Prevalence and Factors Associated with Substance Use Among Patients with Tuberculosis in Uganda

Substance use can negatively impact treatment adherence and health outcomes, thus exacerbating the burden of the disease. This study determined the prevalence and factors associated with substance use among patients with TB disease in Kampala, Uganda.

This was a cross-sectional study of 144 patients with drug-susceptible TB enrolled from July 2020 to March 2021 across five health facilities in Kampala. Eligible participants were 18-65 years old, diagnosed with TB, and had initiated treatment for <= one month. Exclusions included drug-resistant TB, severe illness, or impairments affecting study participation. Data on socio-demographics, substance use, and clinical characteristics were collected using a semi-structured questionnaire. Self-reported substance use was the outcome of interest. Descriptive statistics and simple logistic regression analyses were performed for factors associated with substance use. Stata version 18.0 was used for analysis.

The participants had a median age of 34 years (IQR: 25.5 - 45.0); 50% were female and 31.9% were HIV infected. The prevalence of any substance use was 20.8% among TB patients. Alcohol use was the predominant substance (18.1%), followed by marijuana (2.8%) and tobacco (2.1%). Males were more likely than females to use any substances (COR: 2.38, 95% CI: 1.02 - 5.56, p=0.055), as were HIV-infected persons (COR: 3.20, 95% CI: 1.40 - 7.34, p=0.006), and those affiliated with the Catholic religion (COR: 3.50, 95% CI: 1.06 - 11.60, p=0.040).

Our study found a relatively high level of substance use among persons with TB. TB-HIV co-infected persons should be particularly targeted with interventions to minimize the negative health effects of substance use.