Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 8;9(2):ofab548.
doi: 10.1093/ofid/ofab548. eCollection 2022 Feb.

Alarming Tuberculosis Rate Among People Who Inject Drugs in Vietnam

Nicolas Nagot  1 , Vinh Vu Hai  2 , Thuy Thi Thu Dong  3 , Oanh Khuat Thi Hai  4 , Delphine Rapoud  1 , Giang Thi Hoang  5 , Catherine Quillet  1 , Khue Pham Minh  5 , Roselyne Vallo  1 , Thanh Tuyet Thi Nham  4 , Joëlle Castellani  1 , Jonathan Feelemyer  6 , Don C Des Jarlais  6 , Lan Phuong Nguyen  3 , Hoi Van Le  7 , Nhung Viet Nguyen  7 , Luan Nguyen Quang Vo  3 , Huong Thi Duong  5 , Jean-Pierre Moles  1 , Didier Laureillard  1   8
Affiliations

Alarming Tuberculosis Rate Among People Who Inject Drugs in Vietnam

Nicolas Nagot et al. Open Forum Infect Dis. .

Abstract

Background: The tuberculosis (TB) epidemic is not homogeneous in the general population but presents high-risk groups. People who inject drugs (PWID) are such a group. However, TB among PWID remains largely undocumented. Our goal was to assess the prevalence of TB and the risk factors associated with TB among PWID in Vietnam.

Methods: We implemented a cross-sectional survey among 2 community-based cohorts of human immunodeficiency virus (HIV)-positive and HIV-negative PWID in Hai Phong. Participants were screened for TB using questions on TB symptoms. Those who reported any symptom were accompanied by peers to the TB clinic for chest x-ray. If the latter was abnormal, a sputum was collected to perform an Xpert MTB/RIF test.

Results: A total of 885 PWID were screened for TB. For both cohorts, most PWID were male (>90.0%), with a median age of 42 years. Beside heroin injection, 52.5% of participants reported smoking methamphetamine, and 63.2% were on methadone. Among HIV-positive PWID (N = 451), 90.4% were on antiretroviral therapy and 81.6% had a viral load <1000 copies/mL. Using a complete-case analysis, the estimated TB prevalence was 2.3% (95% confidence interval [CI], 1.0-4.5) and 2.1% (95% CI, 0.8-4.2) among HIV-positive and HIV-negative people, respectively. Living as a couple, arrest over the past 6 months, homelessness, and smoking methamphetamine were independently associated with TB but not HIV infection.

Conclusions: In the context of very large antiretroviral therapy coverage, this extremely high rate of TB among PWID requires urgent actions.

Keywords: drug users; epidemiology; prevalence; risk factors; tuberculosis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow chart of the cohort participants. CXR, chest x-ray; HIV, human immunodeficiency virus; TB, tuberculosis.
See this image and copyright information in PMC

References

    1. Mathema B, Andrews JR, Cohen T, et al. . Drivers of tuberculosis transmission. J Infect Dis 2017; 216:644–53. - PMC - PubMed
    1. Perlman DC, Salomon N, Perkins MP, et al. . Tuberculosis in drug users. Clin Infect Dis 1995; 21:1253–64. - PubMed
    1. Deiss RG, Rodwell TC, Garfein RS.. Tuberculosis and illicit drug use: review and update. Clin Infect Dis 2009; 48:72–82. - PMC - PubMed
    1. Fox GJ, Barry SE, Britton WJ, Marks GB.. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J 2013; 41:140–56. - PMC - PubMed
    1. Winter JR, Stagg HR, Smith CJ, et al. . Injecting drug use predicts active tuberculosis in a national cohort of people living with HIV. AIDS 2017; 31:2403–13. - PMC - PubMed