Risks for tuberculosis in Kazakhstan: Implications for prevention

SETTING: Four regions in Kazakhstan where participants were recruited from June 2012 to May 2014. OBJECTIVE: To examine associations between incarceration history and tobacco, alcohol, and drug consumption, and human immunodeficiency virus (HIV) infection and diabetes mellitus (DM) with TB. DESIGN: This matched case-control study included 1600 participants who completed a survey on sociodemographics, history of incarceration, tobacco, alcohol and drug use, and HIV and DM diagnosis. Conditional logistic regression analysis was used to examine associations between a TB diagnosis and risk factors. RESULTS: Participants who had ever smoked tobacco (aOR 1.73, 95%CI 1.23-2.43, P ≤ 0.01), ever drank alcohol (aOR 1.41, 95%CI 1.03-1.93, P ≤ 0.05), were HIV-positive (aOR 36.37, 95%CI 2.05-646.13, P ≤ 0.05) or had DM (aOR 13.96, 95%CI 6.37-30.56, P ≤ 0.01) were more likely to have TB. CONCLUSIONS: The association between TB and tobacco use, alcohol use, HIV and DM in Kazakhstan suggests a need for comprehensive intervention and prevention approaches that also address tobacco and alcohol use, DM and HIV.