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Volume 14, Number 9—September 2008
Dispatch

Crack Cocaine and Infectious Tuberculosis

Alistair StoryComments to Author , Graham Bothamley, and Andrew Hayward
Author affiliations: Health Protection Agency, London, UK (A. Story); Homerton Hospitals National Health Service Foundation Trust, London (G. Bothamley); University College London Centre for Infectious Disease Epidemiology, London (A. Hayward)

Main Article

Table 1

Univariate analysis of drug-using and non–drug-using patients with pulmonary TB in London, United Kingdom, 2003–2004*


 Variable No known drug use, 
n = 833, 
no. (%) Hard-drug user (unconfirmed crack cocaine user), n = 115, no. (%) Hard-drug user (confirmed crack cocaine user), n = 22, no. (%) p value
Gender <0.0001
Male 445 (54.1) 99 (86.8) 12 (54.6)
Female
377 (45.9)
15 (13.2)
10 (45.5)

Ethnicity <0.0001
White 142 (17.1) 54 (47.0) 5 (22.7)
Black African 344 (41.5) 25 (21.7) 5 (22.7)
Black Caribbean 32 (3.9) 15 (13.0) 9 (40.9)
South Asian 244 (29.4) 17 (14.8) 0
Other
68 (8.2)
4 (3.5)
3 (13.6)

Born in the United Kingdom 162 (19.6) 62 (54.9) 14 (63.7) <0.0001
Previous TB 78 (9.4) 25 (21.7) 5 (22.7) <0.0001

Previous TB past 2 years (relapsed) 36 (4.3) 19 (16.5) 4 (18.2) <0.0001
Known HIV+ 95 (11.4) 9 (7.8) 3 (13.6) 0.478
Delay in diagnosis >3 mo 109 (13.1) 19 (16.5) 2 (9.1) 0.499
Sought treatment at ED 126 (15.1) 32 (27.8) 10 (45.6) <0.0001
Cough during initial examination 589 (70.7) 99 (86.1) 19 (86.40 0.001
Sputum smear positive at diagnosis 302 (36.3) 68 (59.1) 19 (86.4) <0.0001
MDR 32 (3.8) 7 (6.1) 0 0.333
Linked to known INH resistance outbreak 9 (1.1) 10 (8.7) 11 (50.0) <0.0001
INH resistance (not outbreak) 54 (6.5) 11 (9.6) 1 (4.5) 0.783
Treated with DOT from start 74 (9.0) 19 (16.5) 6 (27.3) 0.001
Nonadherent to treatment in first 2 mo 125 (15.0) 59 (51.3) 15 (68.2) <0.0001

Lost to follow-up 19 (2.3) 12 (10.4) 6 (27.3) <0.0001
Homeless 37 (4.4) 22 (19.1) 13 (59.1) <0.0001
Mental health problems 28 (3.4) 27 (23.5) 9 (40.9) <0.0001
Imprisoned during current episode of TB 9 (1.1) 22 (19.1) 14 (63.6) <0.0001

*TB, tuberculosis; ED, emergency department; MDR, multidrug resistant; INH, isoniazid; DOT, directly observed therapy.

Main Article

Page created: July 13, 2010
Page updated: July 13, 2010
Page reviewed: July 13, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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