Effect of food insecurity on hazardous alcohol consumption and psychological well-being among people with tuberculosis in Kampala, Uganda
Loading...
Date
2025-11-27
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Rationale
Food insecurity (FI), hazardous alcohol consumption (HAC), and poor mental health are common among people with tuberculosis (TB), yet empirical evidence on their interrelationships remains limited.
Objective
We evaluated the effect of FI on HAC and psychological well-being among people with pulmonary TB in Kampala, Uganda.
Methods
We collected data across five TB clinics and constructed a quasi-experimental design. FI was the exposure, measured using the FI Experience Scale (FIES). FIES scores range between 0 and 8, and individuals were classified as food insecure if they scored ≥ 4. The primary outcome was HAC, assessed using the Alcohol Use Disorders Identification Test (AUDIT) tool. Participants with AUDIT scores ≥ 16, indicating high-risk drinking or possible alcohol dependence, were categorized as having HAC. The secondary outcome was psychological well-being measured using the World Health Organization’s Five Well-Being Index, with a total score of <15 indicating poor psychological well-being. We used doubly robust estimation to report causal risk ratios (RR) and 95 % confidence intervals (CI).
Results
Of 818 participants, 475 (58.1 %) were from food-insecure households, 153 (18.7 %) had HAC, and 316 (38.6 %) had poor psychological well-being. FI was independently associated with HAC (RR 1.43, 95 % CI: 1.21–1.69), but not poor psychological well-being (RR 1.06, 95 % CI: 0.81–1.37).
Conclusion
FI is associated with a higher likelihood of HAC but not psychological well-being among people with TB in Kampala, Uganda. Given their high prevalence, there is a need to address food insecurity, HAC, and poor psychological well-being within TB control programs.
Description
This study investigates how food insecurity shapes hazardous alcohol use and psychological well-being among individuals living with tuberculosis in Kampala, Uganda. The findings reveal that inconsistent access to food intensifies risky drinking behaviors and negatively impacts health outcomes, underscoring the lived realities of vulnerable populations. By directly addressing Sustainable Development Goals—specifically, SDG 2 (Zero Hunger), SDG 3 (Good Health and Well-being), SDG 1 (No Poverty), and SDG 10 (Reduced Inequalities)—the research demonstrates the intricate connections between nutrition, mental health, economic hardship, and social inequality. The study’s insights offer a human-centered perspective that can inform policies supporting nutrition, health, and social support services. In alignment with Uganda’s National Development Plan IV, which prioritizes strengthening health systems, reducing poverty, and improving social outcomes, these findings contribute to the evidence base for interventions fostering resilience and equitable development.
Keywords
Alcohol consumption, Food insecurity, Psychological well-being, Tuberculosis, Uganda
Citation
Izudi, J., Appeli, S., & Bajunirwe, F. (2025). Effect of food insecurity on hazardous alcohol consumption and psychological well-being among people with tuberculosis in Kampala, Uganda. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 100575.