51
|
Adeloye D, Olawole-Isaac A, Auta A, Dewan MT, Omoyele C, Ezeigwe N, Jacobs W, Mpazanje RG, Harhay MO, Alemu W, Adewole IF. Epidemiology of harmful use of alcohol in Nigeria: a systematic review and meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:438-450. [DOI: 10.1080/00952990.2019.1628244] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Davies Adeloye
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- RcDavies Evidence-Based Medicine, Lagos, Nigeria
| | | | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | | | | | | | - Wura Jacobs
- Department of Kinesiology, California State University, Stanislaus, Turlock, CA, USA
| | | | - Michael O. Harhay
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | |
Collapse
|
52
|
Applying multivariate analysis to characterize waragi spirits from Acoli, Uganda, by their metal contents. Heliyon 2019; 5:e01417. [PMID: 31008383 PMCID: PMC6454205 DOI: 10.1016/j.heliyon.2019.e01417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/20/2019] [Accepted: 03/21/2019] [Indexed: 11/30/2022] Open
Abstract
Quality control during spirits production and means of authenticating or verifying sources of spirits in the sub-Saharan region of Africa are limited due to lack of resources and the scientific acumen required to develop methodologies for characterizing spirits. However, the increasing needs to protect consumers from negligence, or willful contamination of spirits in this region underscores the urgency with which growth in this area must happen. In this paper, we describe a multivariate statistical framework upon which characterization, identification and authentication of spirits could be developed. The framework exploits the unique chemical fingerprints of spirits with the goal of accomplishing three functions simultaneously: the detection of class differences, the authentication of spirits and the verification of sources. In a test case using the metal contents of 17 Ugandan spirits, this framework shows (i) that a class of unrecorded spirits known locally as Lira-Lira can be singled out from other spirits by their Cu contents, (ii) that localities from where the Lira-Lira spirits were purchased can be resolved to within 8 km by cluster analysis and principal component analysis, (iii) that cluster analysis loadings and scores, placed side-by-side, can pair spirits and their unique discriminating contaminants directly, (iv) that the most important metals for authenticating 13 spirits, source verification and production methods are Al, Sr, Ba, Mn, Zn and Cu (high concentration variability across samples is the qualifying factor), (v) that common sources of contamination can be detected by Pearson correlation analysis (this study finds that Sn/Cd, Pb/Cr, Tl/Cr, Pb/Ni or Cu/Ag as well as the triad Se/As/Ni in the 13 Ugandan spirits are from similar sources), and (vi) that inconsistency in spirits production can be detected with empirical data. Such rudimentary solutions to characterizing spirits have never been offered to the sub-Saharan countries.
Collapse
|
53
|
Pengpid S, Peltzer K. Alcohol use among adults in Kenya: Results from the National Non-Communicable Diseases Risk Factor survey, 2015. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1568728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, Thailand
- Department of Research and Innovation, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Research and Innovation, University of Limpopo, Turfloop, South Africa
- HIV/AIDS/STIs and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa
| |
Collapse
|
54
|
Otim O, Juma T, Otunnu O. Assessing the health risks of consuming 'sachet' alcohol in Acoli, Uganda. PLoS One 2019; 14:e0212938. [PMID: 30811520 PMCID: PMC6392317 DOI: 10.1371/journal.pone.0212938] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
Abstract
The increased mortality rate among the Acoli people of northern Uganda is anecdotally blamed on excessive consumption of cheap and widely available sachet-packaged alcohol in the region. In this paper, we quantify this perceived association by determining statistically the health risks associated with ingesting 20 heavy metals in 17 popular spirits products consumed in Acoli. Thirteen of these products were industrially packaged in sachets (locally known as 'sachet,' waragi, arege or moo lyec) and four were locally produced Lira-Lira spirits from Bolo, Awere and Teso Bar in the region and Nsambya in southern Uganda. A Scottish whisky purchased in San Diego (USA) was our reference. Risk assessment was performed according to standardized protocols developed by the United States Environmental Protection Agency (US EPA). Our results show that a strong correlation indeed exists between health risks and ingestion of spirits in Acoli. At >2.5 sachets/day for 240 day/year over a lifetime for example, the risk of developing cancer due to exposure to As, Pb and Cr alone is 1 in 102,041. This estimate excludes ethanol, a known carcinogen, and 17 heavy metals also studied due to lack of their cancer slope factors. The primary non-cancer related health risk factor in all samples tested is ethanol with unacceptably high health index of four. The Lira-Lira spirits, with 100-6000% copper above the US EPA limit for intake by oral ingestion in water, would be the 'cleanest' without copper and at par with the Scottish whisky. Collectively, we find that no amount of alcohol consumed in Acoli is safe. Preventive measures are therefore recommended to reduce mortality in Acoli in particular, and in Uganda in general. These measures should include public education, better public policies, creating productive economic activities other than brewing alcohol, and social activities that engage people away from drinking.
