Association of Substance Abuse and Tuberculosis among Tribes: Study in Three Tribal Settings of Kerala, India

Main Article Content

Anitha Kumari K R Anil Kumar Indira Krishnan

Abstract

Substance abuse such as alcohol consumption and smoking serve as profound indicators for Tuberculosis (TB). Tribes in rural India are the vulnerable population for various diseases and substance abuse is more prevalent among them.  Very few studies have been conducted to find the substance abuse and its association with TB among tribes in Kerala.  Hence, we sought to understand the prevalence of substance abuse among tribes, and its association with chest symptomatic cases and cases with history of TB. This study aimed to identify the predictors of negative social behaviours among tribes and their association with chest symptomatic cases and history of TB. It was part of a collaborative research program to estimate the burden of TB amongst tribal groups, by ICMR, NIRT, Chennai and SRM University, Kancheepuram and Population Research Centre, Kerala conducted in 2018. This article presents the prevalence of substance abuse (tobacco and alcohol) among tribes, and its association with chest symptomatic cases and cases with history of TB.  The study also tried to find out the predictors of substance use among tribes. Among 2609 tribes interviewed, 14.6% were smokers, 47 percent were used smokeless tobacco and 29% were consumed alcohol and only 20 respondents reported using drugs. Significant association of chest symptoms and TB history status with district, category of tribe, age, education, marital status, and nutrition are observed in the study. Chest symptomatic cases and those who had the history of TB had a highly significant association with use of smokeless tobacco and smoking. However, the study could not find a significant difference between those consuming alcohols. The predictors of substance abuse were found to be in higher age groups, low education, being in the low socio-economic profile and in the low BMI. To attain health goals like zero TB, control of substance use is an essential component especially among tribal communities. This study highlights the importance of education and better living conditions in reducing negative health behaviours among tribes.

Article Details

How to Cite
K R, Anitha Kumari; KRISHNAN, Anil Kumar Indira. Association of Substance Abuse and Tuberculosis among Tribes: Study in Three Tribal Settings of Kerala, India. Medical Research Archives, [S.l.], v. 11, n. 1, jan. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3472>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v11i1.3472.
Section
Research Articles

