Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA; Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
College of Medicine, University of Central Florida, Orlando, FL, USA.
Lancet Glob Health. 2014 Oct;2(10):e592-600. doi: 10.1016/S2214-109X(14)70290-6.
Previous attempts to assess the prevalence of drug use in Afghanistan have focused on subgroups that are not generalisable. In the Afghanistan National Urban Drug Use Study, we assessed risk factors and drug use in Afghanistan through self-report questionnaires that we validated with laboratory test confirmation using analysis of hair, urine, and saliva.
The study took place between July 13, 2010, to April 25, 2012, in 11 Afghan provinces. 2187 randomly selected households completed a survey, representing 19 025 household members. We completed surveys with the female head of the household about past and current drug use among members of their household. We also obtained hair, urine, and saliva samples from 5236 people in these households and tested them for metabolites of 13 drugs.
Of 2170 households with biological samples tested, 247 (11·4%) tested positive for any drug. Overall, opioids were the most prevalent drug in the biological samples (5·6%), although prescription drugs (prescription pain pills, sedatives, and tranquilliser) were the most commonly reported in the past 30 days in the questionnaires (7·6%). Of individuals testing positive for at least one substance, opioids accounted for more than 50% of substance use in women and children, but only a third of substances in men, who predominantly tested positive for cannabinoids. After controlling for age with direct standardisation, individual prevalence of substance use (from laboratory tests) was 7·2% (95% CI 6·1-8·3) in men and 3·1% (2·5-3·7) in women-with a national prevalence of 5·1% (4·4-5·8) and a prevalence of 5·0% (4·1-5·8) in Kabul. Concordance between laboratory test results and self-reports was high.
These data suggest the female head of household to be a knowledgeable informant for household substance use. They also might provide insight into new avenues for targeted behavioural interventions and prevention messages.
以往评估阿富汗药物使用情况的尝试主要集中在不具有代表性的亚组人群上。在阿富汗国家城市药物使用研究中，我们通过自我报告问卷调查评估了阿富汗的风险因素和药物使用情况，并使用毛发、尿液和唾液分析的实验室测试确认对问卷进行了验证。
该研究于 2010 年 7 月 13 日至 2012 年 4 月 25 日在阿富汗 11 个省份进行。2187 个随机选择的家庭完成了一项调查，代表了 19025 个家庭的成员。我们对女户主进行了调查，了解家庭其他成员过去和现在的药物使用情况。我们还从这些家庭中抽取了 5236 人的毛发、尿液和唾液样本，并对 13 种药物的代谢物进行了测试。
在接受生物样本测试的 2170 个家庭中，有 247 个（11.4%）检测出至少一种药物呈阳性。总体而言，在生物样本中最常见的药物是阿片类药物（5.6%），尽管在过去 30 天的问卷调查中，最常见的是处方药物（处方止痛药、镇静剂和安定）（7.6%）。在至少检测出一种物质呈阳性的个体中，阿片类药物占女性和儿童药物使用的比例超过 50%，但在男性中仅占三分之一，男性主要检测出大麻素呈阳性。在年龄直接标准化后，个体药物使用（来自实验室检测）的患病率为男性 7.2%（95%CI 6.1-8.3），女性 3.1%（2.5-3.7）-全国患病率为 5.1%（4.4-5.8），喀布尔的患病率为 5.0%（4.1-5.8）。实验室检测结果与自我报告之间的一致性很高。
这些数据表明，家庭中的女户主是了解家庭药物使用情况的知情者。它们还可能为有针对性的行为干预和预防信息提供新的途径。
