The impact of risk factors on tuberculosis in drug users

Abstract

Background: Injected drug users (IDU) are the key population for contracting HIV infection and a high risk group for tuberculosis. Aim: Assessment of the risk factors for tuberculosis in drug users. Material and Methods: A retrospective cohort study which included 48 IDUs diagnosed with tuberculosis (study group- SG) and 185 patients with tuberculosis (control group- CG) without drug addiction in anamnesis was performed. Results: Male/female ratio=7/1 in SG vs. 2,9/1 in CG with the predominance of men in the SG. The group between 25-44 age old predominated in the SG 47 (98%) in SG vs. 88 (47%) in CG. Low social state such as unemployment predominated in the SG 43 (90%) vs. 124 (67%) in CG and lack of the health insurance 40 (83%) in SG vs. 135 (75%) in CG, as well the disablement 3 (6%) in SG vs. 14(8%) in CG. Such risk factors as homelessness were 8 (17%) in SG vs. 29 (16%) in CG, former detention 16 (33%) in SG vs. 2(1%) in CG, close TB contact had 15 (31%) in SG vs. 15 (8%) in CG, HIV 21 (43%) in SG vs. 11 (6%) in CG, alcoholism 3 (6%) in SG vs. 13 (7%) in CG, viral hepatitis 2 (4%) in SG vs 2 (1%) in CG. Conclusions: Men were predisposed for drug addiction, however women frequently developed tuberculosis. The age for acquiring tuberculosis is younger in addicted patients than in those without drug addiction. Socioeconomic vulnerability is extended in the groups of patients with tuberculosis, with or without addiction, however the poverty deepness was more important in addicted patients. Low level of education predominated in drug addicts. Close contact with a sick patient predominated in addicted patients with tuberculosis, but nobody assessed the infectious contact in addicted patients without tuberculosis. Associated diseases predominated in addicts with or without tuberculosis, more expressed were: HIV infected individuals, viral hepatitis and neurological disorders. Risk factors for tuberculosis in drug addicted were: unemployment and associated lack of health insurance, patient’s homeless state, middle adulthood and the immune suppressive condition – HIV infection.