Tuberculosis evolution and treatment outcome in drug addicted patients

Background: Drug injection is considered an important issue for the public health of the Republic of Moldova. In the RM the intravenous drug users (IVDU) are the key population for HIV infection, B and C hepatitis, TB and sexual transmitted diseases. The aim of the study was to assess the tuberculosis evolution and treatment outcome in intravenous drug addicted patients.

Material and methods: A retrospective selective, descriptive study targeting socioeconomic, demographic, economic and epidemiological peculiarities, case-management, diagnosis of radiological aspects and microbiological characteristics of 233 patients with pulmonary tuberculosis registered in Chisinau city from 2012 to 2016 among them 48 IVDU was performed. The results were compared with a sample of 34 IVDU.

Results: Men were predisposed for drug addiction and the age is younger in addicts with tuberculosis. Socioeconomic vulnerability is extended in the selected groups; however, the poverty deepness was more important in addicted patients with tuberculosis. Close contact with a sick patient predominated in addicts with tuberculosis, but nobody assessed the contact in addicts without tuberculosis. Associated diseases predominated in addicts with or without tuberculosis, more frequently were: HIV infected individuals, viral hepatitis and neurological disorders.

Conclusions: Risk factors for tuberculosis in drug addicts were: unemployment and associated lack of health insurance, patient’s homeless state, middle adulthood and the immune suppressive condition – HIV infection. Major disease-related characteristic in IVDU patients was the presence of severe destructive forms of tuberculosis and "loss to follow-up" as outcome.