Nkongoki Alex Mataluma, Balandya Emmanuel, Mamuya Simon, Mbwambo Jessie
Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
BMJ Open. 2025 Sep 26;15(9):e104144. doi: 10.1136/bmjopen-2025-104144.
Heroin users have a high burden of respiratory morbidity, including premature lung function impairment. Further, methadone treatment has been found to aggravate lung function impairment and can independently cause asthma. However, the lung function status among heroin users on medication-assisted therapy (MAT) in Tanzania is yet to be studied. This study aimed to assess the magnitude, pattern and factors associated with lung function impairment among heroin users on MAT.
This was a quantitative, analytical cross-sectional study.
This study was conducted at MAT Clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania.
Individuals aged 18 years or above with heroin use disorder on stable dose of methadone without heroin withdrawal symptoms (Maintenance Phase of Treatment) were recruited.
Participants were enrolled through systematic sampling technique. Data were collected using a questionnaire, and lung functions were measured using a spirometer. Lung function impairment was defined as the percentage of participants with forced expiratory volume in 1 s (FEV1) <70%. Risk factors associated with lung function impairment were assessed via univariate binary logistic regression.
We enrolled 302 participants into the study (mean age of 42.78±7.56 years). Lung function impairment was observed in 28.5% of participants, with an average age of 44±8 years. Restrictive lung disease was the most common pattern of lung function impairment affecting 13.2% of the participants. The predictors of lung function impairment were being underweight (OR) 4.73, 95% CI) 2.61-8.59, p<0.001), living with HIV infection (OR 2.61, 95% CI 1.20 to 5.66, p=0.016) and having a history of pulmonary tuberculosis (OR 2.48, 95% CI 1.48 to 4.17, p=0.001).
Heroin users on MAT have a high magnitude of lung function impairment. Routine lung function testing is recommended.
海洛因使用者存在较高的呼吸系统发病负担，包括肺功能过早受损。此外，已发现美沙酮治疗会加重肺功能损害，且可独立引发哮喘。然而，坦桑尼亚接受药物辅助治疗（MAT）的海洛因使用者的肺功能状况尚未得到研究。本研究旨在评估接受MAT的海洛因使用者中肺功能损害的程度、模式及相关因素。
这是一项定量分析横断面研究。
本研究在坦桑尼亚达累斯萨拉姆的穆希姆比利国家医院的MAT诊所进行。
招募年龄在18岁及以上、患有海洛因使用障碍且服用稳定剂量美沙酮且无海洛因戒断症状（治疗维持阶段）的个体。
通过系统抽样技术招募参与者。使用问卷收集数据，并使用肺活量计测量肺功能。肺功能损害定义为一秒用力呼气量（FEV1）<70%的参与者百分比。通过单变量二元逻辑回归评估与肺功能损害相关的危险因素。
我们招募了302名参与者进入研究（平均年龄42.78±7.56岁）。28.5%的参与者存在肺功能损害，平均年龄为44±8岁。限制性肺病是最常见的肺功能损害模式，影响了13.2%的参与者。肺功能损害的预测因素包括体重过轻（比值比[OR] 4.73，95%置信区间[CI] 2.61 - 8.59，p<0.001）、感染艾滋病毒（OR 2.61，95% CI 1.20至5.66，p = 0.016）和有肺结核病史（OR 2.48，95% CI 1.48至4.17，p = 0.001）。
接受MAT的海洛因使用者肺功能损害程度较高。建议进行常规肺功能检测。
