Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda.
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BMC Public Health. 2024 Jan 29;24(1):314. doi: 10.1186/s12889-024-17732-6.
Globally, there is a concerning surge in the prevalence of substance use among adolescents and children, creating a substantial public health problem. Despite the magnitude of this issue, accessing healthcare explicitly for substance use remains challenging, even though many substance users frequently visit healthcare institutions for other health-related issues. To address this gap, proactive screening for substance use disorders has emerged as a critical strategy for identifying and engaging patients at risk of substance use. The purpose of this study was to investigate the prevalence of probable alcohol and other substance use disorders, and associated factors, among children aged 6 to 17 years old attending health facilities in Mbale, Uganda.
We conducted a health facility cross-sectional study, involving 854 children aged 6-17 years. The prevalence of probable alcohol and other substance use disorders was assessed using a validated Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) screening tool. Univariable and multivariable modified Poisson regression analyses were performed using STATA 15 software.
The overall prevalence of probable alcohol use disorders (AUD) and other substance use disorders (SUD) was 27.8% (95% CI 1.24-1.31) while that of probable AUD alone was 25.3% (95% CI 1.22-1.28). Peer substance use (APR = 1.24, 95% CI 1.10-1.32), sibling substance use (APR = 1.14, 95% CI 1.06-1.23), catholic caregiver religion (APR = 1.07 95% CI 1.01-1.13), caregiver income of more than $128 (APR = 0.90, 95% CI 0.82-0.98), having no parental reprimand for substance use (APR = 1.05, 95% CI 1.01-1.10) and having no knowledge of how to decline an offer to use substances (APR = 1.06, 95% CI 1.01-1.12) were found to be significantly associated with probable AUD/SUD.
Our findings suggest a high prevalence of probable AUD and SUD among children and adolescents visiting healthcare facilities for other conditions, along with a strong link between AUD and SUD prevalence and social factors. The implication for our healthcare system is to actively screen for and treat these conditions at primary healthcare facilities.
在全球范围内，青少年和儿童的物质使用流行率令人担忧，这构成了一个重大的公共卫生问题。尽管这一问题的规模很大，但专门为物质使用寻求医疗保健仍然具有挑战性，尽管许多物质使用者经常因其他与健康相关的问题而前往医疗机构。为了解决这一差距，主动筛查物质使用障碍已成为识别和接触有物质使用风险的患者的关键策略。本研究旨在调查乌干达姆巴莱卫生设施就诊的 6 至 17 岁儿童中，可能的酒精和其他物质使用障碍的流行率以及相关因素。
我们进行了一项卫生设施横断面研究，涉及 854 名 6-17 岁的儿童。使用经过验证的 Car、Relax、Alone、Forget、Friends、Trouble (CRAFFT) 筛查工具评估可能的酒精和其他物质使用障碍的流行率。使用 STATA 15 软件进行单变量和多变量修正泊松回归分析。
总体上，可能的酒精使用障碍（AUD）和其他物质使用障碍（SUD）的流行率为 27.8%（95%CI 1.24-1.31），而单独的可能 AUD 流行率为 25.3%（95%CI 1.22-1.28）。同伴物质使用（APR=1.24，95%CI 1.10-1.32）、兄弟姐妹物质使用（APR=1.14，95%CI 1.06-1.23）、天主教照顾者宗教（APR=1.07，95%CI 1.01-1.13）、照顾者收入超过 128 美元（APR=0.90，95%CI 0.82-0.98）、没有父母因物质使用而责备（APR=1.05，95%CI 1.01-1.10）以及不知道如何拒绝提供使用物质的机会（APR=1.06，95%CI 1.01-1.12）与可能的 AUD/SUD 显著相关。
我们的研究结果表明，在因其他疾病就诊的儿童和青少年中，可能的 AUD 和 SUD 发生率很高，并且 AUD 和 SUD 流行率与社会因素之间存在很强的联系。这对我们的医疗保健系统意味着要在初级保健设施中积极筛查和治疗这些疾病。
