Mwita Winfrida C, Keating Elizabeth M, Philemon Rune Nathaniel, Moshi Baraka, Andongolile Alice, Muro Florida J, Mmbaga Blandina T, Nickenig Vissoci João Ricardo, Msuya Sia E, Staton Catherine A
School of Public Health, Department of Epidemiology and Applied Biostatistics, KCMC University, Moshi, Tanzania.
Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
medRxiv. 2025 Jun 11:2025.06.10.25329384. doi: 10.1101/2025.06.10.25329384.
Alcohol use is a major risk factor for injuries, which are the leading cause of significant morbidity and mortality among young people in sub-Saharan Africa (SSA). In Tanzania, high rates of alcohol use disorders (AUD) and heavy episodic drinking have been documented. However, limited studies have examined age differences in alcohol use and related harm among injury patients. Understanding these differences is essential for designing targeted interventions, particularly for populations at heightened risk.
We conducted a cross-sectional analysis using linked data from the Kilimanjaro Christian Medical Centre (KCMC) Trauma Registry and the Pragmatic Randomized Adaptive Clinical Trial (PRACT). The sample included injured patients aged ≥18 years presenting within 24 hours of injury. Alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT), and alcohol-related consequences were measured using the Drinker Inventory of Consequences (DrInC). We compared prevalence of alcohol use disorder, risk levels, and consequences between young people (18-24 years) and adults (≥25 years) using descriptive statistics and age-stratified analyses.
Of the 2,427 injury patients included, young people (18-24 years) had a mean age of 21.5 (SD 1.9), and adults (25+ years) had a mean age of 41.7 (SD 14.3). Of these, 46.5% of young people and 59.4% of adults reported being current drinkers. A higher proportion of adults had consumed alcohol in the past four weeks (28.7%) and within six hours before injury (21.3%) compared to young people (18.9% and 1.4%, respectively). Drinking frequency differed significantly, with adults more likely to drink four or more times per week than young people (14.1% vs. 5.8%, < 0.001). Young people were significantly more likely to report that they or someone else had been injured as a result of their drinking within the past year (14.0% vs. 9.4%, = 0.026). The majority of participants experienced alcohol-related consequences, with young people reporting significantly higher physical consequences (85.7%) than adults (73.5%) ( = 0.010). Despite these differences, the prevalence of alcohol use disorder (AUD) was comparable between the two groups (37.2% in young people vs. 39.6% in adults; = 0.524).
Although adults reported more frequent alcohol consumption, young people experienced higher occurrences of alcohol-related harms, including a higher frequency of reporting that they or someone else had been injured due to their drinking, as well as having physical consequences. Despite these differences, both groups exhibited a comparable burden of problematic drinking, as measured by screening positive for AUD on the AUDIT. These findings highlight the need for age-specific interventions: for young people, strategies should target episodic, high-risk drinking behaviors associated with acute harms such as injury, while for adults, interventions may focus on habitual patterns of alcohol use.
饮酒是受伤的主要风险因素，而受伤是撒哈拉以南非洲（SSA）年轻人严重发病和死亡的主要原因。在坦桑尼亚，已记录到高比例的酒精使用障碍（AUD）和大量饮酒情况。然而，针对受伤患者中饮酒及相关危害的年龄差异进行的研究有限。了解这些差异对于设计有针对性的干预措施至关重要，特别是针对高风险人群。
我们使用乞力马扎罗基督教医疗中心（KCMC）创伤登记处和实用随机适应性临床试验（PRACT）的关联数据进行了横断面分析。样本包括受伤后24小时内就诊的≥18岁受伤患者。使用酒精使用障碍识别测试（AUDIT）评估饮酒情况，并使用饮酒后果清单（DrInC）测量与酒精相关的后果。我们使用描述性统计和年龄分层分析比较了年轻人（18 - 24岁）和成年人（≥25岁）之间酒精使用障碍的患病率、风险水平和后果。
在纳入的2427名受伤患者中，年轻人（18 - 24岁）的平均年龄为21.5岁（标准差1.9），成年人（25岁及以上）的平均年龄为41.7岁（标准差14.3）。其中，46.5%的年轻人和59.4%的成年人报告目前饮酒。与年轻人相比（分别为18.9%和1.4%），更高比例的成年人在过去四周内饮酒（28.7%）以及在受伤前六小时内饮酒（21.3%）。饮酒频率差异显著，成年人比年轻人更有可能每周饮酒四次或更多次（14.1%对5.8%，<0.001）。年轻人更有可能报告在过去一年中他们自己或他人因饮酒而受伤（14.0%对9.4%，=0.026）。大多数参与者经历了与酒精相关的后果，年轻人报告的身体后果（85.7%）显著高于成年人（73.5%）（=0.010）。尽管存在这些差异，但两组之间酒精使用障碍（AUD）的患病率相当（年轻人为37.2%，成年人 为39.6%；=0.524）。
尽管成年人报告饮酒频率更高，但年轻人经历的与酒精相关的危害发生率更高，包括更频繁地报告他们自己或他人因饮酒而受伤以及身体后果。尽管存在这些差异，但通过AUDIT筛查AUD呈阳性来衡量，两组都表现出相当的饮酒问题负担。这些发现凸显了针对不同年龄进行干预的必要性：对于年轻人，策略应针对与诸如受伤等急性危害相关的偶尔的高风险饮酒行为，而对于成年人，干预措施可能侧重于饮酒的习惯模式。
