The benefits of the CAGE as a screening tool for alcoholism in a closed rural South African community.

OBJECTIVE

Testing the benefits of the CAGE questionnaire (a four-item test with questions on Cutting down, Annoyance at criticism, Guilty feelings and use of Eye-openers) in screening for possible alcoholism in rural underserviced South Africa.

DESIGN

The CAGE questionnaire and the Diagnostic and Statistical Manual i.v. diagnostic criteria for substance abuse and dependence were used to screen a representative sample (N = 96) of a rural community in the North West province of South Africa.

SETTING

The closed community of Ammerville situated at Fraserburg, approximately 500 km from Cape Town.

SUBJECTS

Adults above the age of 18 years.

RESULTS

The prevalence of alcohol dependence in this community was 56%. The 'positive' CAGE (two or more affirmative replies) showed a sensitivity of 100% and a specificity of 78% for alcohol dependence. This compared favourably with similar screening results in other clinical settings.

CONCLUSIONS

The high prevalence of alcohol dependence (56%) in this community, and the possibility of comparable results in many similar rural South African communities, reflect a startling reality that should be addressed. Use of the CAGE by other than traditional sources is recommended and emphasised. Treatment modalities for alcohol dependence and abuse in rural areas should be developed.