Bahram, Omidi Sanaz, Mohammadi Younes
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
Syst Rev. 2025 Jul 5;14(1):139. doi: 10.1186/s13643-025-02888-y.
This study aimed to elucidate the influence of alcohol, smoking, and substance use on tuberculosis (TB) treatment failure using a meta-analysis approach.
A comprehensive search strategy was developed and applied to three major databases: MEDLINE, Web of Science, and Scopus. Additionally, Google Scholar, and Google were used to locate grey literature. Studies were identified through title and abstract screening, followed by a full-text review for eligibility. The Newcastle-Ottawa Scale checklist was employed to assess the quality of included studies. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated for each factor.
The initial database search and other sources yielded 10,518 articles. After applying inclusion criteria, 19 studies with a total of 180,119 participants were selected for the meta-analysis. The results revealed significant associations between all three factors and treatment failure. Pooled ORs indicated that alcohol consumption (OR 2.05; 95% CI 1.65 to 2.55), smoking (OR = 1.85; 95% CI 1.44 to 2.37), and substance use (OR 2.04; 95% CI 1.63 to 2.55) were each associated with an increased risk of TB treatment failure. Additionally, the majority of included studies demonstrated high methodological quality.
Our findings suggest that alcohol, smoking, and substance use are significant risk factors for unsuccessful TB treatment. To enhance TB treatment efficacy, preventive interventions aimed at reducing these behaviors before treatment initiation are recommended.
本研究旨在采用荟萃分析方法阐明饮酒、吸烟和药物使用对结核病（TB）治疗失败的影响。
制定了全面的检索策略，并应用于三个主要数据库：MEDLINE、科学网和Scopus。此外，还使用谷歌学术和谷歌来查找灰色文献。通过标题和摘要筛选确定研究，随后进行全文审查以确定是否符合纳入标准。采用纽卡斯尔-渥太华量表清单评估纳入研究的质量。计算每个因素的合并比值比（OR）及其95%置信区间（CI）。
初步数据库检索和其他来源共得到10518篇文章。应用纳入标准后，选择了19项研究，共180119名参与者进行荟萃分析。结果显示，所有这三个因素与治疗失败之间均存在显著关联。合并OR值表明，饮酒（OR 2.05；95%CI 1.65至2.55）、吸烟（OR = 1.85；95%CI 1.44至2.37）和药物使用（OR 2.04；95%CI 1.63至2.55）均与结核病治疗失败风险增加相关。此外，大多数纳入研究显示出较高的方法学质量。
我们的研究结果表明，饮酒、吸烟和药物使用是结核病治疗失败的重要危险因素。为提高结核病治疗效果，建议在治疗开始前采取旨在减少这些行为的预防性干预措施。
