Prevalence and associated factors for alcohol use disorder among tuberculosis patients: a systematic review and meta-analysis study.

BACKGROUND: Alcohol use disorders (AUD) in tuberculosis patients are complicated with poor compliance to anti-tuberculosis treatment and poor tuberculosis treatment outcomes. However, aggregate data concerning this problem is not available. Therefore, this review aimed to fill the above gap by generating an average prevalence of AUD in tuberculosis patients. METHOD: Our electronic search for original articles was conducted in the databases of Scopus, PubMed, and EMBASE, African Index Medicus, and psych-info. Besides, the reference list of selected articles was looked at manually to have further eligible articles for the prevalence and associated factors of AUD in tuberculosis patients. The random-effects model was employed during the analysis. MS-Excel was used to extract data and stata-11 to determine the average prevalence of AUD among tuberculosis patients. A sub-group analysis and sensitivity analysis were also run. A visual inspection of the funnel plots and an Eggers publication bias plot test were checked for the presence of publication bias. RESULT: A search of the electronic and manual system resulted in 1970 articles. After removing duplicates and unoriginal articles, only 28 articles that studied 30,854 tuberculosis patients met the inclusion criteria. The average estimated prevalence of AUD in tuberculosis patients was 30% (95% CI: 24.00, 35.00). This was with a slight heterogeneity (I2 = 57%, p-value < 0.001). The prevalence of AUD in tuberculosis patients was higher in Asia and Europe; 37% than the prevalence in the US and Africa; 24%. Besides, the average prevalence of AUD was 39, 30, 30, and 20% in studies with case-control, cohort, cross-sectional and experimental in design respectively. Also, the prevalence of AUD was higher in studies with the assessment tool not reported (36%) than studies assessed with AUDIT. AUD was also relatively higher in studies with a mean age of ≥40 years (42%) than studies with a mean age < 40 years (24%) and mean age not reported (27%). Based on a qualitative review; the male gender, older age, being single, unemployment, low level of education and income from socio-demographic variables, retreatment and treatment failure patients, stigma, and medication non-adherence from clinical variables were among the associated factors for AUD. CONCLUSION: This review obtained a high average prevalence of AUD in tuberculosis patients and this varies across continents, design of studies, mean age of the participants, and assessment tool used. This implied the need for early screening and management of AUD in tuberculosis patients.

Depression, anxiety symptoms, Insomnia, and coping during the COVID-19 pandemic period among individuals living with disabilities in Ethiopia, 2020.

BACKGROUND: People with disabilities face multiple barriers that prevent them from accessing care and essential information related to the COVID-19 pandemic that poses additional stress and psychopathology. Therefore, the investigation of psychopathologies during the COVID-19 outbreak and emergency response is critical. METHODS: A cross-sectional survey was implemented from July 15/2020 to July 30/2020. The PHQ-9, GAD-7 scale, insomnia severity index-7, and brief resilient coping scale were administered to participants. The collected data was then entered into Epi-data version 3.1 and exported to SPSS-20 for analysis. Descriptive statistical procedures were employed to describe the various psychopathologies. A binary logistic regression method was used to identify the related factors for the psychopathologies. Furthermore, an odds ratio with its 95%CI was driven to show association strength, and a P-value <0.05 was declared as statistically significant. RESULTS: A significant proportion of individuals living with disability had psychopathologies; 46.2% for depression symptoms, 48.1% for generalized anxiety disorder symptoms, and 71% for insomnia symptoms. Nearly 45.7% of participants were low resilient copers to their psychopathology. Depression was significantly higher in divorced/widowed/separated (AOR = 3.4, 95% CI: 1.28-8.92, P-value = 0.006), non-educated (AOR = 2.12, 95% CI: 1.12, 5.90, P-value = 0.001), and unemployed (AOR = 2.1, 95% CI: 1.32, 5.11, P-value = 0.005) as well as a daily laborer (AOR = 2.4, 95% CI: 1.20, 4.89, P-value = 0.014) subjects. Generalized anxiety disorder was also significantly higher in young age (<40 years) (AOR = 1.7, 95% CI: 1.32, 2.98, P-value = 0.02), single (AOR = 2.3, 95% CI: 1.24, 5.3, P-value = 0.011), widowed/divorced/separated (AOR = 1.5, 95% CI: 1.12, 2.78, P-value = 0.032), preparatory school completed (AOR = 3.00, 95% CI: 1.59, 5.46, P-value = 0.001), daily laborer (AOR = 2.7, 95% CI: 1.21, 5.23, P-value = 0.003), and unemployed (AOR = 2.5, 95% CI: 1.17, 4.78, P-value = 0.005) participants. Moreover, insomnia was significantly higher in single (AOR = 1.5, 95% CI: 1.12, 3.09, P-value = 0.027), divorced/widowed/separated(AOR = 6.2, 95% CI: 1.08, 11.29, P-value = 0.032), unemployed (AOR = 3.00, 95% CI: 1.22, 7.03, P-value = 0.001), blind (AOR = 2.8, 95% CI: 1.42, 6.35, P-value = 0.001), and deaf (AOR = 10.2, 95% CI: 4.52, 35.33, P-value = 0.002) participants. CONCLUSION: Depression, anxiety, and insomnia were highly prevalent among individuals with a disability during the COVID-19 period. Multiple sociodemographic and disability-related factors were associated with this high psychopathology. Attention has to be given by the government and other stakeholders to intervene in psychopathology and its associated factors.