Emmanuel Godwin Omokhagbo, Akinsolu Folahanmi Tomiwa, Abodunrin Olunike Rebecca, Ezechi Oliver Chukwujekwu
Mozuk Future Solutions, Nigeria.
Center for Reproduction and Population Health Studies, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.
PLOS Glob Public Health. 2024 Dec 31;4(12):e0004019. doi: 10.1371/journal.pgph.0004019. eCollection 2024.
Substance use is a growing public health concern in West Africa, contributing to significant morbidity, mortality, and socioeconomic challenges. Despite the increasing prevalence, comprehensive data on the patterns and factors influencing substance use in the region remain limited. This systematic review and meta-analysis aim to synthesize existing research on the prevalence and patterns of substance use in West Africa, providing critical insights for developing targeted interventions and policies.
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. A systematic search was performed across four major databases [PubMed, Web of Science, CINAHL, and Scopus] from January 2000 to June 2024. A total of 22 studies involving 43,145 participants met the inclusion criteria. Multiple reviewers performed data extraction and quality assessment independently, and a random-effects meta-analysis was used to estimate the pooled prevalence of various substances. Sensitivity analysis was conducted using a leave-one-out approach to evaluate the influence of individual studies on the overall prevalence.
The meta-analysis revealed the pooled prevalence rates of alcohol [44%], cannabis [6%], tramadol [30%], codeine [11%], and kolanut [39%]. The analysis identified high heterogeneity across studies [I2 = 98-99%], reflecting diverse substance use patterns and influencing factors, including peer influence, availability of substances, socioeconomic conditions, and demographic characteristics. Sensitivity analysis indicated that no single study significantly impacted the overall prevalence estimates, confirming the robustness of the findings.
Substance use in West Africa is widespread and influenced by complex factors. The high prevalence of alcohol and tramadol use highlights the urgent need for targeted public health interventions, including stricter regulatory frameworks, community-based prevention programs, and comprehensive public education campaigns. This study provides a critical foundation for developing effective strategies to mitigate the escalating substance use crisis in the region.
物质使用在西非已成为一个日益严重的公共卫生问题，导致了大量的发病、死亡以及社会经济挑战。尽管其患病率不断上升，但关于该地区物质使用模式及影响因素的全面数据仍然有限。本系统评价和荟萃分析旨在综合现有的关于西非物质使用患病率和模式的研究，为制定有针对性的干预措施和政策提供关键见解。
本研究遵循系统评价和荟萃分析的首选报告项目[PRISMA]指南。从2000年1月至2024年6月，在四个主要数据库[PubMed、科学网、护理学与健康领域数据库（CINAHL）和Scopus]中进行了系统检索。共有22项涉及43145名参与者的研究符合纳入标准。多名评审员独立进行数据提取和质量评估，并采用随机效应荟萃分析来估计各种物质的合并患病率。使用逐一剔除法进行敏感性分析，以评估个别研究对总体患病率的影响。
荟萃分析显示酒精的合并患病率为44%，大麻为6%，曲马多为30%，可待因为11%，可乐果为39%。分析发现各研究之间存在高度异质性（I² = 98 - 99%），反映出不同的物质使用模式和影响因素，包括同伴影响、物质可得性、社会经济状况和人口特征。敏感性分析表明，没有一项研究对总体患病率估计有显著影响，证实了研究结果的稳健性。
西非的物质使用很普遍且受到复杂因素的影响。酒精和曲马多的高使用率凸显了针对性公共卫生干预措施的迫切需求，包括更严格的监管框架、基于社区的预防项目以及全面的公众教育活动。本研究为制定有效策略以缓解该地区不断升级的物质使用危机提供了关键基础。
