Mental health interventions for rifampicin-resistant tuberculosis patients with alcohol use disorders, Zhytomyr, Ukraine.

Journal: Journal of infection in developing countries

Volume: 15

Issue: 9.1

Year of Publication: 2022

Affiliated Institutions:  Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine. vitality@ukr.net. Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine. Southern Africa Medical Unit, Médecins Sans Frontières, Johannesburg, South Africa. Fountain Medical Development K and L Europe, Yerevan, Armenia. Médecins Sans Frontières Operational Centre Brussels, Operational Research Unit, LuxOR, Canada. Regional TB Hospital, Zhytomyr Oblast, Zhytomyr, Ukraine. Yanovsky National Institute of Phthisiology and Pulmonology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.

Abstract summary 

Despite concerted efforts, Ukraine is challenged by increasing rates of multidrug and rifampicin-resistant tuberculosis (MDR/RR-TB) comorbid with alcohol use disorder (AUD). This study describes a cohort of RR-TB patients with high alcohol consumption treated in MSF Zhytomyr Project, Ukraine.We used programmatic data for 73 RR-TB patients screened with the AUD Identification Test March-July 2019 and followed-up for culture conversion/TB treatment outcome till 31 January 2020. We described socio-demographic, behavioral, and clinical characteristics, the level of depressive symptoms, and TB treatment outcomes in three groups: 1) patients with AUD who received mental health interventions (MHI); 2) patients with AUD who did not receive MHI; 3) patients with no AUD. We also found three potential contributors to declining to receive MHI.Main characteristics of the study groups did not differ substantially. Those receiving MHI (mean: nine sessions) were rated for alcohol consumption as 'hazardous' (41%), 'harmful' (43%) and 'dependence' (36%) and had higher depression scores versus the second (p=0.009) and third (p=0.095) groups at baseline. Depressive symptoms declined at 9-month follow-up for all patients. Culture conversion was seen at 77%, 73%, and 83% for each group respectively. We also found three reasons for declining from MHI.We detected little differences across the groups. However, our study cohort demonstrated substantially higher adherence rates, culture conversion and reduction of depressive symptoms than reported globally. We recommend further research on the effectiveness of MHI in changing the drinking habits, quality of life and/or TB treatment outcomes of patients with AUD.

Authors & Co-authors:  Plokhykh Vitalii V Duka Marve M Cassidy Laurel L Chen Chung-Yu CY Malakyan Khachatur K Isaakidis Petros P Donchuk Dimitri D Truzyan Nune N Reid Anthony A Siomak Olha O Pogrebna Maryna M Lytvinenko Nataliia N

Study Outcome 

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Statistics
Citations : 
Authors :  12
Identifiers
Doi : 10.3855/jidc.13827
SSN : 1972-2680
Study Population
Male,Female
Mesh Terms
Alcoholism
Other Terms
SORT IT;Tuberculosis;alcohol use disorder;mental health intervention
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
Italy