Prevalence of Pulmonary Tuberculosis among Illicit Injecting Drug Users of Karachi, Pakistan

Tuberculosis is endemic and is a major public health challenge in Pakistan. Illicit drug users continue to be a group at high risk for tuberculosis (TB). Drug users and injection drug users in particular, have driven TB epidemics in a number of countries including Pakistan. The successful identification and treatment of TB among illicit drug users remain important components of a comprehensive TB strategy, but illicit drug users present a unique set of challenges for TB diagnosis and control due to their exposure to risk factors like HIV Infection, homelessness, health disparities and other negative socio-economic factors poverty among them. In this study we aimed to determine the prevalence of Tuberculosis among injecting Drug Users (IDUs) in Karachi, Pakistan. A descriptive cross sectional study was conducted, in the year 2015 in two towns of Karachi (Kimari and Saddar), Pakistan. Trained investigators used a standardized multiple-choice and open-ended questionnaire to collect the data regarding demographic profile of the respondents, injecting practices and other related information to identify Tuberculosis suspects. Written informed Consent was obtained and questionnaire was completed by 155 injection drug user (IDUs) selected through proportionate stratified sampling. The sputum samples were collected as per guidelines of National TB Control Program from identified TB suspects. The data were analysed using IBM SPSS Statistics version 20.0 and Microsoft excel. There were 151 men (97%), 3 female (2%) and 1 (1%) transgender among participants. In our study prevalence of TB among IDUs was 12% and most (72%) of them were living on street and 46 (30.9%) were married, therefore making their spouses and family members a high risk group for TB. The prevalence of Tuberculosis among injecting illicit drug users is 12%. Future research needs to be directed toward this sensitive issue and social support programs with treatment services should be ensured for TB positive IDUs living on streets to reduce the disparities in provision of health services for this vulnerable stratum of our society.