Global burden of tuberculosis and lower respiratory infections attributable to alcohol consumption in 2004

Shield, K. D., Samokhvalov, A. V. & Rehm, J. (2013). Global burden of tuberculosis and lower respiratory infections attributable to alcohol consumption in 2004. International Journal of Alcohol and Drug Research, 2(1), 11-18. doi: 10.7895/ijadr.v2i1.49 (http://dx.doi.org/10.7895/ijadr.v2i1.49)Aim: To quantify the extent to which alcohol contributes to the global burden of tuberculosis (TB) and lower respiratory infections (LRI).Design: TB and LRI deaths and disability-adjusted life years (DALYs) lost due to alcohol consumption were calculated from alcohol-attributable fractions (AAFs) using various data sources.Measures: Deaths and DALYs lost were obtained from the World Health Organization (2004 revision of the Global Burden of Disease study). Alcohol consumption indicators were obtained from the ongoing Comparative Risk Assessment study. Relative risks were obtained from meta-analyses, and confidence intervals (CIs) for the AAFs were obtained using Monte Carlo simulations.Findings: In 2004 alcohol was responsible for 381,000 deaths (95% CI: 209,000–560,000), 215,000 from TB (95% CI: 135,000–295,000) and 167,000 from LRI (95% CI: 74,000–264,000); and 6,101,000 DALYs lost (95% CI: 3,463,000–8,777,000), 4,581,000 due to TB (95% CI: 2,835,000 to 6,326,000) and 1,152,000 due to LRI (95%CI: 954,000–566,000). This represents 0.65% of all deaths (95% CI: 0.36%–0.95%) and 0.40% of all DALYs lost (95% CI: 0.23%–0.23%) for people aged 15 years and older.Conclusions: The global burden of alcohol-attributable TB and LRI is substantial, and significant attention should be paid to monitoring it. Future research should focus on quantifying alcohol’s role in (1) the risk for infection, (2) disease progression, and (3) adherence to medication regimens, in order to ensure accurate descriptions of the resulting global burden attributable to alcohol consumption.