Onohuean Hope, Oosthuizen Frasia
Biopharmaceutics Unit, Department of Pharmacology and Toxicology, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda.
Discipline of Pharmaceutical Sciences, School of Health Sciences, Westville Campus, University of KwaZulu-Natal, Durban, South Africa.
PLoS One. 2025 Mar 7;20(3):e0317036. doi: 10.1371/journal.pone.0317036. eCollection 2025.
There is an ongoing global upsurge of opioid misuse, fatal overdose and other related disorders, significantly affecting the African continent, due to resource-limited settings and poor epidemiological surveillance systems. This scoping review maps scientific evidence on epidemiological data on unlawful opioid use to identify knowledge gaps and policy shortcomings.
The databases (PubMed, Scopus, Web of Sciences) and references were searched guided by Population, Concept, and Context (PCC) and PRISMA-ScR. The extracted characteristics examined were author/year, African country, epidemiological distribution, age group (year), gender, study design and setting, common opioid/s abused, sources of drugs, reasons for misuse, summary outcomes and future engagement.
A population of 55132 participated in the included studies of 68 articles, with the largest sample size of 17260 (31.31%) in a study done in South Africa, 11281(20.46%) in a study from Egypt and 4068 (7.38%) in a study from Ethiopia. The gender of the participants was indicated in 65(95.59%) papers. The mean and median age reported in 57(83.82%) papers were 15.9-38, and 22-31years. The majority of study-designs were cross-sectional, 44(64.71%), and the most used opioids were heroin, 14articles (20.59%), tramadol, 8articles (11.76%), and tramadol & heroin, 6 articles (8.82%) articles. Study-settings included urban community 15(22.06%), hospital 15(22.06%), university students 11(16.18%), and secondary school learners 6(8.82%). The highest epidemiological distributions were recorded in the South African study, 19615(35.60%), Egyptian study, 14627(26.54%), and Nigerian study 5895(10.70%). Nine (13.24%) papers reported major opioid sources as black market, friends, and drug dealers. To relieve stress, physical pain and premature ejaculation, improve mood and sleep-related problems and help to continue work, were the major reasons for taking these drugs as reported in twenty articles (29.41%).
The findings of this scoping review show significant knowledge gaps on opioid usage in the African continent. The epidemiological distribution of unlawful use of opioids among young adults, drivers, and manual labourers in both genders is evident in the findings. The reason for use necessity scrutinises the role of social interaction, friends and family influence on illicit opiate use. Therefore, there is a need for regular epidemiological surveillance and investigations into multilevel, value-based, comprehensive, and strategic long-term intervention plans to curb the opioid problem in the region.
由于资源有限和流行病学监测系统不完善，全球范围内阿片类药物滥用、致命过量及其他相关疾病呈持续上升趋势，对非洲大陆造成了严重影响。本综述旨在梳理关于非法阿片类药物使用的流行病学数据的科学证据，以识别知识空白和政策缺陷。
以人群、概念和背景（PCC）及PRISMA-ScR为指导，检索数据库（PubMed、Scopus、Web of Sciences）及参考文献。提取的特征包括作者/年份、非洲国家、流行病学分布、年龄组（年份）、性别、研究设计与环境、常用滥用阿片类药物/药物、药物来源、滥用原因、总结结果及未来参与情况。
55132人参与了纳入的68篇文章的研究，其中南非一项研究的样本量最大，为17260人（31.31%），埃及一项研究为11281人（20.46%），埃塞俄比亚一项研究为4068人（7.38%）。65篇（95.59%）论文表明了参与者的性别。57篇（83.82%）论文报告的平均年龄和中位数年龄分别为15.9 - 38岁和22 - 31岁。大多数研究设计为横断面研究，共44项（64.71%），最常用的阿片类药物是海洛因，有14篇文章（20.59%）提及，曲马多有8篇文章（11.76%）提及，曲马多和海洛因有6篇文章（8.82%）提及。研究环境包括城市社区15项（22.06%）、医院15项（22.06%）、大学生11项（16.18%）和中学生6项（8.82%）。流行病学分布最高的是南非的研究，为19615人（35.60%），埃及的研究为14627人（26.54%），尼日利亚的研究为5895人（10.70%）。9篇（13.24%）论文报告主要阿片类药物来源为黑市、朋友和毒贩。二十篇文章（29.41%）报告称，缓解压力、身体疼痛和早泄、改善情绪和睡眠相关问题以及有助于继续工作是使用这些药物的主要原因。
本综述的结果表明非洲大陆在阿片类药物使用方面存在重大知识空白。研究结果显示非法使用阿片类药物在年轻成年人、司机和男女体力劳动者中的流行病学分布明显。使用必要性的原因审视了社会互动、朋友和家庭对非法阿片类药物使用的影响作用。因此，有必要定期进行流行病学监测，并对多层次、基于价值、全面和战略性的长期干预计划进行调查，以遏制该地区的阿片类药物问题。
