Alcohol use and clinical manifestations of tuberculosis

Summary 

Objectives

Excess alcohol use represents a significant challenge in tuberculosis control. Whether alcohol use enhances transmission of Mycobacterium tuberculosis is not known.

Methods

We analyzed North Carolina, USA surveillance data for all adult (>14 years) tuberculosis cases reported 1994–2006 (N=5556).

Results

The prevalence of excess alcohol use among tuberculosis cases declined from 27.3% in 1994 to 17.9% in 2006. Cases with excess alcohol use were more likely to have pulmonary tuberculosis compared with cases without excess alcohol use (92.5% vs. 77.2%, p<0.0001). Among pulmonary cases, excess alcohol use was associated with cavities on chest radiograph (36.8% vs. 28.2%, p<0.0001) and positive acid-fast sputum smears (65.9% vs. 45.8%, p<0.0001).

Conclusions

Although excess alcohol use is becoming less prevalent among tuberculosis cases in North Carolina, cases who use excess alcohol had clinical features associated with greater infectiousness, and represent a significant public health problem.

Keywords: Tuberculosis, Alcoholism, Epidemiology