References

1. WHO Tuberculosis. https://www.who.int/news-room/fact-sheets/detail/tuberculosis Oct2022
2. Bates MN, Khalakdina A, Pai M, Chang L, Lessa F, Smith KR. The risk of tuberculosis from exposure to tobacco smoke a systematic review and meta-analysis. Arch Intern Med. 2007;167(4):335–342. doi: 10.1001/archinte.167.4.335.
3. Lin HH, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis a systematic review and meta-analysis. PLoS Med. 2007;4(1):e20. doi: 10.1371/journal.pmed.0040020]
4. Wen CP, Chan TC, Chan HT, Tsai MK, Cheng TY, Tsai SP. The reduction of tuberculosis risks by smoking cessation. BMC Infect Dis. 2010;10:156. https://doi.org/10.1186/1471-2334-10-156
5. Van Zyl, Smit RN, Pai M, Yew WW, Leung CC, Zumla A, Bateman ED. Global lung health the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD. Eur Respir J. 2010;35(1):27–33.
6. Government of India, ‘National Framework for Joint TB-Tobacco Collaborative Activities’ Revised National TB Control Programmeand National Tobacco Control Programme, Directorate General of Health Services Ministry of Health & Family Welfare 2017
7. Lönnroth K, Williams B, Stadlin S. Alcohol use as a risk factor for tuberculosis – a systematic review. BMC Public Health 2008; 8: 289.
8. Rehm J, Samokhvalov AV, Neuman MG. The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health 2009; 9: 450.
9. Imtiaz S, Shield KD, Roerecke M, et al. Alcohol consumption as a risk factor for tuberculosis: meta-analyses and burden of disease. Eur Respir J 2017; 50: 1700216 [https://doi.org/10.1183/ 13993003.00216-2017].
10. Kumar, Sunil. Contextualising the End TB Strategy for a Push toward TB Elimination in Kerala NTI Bulletin 2016, Vol. 52/1-4
11. Government of Kerala. Guidance document for the peoples’ movement against Tuberculosis in Kerala. Kerala TB Elimination Mission Principles, Strategies and Activities. Department of Health and Family Welfare and Arogyakeralam, 2017.
12. Oladipupo, OmobolaAjoke, Dibyendu Dutta, and Ngee Sing Chong. Analysis of chemical constituents in mainstream bidi smoke. BMC Chemistry (2019) 13:93.
13. Rao VG, Bhat J, Yadav R, Gopi PG, Selvakumar N, Wares DF. Prevalence of pulmonary tuberculosis among the Bharia, a primitive tribe of Madhya Pradesh, central India. Int J Tuberc Lung Dis. 2010;14:368–70
14. Burden of Tuberculosis among the Tribal Population in India Policy Brief https://www.nirt.res.in/pdf/Policy-Social/01032022/Burden%20of%20TB%20among%20the%20Tribal%20Population%20in%20India.pdf
15. Census. Scheduled Tribe Population. Available from: http://www.census2011.co.in / 380 scheduled-tribes.php
16. Janakiram C, Joseph J, Vasudevan S, Taha F, Deepan Kumar CV, et al. (2016) Prevalence and Dependency of Tobacco Use in an Indigenous Population of Kerala, India. J Oral Hyg Health 4:198. doi:10.4172/2332-0702.1000198
17. Javed, Reshma et al. Prevalence, pattern and determinants of tobacco use among persons of tribal origin in a primary care centre in Wayanad, Kerala. International Journal Of Community Medicine And Public Health Available at: . doi:http://dx.doi.org/10.18203/2394-6040.ijcmph2020339
18. Priyanka S, Biju S. Prevalence of noncommunicable disease risk factors among the Kani tribe in Thiruvananthapuram district, Kerala. Indian Heart J. 2018;70(5):598-603
19. Krishnan, AK and Alex Joseph Prevalence of tuberculosis among tribes aged 15 and above in Tamil Nadu. A community based cross-sectional study.Indian Journal of TuberculosisVolume 67, Issue 4, October 2020, Pages 488-494
20. Thomas BE, Thiruvengadam K, S. R, Rani S, S. V, Gangadhar Rao V, et al. (2021) Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. PLoS ONE 16(5): e0250971. https://doi.org/10.1371/journal. pone.0250971
21. Hussain T, Tripathy SS, Das S, et al. Prevalence, risk factors and health seeking behaviour of pulmonary tuberculosis in four tribal dominated districts of Odisha: comparison with studies in other regions of India. PLoS One. 2020;15(4), e0227083. https://doi.org/10.1371/journal.pone.022708. Published 2020 Apr 6
22. Sadath A, Jose K, Jiji KM, Mercy VT, Ragesh G, Arensman E. Prevalence and Determinants of Substance Use Among Indigenous Tribes in South India: Findings from a Tribal Household Survey. J Racial Ethn Health Disparities. 2022 Feb;9(1):356-366. doi: 10.1007/s40615-021-00964-2. Epub 2021 Jan 25. PMID: 33495925.
23. Rao VG, Gopi PG, Bhat J, Yadav R, Selvakumar N, Wares DF. Selected risk factors associated with pulmonary tuberculosis among Saharia tribe of Madhya Pradesh, central India.Eur J Public Health. 2012 Apr;22(2):271-3. doi: 10.1093/eurpub/ckr009. Epub 2011 Feb 15.PMID: 21324957
24. Imtiaz S, Shield KD, Roerecke M, et al. Alcohol consumption as a risk factor for tuberculosis: meta-analyses and burden of disease. Eur Respir J 2017; 50: 1700216 [https://doi.org/10.1183/ 13993003.00216-2017].
25. Gajalakshmi, Vendhan&Peto, Richard. (2009). Smoking, drinking and incident tuberculosis in rural India: Population-based case-control study. International journal of epidemiology. 38. 1018-25. 10.1093/ije/dyp225
26. Thomas BE, Thiruvengadam K, Vedhachalam C, A S, Rao VG, Vijayachari P, et al. (2021) Prevalence of pulmonary tuberculosis among the tribal populations in India. PLoS ONE 16(6): e0251519. https://doi.org/10.1371/journal. pone.0251519
27. Nair SB et al., Knowledge about tuberculosis among tribal population in Kerala in the backdrop of TB elimination goal by 2025, Indian Journal of Tuberculosis, https://doi.org/10.1016/j.ijtb.2022.03.015