Alcohol Consumption as a Risk Factor for Tuberculosis: Meta-Analyses and Burden of Disease

Eur Respir J. 2017 Jul 13;50(1):1700216. doi: 10.1183/13993003.00216-2017. Print 2017 Jul.

Abstract

Meta-analyses of alcohol use, alcohol dosage and alcohol-related problems as risk factors for tuberculosis incidence were undertaken. The global alcohol-attributable tuberculosis burden of disease was also re-estimated.Systematic searches were conducted, reference lists were reviewed and expert consultations were held to identify studies. Cohort and case-control studies were included if there were no temporal violations of exposure and outcome. Risk relations (RRs) were pooled by using categorical and dose-response meta-analyses. The alcohol-attributable tuberculosis burden of disease was estimated by using alcohol-attributable fractions.36 of 1108 studies were included. RRs for alcohol use and alcohol-related problems were 1.35 (95% CI 1.09-1.68; I2: 83%) and 3.33 (95% CI 2.14-5.19; 87%), respectively. Concerning alcohol dosage, tuberculosis risk rose as ethanol intake increased, with evidence of a threshold effect. Alcohol consumption caused 22.02 incident cases (95% CI 19.70-40.77) and 2.35 deaths (95% CI 2.05-4.79) per 100 000 people from tuberculosis in 2014. Alcohol-attributable tuberculosis incidence increased between 2000 and 2014 in most high tuberculosis burden countries, whereas mortality decreased.Alcohol consumption was associated with an increased risk of tuberculosis in all meta-analyses. It was consequently a major contributor to the tuberculosis burden of disease.

Publication types

  • Meta-Analysis

MeSH terms

  • Alcohol Drinking / adverse effects*
  • Case-Control Studies
  • Cohort Studies
  • Global Burden of Disease
  • Humans
  • Incidence
  • Risk Factors
  • Tuberculosis / epidemiology*