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

  • Vitalii Plokhykh Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine
  • Marve Duka Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine
  • Laurel Cassidy Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine
  • Chung-Yu Chen Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine
  • Khachatur Malakyan Medecins Sans Frontieres (MSF) - Operational Center Brussels (OCB) Zhytomyr, Zhytomyr, Ukraine
  • Petros Isaakidis Southern Africa Medical Unit, Médecins Sans Frontières, Johannesburg, South Africa
  • Dimitri Donchuk Southern Africa Medical Unit, Médecins Sans Frontières, Johannesburg, South Africa
  • Nune Truzyan Fountain Medical Development K and L Europe, Yerevan, Armenia
  • Anthony Reid Médecins Sans Frontières Operational Centre Brussels, Operational Research Unit, LuxOR, Canada
  • Olha Siomak Regional TB Hospital, Zhytomyr Oblast, Zhytomyr, Ukraine
  • Maryna Pogrebna Yanovsky National Institute of Phthisiology and Pulmonology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  • Nataliia Lytvinenko Yanovsky National Institute of Phthisiology and Pulmonology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
Keywords: Tuberculosis, alcohol use disorder, mental health intervention, SORT IT

Abstract

Introduction: 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.

Methodology: 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.

Results: 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.

Conclusions: 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.

Published
2021-09-29
How to Cite
1.
Plokhykh V, Duka M, Cassidy L, Chen C-Y, Malakyan K, Isaakidis P, Donchuk D, Truzyan N, Reid A, Siomak O, Pogrebna M, Lytvinenko N (2021) Mental health interventions for rifampicin-resistant tuberculosis patients with alcohol use disorders, Zhytomyr, Ukraine. J Infect Dev Ctries 15:25S-33S. doi: 10.3855/jidc.13827
Section
EECA Regional SORT IT