A Centre of Excellence for Biomedical Research and Training In Africa
Integrated Alcohol and Smoking Behavioural Interventions with TB Care for Improved TB Treatment Outcomes in Zimbabwe: A Randomized Controlled Trial
Principal Investigators & Institutional Affiliation:
Dr. Charles Sandy, M.D., National TB Programme Manager, Zimbabwe Ministry of Health and Child Welfare
Co-Investigators & Institutional Affiliation:
Dr. Shungu Munyati, BSc, MSc, PhD, Director-General, Biomedical Research & Training Institute (BRTI) and Chairperson-Medical Research Council of Zimbabwe (MRCZ
Each year, 10.4 million patients are diagnosed with and 1.7 million people die from Tuberculosis (TB). There is a wide body of evidence demonstrating that tobacco and alcohol use are strongly associated with poor TB outcomes. Despite support for integrating smoking cessation and alcohol moderation interventions into TB care, tobacco, alcohol and TB have long been treated as separate issues.
In Zimbabwe, comparatively high rates of TB, tobacco use, and alcohol use coincide: Zimbabwe is a high burden TB (34,000 cases) country, 31.2% of adult males in Zimbabwe smoke daily – a proportion greater than the average for low human development index countries – and prevalence of alcohol use disorders and alcohol dependence in men is almost three times as high as the regional average. Interventions that address alcohol and tobacco consumption remain underutilized in TB care. The interconnectedness between these risk factors, as well as the potential for achieving improved access, treatment outcomes, cost-savings or cost-effectiveness, suggests tremendous benefits can be realized by integrating services.
This 3,800 patient randomized controlled trial evaluates a low-cost behavioural intervention designed to aid smoking cessation and reductions in alcohol consumption among TB patients. The study will provide causal evidence on the impact of integrating such care on TB health outcomes, and aims to provide a scalable way to improve TB outcomes, while also ensuring that health services adhere with WHO guidelines.