Teferra Solomon, Medhin Girmay, Selamu Medhin, Bhana Arvin, Hanlon Charlotte, Fekadu Abebaw
Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Public Health. 2016 Mar 3;16:218. doi: 10.1186/s12889-016-2911-6.
Alcohol related health and social problems are on the rise in sub-Saharan Africa. This survey reports the prevalence and associated factors for hazardous drinking in rural Sodo district, southern Ethiopia. The survey was part of a multi-center study, Programme for Improving Mental Health Care (PRIME), which is a consortium of research institutions and ministries of health of five low and middle income countries, namely Ethiopia, India, Nepal, South Africa and Uganda in partnership with UK institutions and World Health Organization (WHO).
A cross-sectional community survey was conducted involving 1500 adults, age 18 and above, recruited using multi-stage random sampling. Data on alcohol use was collected using the Fast Alcohol Screening Test (FAST). Standardised instruments were used to measure potential associated factors, including a validated adaptation of the Kessler 10 (psychological distress), the List of Threatening Experiences (number of adverse life events). Exploratory multivariable logistic regression was conducted to examine factors associated with hazardous alcohol use.
The overall prevalence of hazardous alcohol use was found to be 21 %; 31 % in males and 10.4 % in females, P < 0.05. Factors independently associated with hazardous alcohol use were being male (adjusted OR = 4.0, 95 % CI = 2.44, 6.67), increasing age, having experienced one or more stressful life events (adjusted OR = 1.71, 95 % CI = 1.18, 2.48, and adjusted OR = 2.12, 95 % CI = 1.36, 3.32 for 1-2 and 3 or more adverse life events, respectively) and severe psychological distress (adjusted OR = 2.96, 95 % CI = 1.49, 5.89). High social support was found to be protective from hazardous alcohol use (adjusted OR = 0.41, 95 % CI = 0.23, 0.72).
High level of hazardous alcohol use was detected in this predominantly rural Ethiopian setting. The finding informed the need to integrate services for hazardous alcohol use such as brief intervention at different levels of primary care services in the district. Public health interventions to reduce hazardous alcohol use also need to be launched.
撒哈拉以南非洲地区与酒精相关的健康和社会问题呈上升趋势。本调查报道了埃塞俄比亚南部索多区农村地区有害饮酒的患病率及相关因素。该调查是多中心研究“改善精神卫生保健计划”(PRIME)的一部分,PRIME是一个由埃塞俄比亚、印度、尼泊尔、南非和乌干达这五个低收入和中等收入国家的研究机构及卫生部与英国机构和世界卫生组织(WHO)合作组成的联盟。
采用多阶段随机抽样法招募了1500名18岁及以上的成年人,进行了一项横断面社区调查。使用快速酒精筛查测试(FAST)收集饮酒数据。采用标准化工具测量潜在的相关因素,包括经过验证改编的凯斯勒10项量表(心理困扰)、威胁性经历清单(不良生活事件数量)。进行探索性多变量逻辑回归分析以研究与有害饮酒相关的因素。
发现有害饮酒的总体患病率为21%;男性为31%,女性为10.4%,P<0.05。与有害饮酒独立相关的因素包括男性(调整后的比值比=4.0,95%置信区间=2.44,6.67)、年龄增长、经历过一次或多次压力性生活事件(对于1 - 2次和3次或更多次不良生活事件,调整后的比值比分别为1.71,95%置信区间=1.18,2.48和2.12,95%置信区间=1.36,3.32)以及严重心理困扰(调整后的比值比=2.96,95%置信区间=1.49,5.89)。发现高社会支持对有害饮酒具有保护作用(调整后的比值比=0.41,95%置信区间=0.23,0.72)。
在这个以农村为主的埃塞俄比亚地区检测到高水平的有害饮酒情况。这一发现表明需要在该地区不同级别的初级保健服务中整合针对有害饮酒的服务,如简短干预。还需要开展减少有害饮酒的公共卫生干预措施。