Division of Emergency Medicine, Duke University Medical Center, Box 3096, 2301 Erwin Road, Durham, North Carolina, USA.
Duke Global Health Institute, Duke University, Box 3096, 2301 Erwin Road, Durham, North Carolina, USA.
BMC Public Health. 2018 Feb 21;18(1):275. doi: 10.1186/s12889-018-5144-z.
Globally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death and disability. This project aimed to determine the proportion of injuries related to alcohol and the increased risk of injury due to alcohol among injury patients seeking care at the emergency department (ED) of Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania.
A representative cross-sectional sample of adult patients presenting to the KCMC ED with acute injury were enrolled in this study with a nested case-crossover design. Patient demographics, injury characteristics, and severity as well as alcohol use behaviors were collected. Alcohol breathalyzers were administered to the enrolled patients. Data on activities and alcohol use were collected for the time period 6 h prior to injury and two control periods: 24-30 h prior to injury and 1 week prior to injury.
During 47 weeks of data collection, 24,070 patients were screened, of which 2164 suffered injuries, and 516 met the inclusion and exclusion criteria, consented to participate, and had complete data. Of the study participants, 76% were male, and 30% tested positive for alcohol on arrival to the ED. Alcohol use was associated with being male and being employed. Alcohol use was associated with an increased risk of injury (OR 5.71; 95% CI 3.84-8.50), and specifically road traffic injuries were associated with the highest odds of injury with alcohol use (OR 6.53, 95% CI 3.98-10.71). For all injuries and road traffic injuries specifically, we found an increase in the odds of injury with an incremental increase in the dose of alcohol.
At KCMC in Moshi, Tanzania, 3 of 10 injury patients tested positive for alcohol on presentation for care. Similarly, alcohol use conveys an increased risk for injury in this setting. Evidence-based prevention strategies for alcohol-related injuries need to be implemented to reduce alcohol misuse and alcohol-related injuries.
在全球范围内，酒精每年导致 330 万人死亡，占全球疾病总负担的 5.9%。在撒哈拉以南非洲，酒精是可避免的首要风险因素，导致了大量的死亡和残疾。本项目旨在确定与酒精相关的伤害比例以及在坦桑尼亚莫希的基督复临安息日会基利马尼基督教医学中心（KCMC）急诊科就诊的伤害患者因酒精而受伤的风险增加。
采用嵌套病例对照设计，对 KCMC 急诊科因急性损伤就诊的成年患者进行了有代表性的横断面样本采集。收集了患者的人口统计学特征、损伤特征和严重程度以及酒精使用行为。对入组患者进行了酒精呼气测试。收集了受伤前 6 小时以及两个对照期（受伤前 24-30 小时和 1 周前）的活动和酒精使用数据。
在 47 周的数据收集期间，对 24070 名患者进行了筛查，其中 2164 名患者受伤，516 名患者符合纳入和排除标准、同意参与并完成了完整的数据。在研究参与者中，76%为男性，30%在到达急诊科时酒精检测呈阳性。酒精使用与男性和就业有关。酒精使用与受伤风险增加有关（OR 5.71；95%CI 3.84-8.50），特别是与道路交通伤害相关的酒精使用与受伤的最高几率相关（OR 6.53，95%CI 3.98-10.71）。对于所有伤害和道路交通伤害，我们发现随着酒精剂量的增加，受伤的几率也随之增加。
在坦桑尼亚莫希的 KCMC，10 名受伤患者中有 3 名在就诊时检测出酒精呈阳性。同样，在这种情况下，酒精使用也会增加受伤的风险。需要实施基于证据的预防策略来减少酒精滥用和与酒精相关的伤害。
