Incidence of Tuberculosis and Associations with Indicators of Alcohol Consumption in Three Regions of Northwest Russia in 1975–2009: A Time-Series Analysis

Background. Alcohol has several social consequences that are associated with increased risk of tuberculosis. However, there have been no studies assessing the links between tuberculosis and alcohol consumption in northwest Russia. The aim of this study was to assess associations between the incidence of tuberculosis and indicators of alcohol consumption in three regions of northwest Russia. Methods. The study was performed in Arkhangelsk, Murmansk and Vologda regions using the data from 1975 to 2009. Deaths from alcohol poisoning and the incidence of alcohol psychoses were used as indicators of alcohol consumption. Associations between the incidence of tuberculosis and the above mentioned indicators were studied using time-series analysis. Results. We identified significant positive associations between the incidence of tuberculosis and the incidence of alcohol psychoses in the same year in Arkhangelsk region ( , 95% CI: 0.10–0.37) and in Vologda region ( , 95% CI: 0.10–0.25), but not in Murmansk region. Conclusions. We found an association between the incidence of alcohol psychoses and the incidence of tuberculosis in the same year in Arkhangelsk and Vologda regions suggesting an indirect link between excessive levels of alcohol consumption and the incidence of tuberculosis in Russia. 1. Introduction Russia is one of the countries with the highest incidence of tuberculosis in the world. The incidence of tuberculosis on the national level was 85.1 per 100,000 in 2008 [1]. However, a considerable reduction in the incidence of the disease has been observed in recent years, particularly in northwest Russia. For example, in the Arkhangelsk region the incidence of tuberculosis decreased from 104.0 per 100,000 in 2000 to 52.2 per 100,000 in 2011 while the overall number of deaths from tuberculosis decreased from 16.2 to 6.8 per 100,000 during the same period [2]. However, multidrug-resistant (MDR) strains of mycobacterium were found in 35.5% of new cases diagnosed in the region [3]. Most of those who are diagnosed with MDR-tuberculosis are alcohol abusers [4]. Socioeconomic factors, such as poverty, poor access to health care services, crowded housing, poor nutrition, poor general health, smoking, and alcohol abuse, have been shown to be associated with tuberculosis [5]. The associations between indicators of alcohol use and the incidence of tuberculosis are well described in the literature [6–9]. The risk of having active tuberculosis is three times as high as among persons with alcohol-related problems than among their counterparts without alcohol problems