Prevalence and correlates of substance use among school children in six African countries.

An increasing trend of noncommunicable diseases is a worldwide phenomenon, also including the developing countries. Few studies focus on adolescents' substance use in relation to mental distress and protective factors in African countries. The purpose of this study was to assess the prevalence and correlates (mental distress and protective factors) of substance use among school-going adolescents in six African countries. The sample included 20,765 students aged from 13 to 15 years from six African countries (Kenya, Namibia, Swaziland, Uganda, Zambia, Zimbabwe), chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The measure used was part of the Global School-Based Health Survey (GSHS) questionnaire, including various domains of health behaviour. Results indicate a prevalence of 12.6% tobacco use (past month), 6.6% risky alcohol use (two or more per day for at least 20 days or more in the past month), and 10.5% of illicit drug use (three or more times ever) in school-going adolescents in six African countries. School truancy, loneliness, sleeping problems, sadness, suicidal ideation, suicide plans, and poverty were associated with substance use (tobacco, alcohol, illicit drugs), while school attendance and parental supervision and connectedness were protective factors for substance use, and peer support protective for tobacco use. It is concluded that tobacco use, risky drinking and illicit drug use were common, clustered together and were associated with school truancy, mental distress, and lack of parental and peer support among adolescent African school children. These findings stress the need for early and integrated prevention programmes.