Bajunirwe F, Maling S, Adami H-O, Ajayi I O, Volmink J, Adebamowo C, Laurence C, Reid T, Nankya-Mutyoba J, Chiwanga F S, Dalal S, Njelekela M, Guwatudde D, Holmes M D
Department of Community Health, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
Department of Psychiatry, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
Glob Ment Health (Camb). 2018 Oct 2;5:e31. doi: 10.1017/gmh.2018.22. eCollection 2018.
In sub-Saharan Africa, there are limited data on burden of non-alcohol substance abuse (NAS) and depressive symptoms (DS), yet potential risk factors such as alcohol and intimate partner violence (IPV) are common and NAS abuse may be the rise. The aim of this study was to measure the burden of DS and NAS abuse, and determine whether alcohol use and IPV are associated with DS and/or NAS abuse. We conducted a cross-sectional study at five sites in four countries: Nigeria (nurses), South Africa (teachers), Tanzania (teachers) and two sites in Uganda (rural and peri-urban residents). Participants were selected by simple random sampling from a sampling frame at each of the study sites. We used a standardized tool to collect data on demographics, alcohol use and NAS use, IPV and DS and calculated prevalence ratios (PR). We enrolled 1415 respondents and of these 34.6% were male. DS occurred among 383 (32.3%) and NAS use among 52 (4.3%). In the multivariable analysis, being female (PR = 1.49, = 0.008), NAS abuse (PR = 2.06, = 0.02) and IPV (PR = 2.93, < 0.001) were significantly associated with DS. Older age [odds ratio (OR) = 0.31, < 0.001)], female (OR = 0.48, = 0.036) were protective of NAS but current smokers (OR = 2.98, < 0.001) and those reporting IPV (OR = 2.16, = 0.024) were more likely to use NAS. Longitudinal studies should be done to establish temporal relationships with these risk factors to provide basis for interventions.
在撒哈拉以南非洲地区，关于非酒精物质滥用（NAS）和抑郁症状（DS）负担的数据有限，但诸如酒精和亲密伴侣暴力（IPV）等潜在风险因素很常见，且NAS滥用情况可能正在增加。本研究的目的是衡量DS和NAS滥用的负担，并确定饮酒和IPV是否与DS和/或NAS滥用相关。我们在四个国家的五个地点开展了一项横断面研究：尼日利亚（护士）、南非（教师）、坦桑尼亚（教师）以及乌干达的两个地点（农村和城市周边居民）。通过简单随机抽样从每个研究地点的抽样框架中选取参与者。我们使用标准化工具收集有关人口统计学、饮酒和NAS使用情况、IPV和DS的数据，并计算患病率比（PR）。我们招募了1415名受访者，其中34.6%为男性。383人（32.3%）出现DS，52人（4.3%）存在NAS使用情况。在多变量分析中，女性（PR = 1.49， = 0.008）、NAS滥用（PR = 2.06， = 0.02）和IPV（PR = 2.93， < 0.001）与DS显著相关。年龄较大[比值比（OR） = 0.31， < 0.001]、女性（OR = 0.48， = 0.036）对NAS有保护作用，但当前吸烟者（OR = 2.98， < 0.001）和报告遭受IPV者（OR = 2.16， = 0.024）更有可能使用NAS。应开展纵向研究以确定与这些风险因素的时间关系，为干预措施提供依据。
