Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Subst Abuse Treat Prev Policy. 2022 Jul 6;17(1):50. doi: 10.1186/s13011-022-00479-x.
The study aimed to identify the missed opportunity for detection and management of alcohol use disorder by primary health care workers.
A cross-sectional survey SETTING: Outpatient services in the six governmental primary health care facilities in Moshi district council in Tanzania.
A total of 1604 adults were screened for alcohol use disorder (AUD) using the Alcohol Use Disorder Identification Test (AUDIT). Participants scoring 8 or above then provided details about their help-seeking behavior and barriers to seeking care. Participants' records were reviewed to assess the screening and management of AUD.
In the last 12 months, 60.7% reported alcohol use, and heavy episodic drinking (HED) was reported by 37.3%. AUD (AUDIT ≥ 8) was present in 23.9%. Males were more likely to have HED (aPR = 1.43;95% CI:1.3 to 1.4) or AUD (aPR = 2.9; 95% CI 1.9 to 4.2). Both HED and AUD increased with age. Only one participant (0.3%) had documented AUD screening and management. Only 5% of participants screening positive for AUD had sought help. Reasons for not seeking care were thinking that the problem would get better by itself (55.0%), wanting to handle the problem alone (42.0%), or not being bothered by the problem (40.0%).
While reported alcohol use, HED, and AUD are common among patients presenting to primary healthcare facilities in northern Tanzania, help-seeking behavior and detection are very low. Not screening for AUD in primary health care is a missed opportunity for early detection and management. There is an urgent need to develop interventions to increase the detection of AUD by health care providers, while also addressing help-seeking behavior and barriers to seeking care.
本研究旨在确定初级保健工作者在发现和管理酒精使用障碍方面的错失机会。
横断面调查
坦桑尼亚莫希区议会的六家政府初级保健设施的门诊服务。
共对 1604 名成年人进行了酒精使用障碍（AUD）筛查，使用酒精使用障碍识别测试（AUDIT）。得分 8 分或以上的参与者则提供了有关其寻求帮助的行为和寻求护理障碍的详细信息。对参与者的记录进行了审查，以评估 AUD 的筛查和管理情况。
在过去的 12 个月中，60.7%的人报告饮酒，37.3%的人报告重度间歇性饮酒（HED）。AUD（AUDIT≥8）的发生率为 23.9%。男性更有可能出现 HED（aPR=1.43；95%CI：1.3 至 1.4）或 AUD（aPR=2.9；95%CI 1.9 至 4.2）。HED 和 AUD 均随年龄增长而增加。只有一名参与者（0.3%）有记录的 AUD 筛查和管理。只有 5%的 AUD 筛查阳性的参与者寻求了帮助。不寻求治疗的原因包括认为问题会自行好转（55.0%）、希望独自处理问题（42.0%）或对问题不感到困扰（40.0%）。
尽管在坦桑尼亚北部的初级保健设施就诊的患者中报告的酒精使用、HED 和 AUD 很常见，但寻求帮助的行为和检测率却很低。在初级保健中不筛查 AUD 是早期发现和管理的错失机会。迫切需要制定干预措施，以提高医疗保健提供者对 AUD 的检测率，同时解决寻求帮助的行为和寻求护理的障碍。
