Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, P.O. Box LG 84, Legon, Accra, Ghana.
Department of Psychology, University of the Free State, Bloemfontein, South Africa.
BMC Psychiatry. 2023 Oct 24;23(1):778. doi: 10.1186/s12888-023-05283-w.
Global evidence indicates that early onset of illicit substance use among adolescents and emerging adults is associated with negative mental-health related-outcomes that can persist into adulthood. However, the lack of quality regional data on adolescent illicit substance use and its determinants remains a common barrier to evidence-based policy-making and the development of school-based interventions in Africa. The purpose of our study was to estimate the prevalence and describe the correlates of cannabis and amphetamine use among school-going adolescents in eight sub-Saharan African countries (SSA) - Benin, Ghana, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and Tanzania.
We analysed 15,553 school-going adolescents that participated in the Global School-based Student Health Survey. A two-stage sampling approach was used to generate a nationally representative sample of school children (grades 7-12) in each of these countries. Students responded to a self-administered structured questionnaire that contained information on sociodemographic factors, family involvement factors, mental health factors, school environment factors and past-month cannabis and life-time amphetamine use.
The overall prevalence estimates of past-month cannabis use and lifetime amphetamine use among school-going adolescents in the eight SSA countries was 4.39% (95% CI = 4.08, 4.72) and 3.05% (95% CI = 2.79, 3.34) respectively. In the multivariable logistic regression analysis, demographic characteristics (age and male gender), mental health factors (suicide ideation and attempt), lifestyle factors (cigarette smoking, past-month alcohol use, lifetime drunkenness and leisure-time sedentary behaviour) and school level factors (truancy and bullying victimisation) showed strong associations with increased odds of both past-month cannabis use and lifetime amphetamine use. Social support at school was associated with increased odds for lifetime amphetamine, while parental monitoring decreases the odds for lifetime amphetamine use. It was also observed that parental tobacco use was associated with increased odds of both past-month cannabis use and lifetime amphetamine use.
The relatively low overall prevalence estimates of past-month cannabis use and lifetime amphetamine use among school-going adolescents in not surprising. However, the identified risk and protective factors associated with cannabis and amphetamine use underscores the need for these eight countries in SSA to develop contextual and multi-sectoral intervention and school-based prevention programmes that could target school-going adolescents who may be at risk of misusing these illicit drugs.
全球证据表明，青少年和刚步入成年的人早期开始滥用非法物质与负面的心理健康相关后果有关，这些后果可能会持续到成年。然而，非洲缺乏关于青少年滥用非法物质及其决定因素的高质量区域数据，这仍然是循证决策和制定基于学校的干预措施的常见障碍。我们研究的目的是估计 8 个撒哈拉以南非洲国家（SSA）-贝宁、加纳、利比里亚、毛里求斯、莫桑比克、纳米比亚、塞舌尔和坦桑尼亚-在校青少年中使用大麻和苯丙胺的流行率，并描述其相关因素。
我们分析了参加全球学校学生健康调查的 15553 名在校青少年的数据。使用两阶段抽样方法，在每个国家抽取了具有全国代表性的在校儿童（7-12 年级）样本。学生们回答了一份自我管理的结构化问卷，其中包含社会人口因素、家庭参与因素、心理健康因素、学校环境因素以及过去一个月使用大麻和终身使用苯丙胺的信息。
这 8 个 SSA 国家在校青少年过去一个月使用大麻和终身使用苯丙胺的总体流行率估计分别为 4.39%（95%CI=4.08，4.72）和 3.05%（95%CI=2.79，3.34）。在多变量逻辑回归分析中，人口统计学特征（年龄和性别）、心理健康因素（自杀意念和自杀企图）、生活方式因素（吸烟、过去一个月饮酒、终身醉酒和闲暇时间久坐行为）和学校水平因素（逃学和受欺凌）与过去一个月使用大麻和终身使用苯丙胺的几率增加均有很强的关联。学校的社会支持与终身使用苯丙胺的几率增加有关，而父母的监督则降低了终身使用苯丙胺的几率。还观察到，父母的烟草使用与过去一个月使用大麻和终身使用苯丙胺的几率增加有关。
在校青少年过去一个月使用大麻和终身使用苯丙胺的总体流行率相对较低并不令人惊讶。然而，与大麻和苯丙胺使用相关的已确定的风险和保护因素强调了这 8 个 SSA 国家需要制定针对可能滥用这些非法药物的在校青少年的情境和多部门干预和基于学校的预防方案。
