Othieno C J, Kathuku D M, Ndetei D M
Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi.
East Afr Med J. 2000 Nov;77(11):592-5. doi: 10.4314/eamj.v77i11.46728.
To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya.
A descriptive cross-sectional prevalence survey.
Urban health centres of Jericho and Kenyatta University (KU) and rural health centres in Muranga district.
One hundred and fifty adult patients (seventy eight males and seventy two females) were included in the study.
Semi-structured questionnaires and the DSM IV diagnostic criteria were used to record the socio-demographic data and to determine substance dependence or abuse.
The substances commonly used in descending order of frequency were alcohol, tobacco, khat and cannabis. Only alcohol and tobacco were extensively used. Lifetime prevalence rates of alcohol use for the two urban health centres were 54% and 62% compared to 54% for the rural health centres. For tobacco the lifetime prevalence rates were 30% for Jericho, 28% for KU and 38% for Muranga. The differences between the rural and urban samples were not statistically significant. More males than females had used alcohol (average lifetime use 80.8% for males compared to 30.6% for females: p<0.05) and tobacco (average lifetime use 56.4% for males compared to 5.6% for females p<0.05).
The rates of substance abuse were generally low with the exception of alcohol and tobacco. Socio-cultural factors might be responsible for the differences noted. It is suggested that preventive measures and education should be emphasised at the primary care level.
评估肯尼亚城乡地区基层医疗中心患者使用药物的流行情况及模式。
描述性横断面患病率调查。
杰里科和肯雅塔大学（KU）的城市医疗中心以及穆兰加区的农村医疗中心。
150名成年患者（78名男性和72名女性）纳入研究。
采用半结构化问卷和《精神疾病诊断与统计手册》第四版（DSM-IV）诊断标准记录社会人口学数据并确定药物依赖或滥用情况。
按使用频率从高到低排列，常用的药物依次为酒精、烟草、巧茶和大麻。仅酒精和烟草被广泛使用。两个城市医疗中心酒精的终生使用率分别为54%和62%，农村医疗中心为54%。烟草的终生使用率，杰里科为30%，KU为28%，穆兰加为38%。城乡样本之间的差异无统计学意义。使用酒精的男性多于女性（男性终生平均使用率为80.8%，女性为30.6%：p<0.05），使用烟草的男性也多于女性（男性终生平均使用率为56.4%，女性为5.6%，p<0.05）。
除酒精和烟草外，药物滥用率总体较低。社会文化因素可能是造成所观察到差异的原因。建议在初级保健层面强调预防措施和教育。
