Alcohol use disorder among people diagnosed with tuberculosis in a large urban case-finding project in central Uganda

Background
Heavy alcohol consumption increases the risk of developing tuberculosis (TB), delays diagnosis, and affects treatment adherence. This study aimed to examine the prevalence of alcohol use disorder (AUD) among individuals with TB and to explore the challenges they face in accessing and adhering to TB treatment.

Methods
An explanatory sequential study was conducted in two urban districts in Uganda. Quantitative data on the prevalence of AUD were collected using the CAGE tool. Factors associated with AUD were analyzed using Poisson regression. Focus group discussions (FGDs) were held with individuals diagnosed with both TB and AUD, and the data were transcribed and analyzed using NVIVO version 12 software.

Results
Among 325 people with TB, 62 (18.7%) screened positive for AUD, with 82.3% of them being male. Significant associations with AUD included being male and living in an urban area. There was a trend toward suboptimal TB treatment outcomes among those with AUD, although this did not reach statistical significance. Fourteen participants who screened positive for AUD took part in two FGDs, where they reported not disclosing alcohol use to healthcare providers and missing clinic appointments due to lack of transport.

Conclusion
A significant proportion of people with TB also had AUD but did not disclose their alcohol use to healthcare workers. These individuals faced numerous challenges during TB treatment, indicating the need for TB programs to actively screen for AUD and address the related issues.