Rathod Sujit D, Nadkarni Abhijit, Bhana Arvin, Shidhaye Rahul
Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Sangath, Goa, India.
BMJ Open. 2015 Dec 18;5(12):e009802. doi: 10.1136/bmjopen-2015-009802.
We sought to estimate the proportion of adults in Sehore District, India, who consumed alcohol, and the proportion who had behaviours consistent with alcohol use disorders (AUDs), using the Alcohol Use Disorders Identification Test (AUDIT). Among men who drank, we identified individual-level, household-level and community-level factors associated with AUDIT scores. Men with AUDs (AUDIT score ≥ 8) reported on whether and where they had sought treatment, and about alcohol-related internal stigma.
Population-based cross-sectional study.
Rural villages and urban wards in Sehore District, Madhya Pradesh, India.
n=3220 adult (≥ 18 years of age) residents of Sehore District.
Score on the AUDIT.
Nearly one in four men (23.8%) had consumed alcohol in the past 12 months, while few (0.6%) women were consumers. Among drinkers, 33.2% (95% CI 28.6% to 38.1%) had AUDIT scores consistent with hazardous drinking, 3.3% (95% CI 2.1% to 5.1%) with harmful drinking and 5.5% (95% CI 3.8% to 8.0%) with dependent drinking. We observed that AUDIT scores varied widely by village (intraclass correlation=0.052). Among men who had recently consumed alcohol, AUDIT scores were positively associated with depression, having at least one child, high-quality housing, urban residence, tobacco use and disability. AUDIT scores were negatively associated with land ownership, out-of-pocket healthcare expenditure and participation in the national employment programme. While 49.2% of men with AUDs felt embarrassed by their problems with alcohol, only 2.8% had sought treatment in the past 12 months.
A need exists for effectively identifying and treating adults with AUDs. Health promotion services, informed by commonly-expressed stigmatised beliefs held among those affected by AUDs and which are targeted at the most affected communities, may be an effective step in closing the treatment gap.
我们试图通过酒精使用障碍识别测试（AUDIT）来估计印度塞霍雷区成年人中饮酒者的比例，以及有与酒精使用障碍（AUD）相符行为者的比例。在饮酒男性中，我们确定了与AUDIT评分相关的个人层面、家庭层面和社区层面因素。患有AUD的男性（AUDIT评分≥8）报告了他们是否寻求过治疗、在哪里寻求治疗以及与酒精相关的内在耻辱感。
基于人群的横断面研究。
印度中央邦塞霍雷区的农村村庄和城市选区。
n = 3220名塞霍雷区成年（≥18岁）居民。
AUDIT评分。
近四分之一的男性（23.8%）在过去12个月内饮酒，而女性饮酒者很少（0.6%）。在饮酒者中，33.2%（95%CI 28.6%至38.1%）的AUDIT评分与危险饮酒相符，3.3%（95%CI 2.1%至5.1%）与有害饮酒相符，5.5%（95%CI 3.8%至8.0%）与依赖饮酒相符。我们观察到AUDIT评分在不同村庄之间差异很大（组内相关系数 = 0.052）。在最近饮酒的男性中，AUDIT评分与抑郁、至少有一个孩子、高质量住房、城市居住、吸烟和残疾呈正相关。AUDIT评分与土地所有权、自付医疗费用和参与国家就业计划呈负相关。虽然49.2%患有AUD的男性对自己的酒精问题感到尴尬，但在过去12个月中只有2.8%的人寻求过治疗。
有必要有效识别和治疗患有AUD的成年人。以受AUD影响者普遍表达的耻辱信念为依据、针对受影响最严重社区的健康促进服务，可能是缩小治疗差距的有效举措。
