Impact of alcohol consumption, substance use, and smoking on treatment outcomes in tuberculosis: a systematic review and meta-analysis.

Publication date: Jul 05, 2025

This study aimed to elucidate the influence of alcohol, smoking, and substance use on tuberculosis (TB) treatment failure using a meta-analysis approach. A comprehensive search strategy was developed and applied to three major databases: MEDLINE, Web of Science, and Scopus. Additionally, Google Scholar, and Google were used to locate grey literature. Studies were identified through title and abstract screening, followed by a full-text review for eligibility. The Newcastle-Ottawa Scale checklist was employed to assess the quality of included studies. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated for each factor. The initial database search and other sources yielded 10,518 articles. After applying inclusion criteria, 19 studies with a total of 180,119 participants were selected for the meta-analysis. The results revealed significant associations between all three factors and treatment failure. Pooled ORs indicated that alcohol consumption (OR 2. 05; 95% CI 1. 65 to 2. 55), smoking (OR = 1. 85; 95% CI 1. 44 to 2. 37), and substance use (OR 2. 04; 95% CI 1. 63 to 2. 55) were each associated with an increased risk of TB treatment failure. Additionally, the majority of included studies demonstrated high methodological quality. Our findings suggest that alcohol, smoking, and substance use are significant risk factors for unsuccessful TB treatment. To enhance TB treatment efficacy, preventive interventions aimed at reducing these behaviors before treatment initiation are recommended.

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Concepts Keywords
Databases Alcohol consumption
Google Alcohol Drinking
Therapy Antitubercular Agents
Tuberculosis Antitubercular Agents
Humans
Smoking
Smoking
Substance use
Substance-Related Disorders
Treatment Failure
Treatment Outcome
Treatment outcome
Tuberculosis
Tuberculosis

Semantics

Type Source Name
drug DRUGBANK Ethanol
disease MESH substance use
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH treatment failure
disease IDO quality
pathway REACTOME Reproduction
drug DRUGBANK Indoleacetic acid
disease IDO bacteria
disease MESH latent infections
drug DRUGBANK Coenzyme M
drug DRUGBANK Isoniazid
drug DRUGBANK Trestolone
disease MESH morbidity
disease MESH educational attainment
disease IDO geographical region
disease IDO country
drug DRUGBANK Spinosad
disease MESH extrapulmonary tuberculosis
disease MESH pulmonary tuberculosis
disease MESH Alcoholism
pathway KEGG Alcoholism
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH death
disease MESH latent tuberculosis infection

Original Article

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