Nalwadda Oliva, Rathod Sujit D, Nakku Juliet, Lund Crick, Prince Martin, Kigozi Fred
1Butabika National Referral Mental Hospital, P.O Box 7017, Kampala, Uganda.
2London School of Hygiene and Tropical Medicine, London, UK.
Int J Ment Health Syst. 2018 Apr 3;12:12. doi: 10.1186/s13033-018-0191-5. eCollection 2018.
Uganda has one of the highest per capita alcohol consumption rates in sub-Saharan Africa. However, the prevalence of alcohol use disorders (AUD) remains unknown in many areas, especially in rural districts. This study aimed to estimate the prevalence of alcohol consumption and of alcohol use disorder among men, and to describe the distribution of drinking intensity, among men in in Kamuli District, Uganda.
Men attending primary care clinics in Kamuli District were consecutively interviewed in a facility-based cross-sectional study, and a separate group of men were interviewed in a population-based cross-sectional study. In both studies the men were administered a structured questionnaire, which included the alcohol use disorder identification test (AUDIT) to screen for AUD, as well as sections about demographic characteristics, depression screening, internalized stigma for alcohol problems and treatment-seeking.
Among the 351 men enrolled in the Community study, 21.8% consumed alcohol in the past 12 months, compared to 39.6% of 778 men in the Facility Survey. The proportion of men who screened positive for AUD was 4.1% in the community study and 5.8% in the facility study. AUDIT scores were higher among older men, men with paid/self-employment status and higher PHQ-9 score (P < 0.05). Nearly half (47.5%) of the men with AUDIT-positive scores reported that alcohol use problems had ruined their lives. A majority (55.0%) of men with AUDIT-positive scores did not seek treatment because they did not think AUD was a problem that could be treated.
Internalized stigma beliefs among AUDIT-positive men impede treatment-seeking. As part of any efforts to increase detection and treatment services for alcohol use problems, routine screening and brief interventions for internalized stigma must be incorporated within the normal clinical routine of primary health care.
乌干达是撒哈拉以南非洲人均酒精消费量最高的国家之一。然而，许多地区，尤其是农村地区，酒精使用障碍（AUD）的患病率仍然未知。本研究旨在估计乌干达卡穆利区男性的酒精消费和酒精使用障碍患病率，并描述饮酒强度分布情况。
在一项基于机构的横断面研究中，对卡穆利区初级保健诊所的男性进行连续访谈，在另一项基于人群的横断面研究中，对另一组男性进行访谈。在两项研究中，均对男性进行结构化问卷调查，其中包括酒精使用障碍识别测试（AUDIT）以筛查AUD，以及关于人口统计学特征、抑郁筛查、酒精问题内化耻辱感和寻求治疗的部分。
在社区研究纳入的351名男性中，21.8%在过去12个月内饮酒，而在机构调查的778名男性中这一比例为39.6%。社区研究中AUD筛查呈阳性的男性比例为4.1%，机构研究中为5.8%。年龄较大的男性、有带薪/自营职业身份的男性以及PHQ-9得分较高的男性AUDIT得分更高（P<0.05）。AUDIT得分呈阳性的男性中，近一半（47.5%）报告酒精使用问题毁了他们的生活。AUDIT得分呈阳性的男性中，大多数（55.0%）没有寻求治疗，因为他们认为AUD不是一个可以治疗的问题。
AUDIT得分呈阳性的男性中的内化耻辱感信念阻碍了他们寻求治疗。作为增加酒精使用问题检测和治疗服务的任何努力的一部分，必须将针对内化耻辱感的常规筛查和简短干预纳入初级卫生保健的正常临床常规中。