Collapse
Affiliation(s)
- Ochan Otim
- Department of Humanities and Sciences, University of California-Los Angeles, Los Angeles, California, United States of America.,Environmental Monitoring Division, City of Los Angeles, Playa Del Rey, California, United States of America
| | - Tom Juma
- Environmental Monitoring Division, City of Los Angeles, Playa Del Rey, California, United States of America
| | - Olara Otunnu
- Former Under-Secretary-General of the United Nations, New York, New York, United States of America
| |
Collapse
|
55
|
Breur C, Bloom B, Miller AP, Kigozi G, Nakyanjo N, Ddaaki W, Nalugoda F, Wagman JA. "The Bottle Is My Wife": Exploring Reasons Why Men Drink Alcohol in Ugandan Fishing Communities. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:657-672. [PMID: 31570062 PMCID: PMC6952172 DOI: 10.1080/19371918.2019.1666072] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Fishing communities in Uganda have high rates of excessive alcohol consumption and negative health outcomes related to alcohol consumption, such as HIV acquisition and transmission and intimate partner violence victimization and perpetration. Research lacks understanding of alcohol use in Ugandan fishing communities, underlying reasons for excessive drinking among fishermen or how their community perceives negative health outcomes linked to excessive alcohol consumption. This qualitative study was conducted among Ugandan fisherfolk to determine why excessive alcohol consumption has overtaken their communities. Through analyzing in-depth interviews and focus group discussions, reasons for drinking and community perceptions of drinking were explored using the Socio Ecological Model and the Time Perspective Theory. Interviews were coded into two content themes: social influences on drinking and using alcohol to cope with stress. Participants acknowledged links between excessive alcohol consumption and negative health outcomes within their families and communities. These findings highlight the need for alcohol-related reduction interventions that are sensitive to contextual factors and self-identified contributors to problematic alcohol use within individuals and their communities. Such interventions must consider the social, ecological and economic conditions within fishing sites, focusing not only on individual-level behavioral change but also challenging the underlying structures that foster excessive alcohol consumption.
Collapse
Affiliation(s)
- Celia Breur
- Siku Njema Kesho Community-Based Organization, Nakuru, Kenya
| | - Brittnie Bloom
- University of California San Diego, School of Medicine, Department of Medicine, La Jolla, California
| | - Amanda P Miller
- University of California San Diego, School of Medicine, Department of Medicine, La Jolla, California
| | - Godfrey Kigozi
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Neema Nakyanjo
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - William Ddaaki
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Fred Nalugoda
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Jennifer A. Wagman
- University of California San Diego, School of Medicine, Department of Medicine, La Jolla, California
| |
Collapse
|
56
|
Mootz JJ, Muhanguzi FK, Panko P, Mangen PO, Wainberg ML, Pinsky I, Khoshnood K. Armed conflict, alcohol misuse, decision-making, and intimate partner violence among women in Northeastern Uganda: a population level study. Confl Health 2018; 12:37. [PMID: 30127845 PMCID: PMC6091151 DOI: 10.1186/s13031-018-0173-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 07/20/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Relations among and interactions between exposure to armed conflict, alcohol misuse, low socioeconomic status, gender (in)equitable decision-making, and intimate partner violence (IPV) represent serious global health concerns. Our objective was to determine extent of exposure to these variables and test pathways between these indicators of interest. METHODS We surveyed 605 women aged 13 to 49 who were randomly selected via multistage sampling across three districts in Northeastern Uganda in 2016. We used Mplus 7.4 to estimate a moderated structural equation model of indirect pathways between armed conflict and intimate partner violence for currently partnered women (n = 558) to evaluate the strength of the relationships between the latent factors and determine the goodness-of-fit of the proposed model with the population data. RESULTS Most respondents (88.8%) experienced conflict-related violence. The lifetime/ past 12 month prevalence of experiencing intimate partner violence was 65.3%/ 50.9% (psychological) and 59.9%/ 43.8% (physical). One-third (30.7%) of women's partners reportedly consumed alcohol daily. The relative fit of the structural model was superior (CFI = 0.989; TLI = 0.989). The absolute fit (RMSEA = 0.029) closely matched the population data. The partner and joint decision-making groups significantly differed on the indirect effect through partner alcohol use (a1b1 = 0.209 [0.017: 0.467]). CONCLUSIONS This study demonstrates that male partner alcohol misuse is associated with exposure to armed conflict and intimate partner violence-a relationship moderated by healthcare decision-making. These findings encourage the extension of integrated alcohol misuse and intimate partner violence policy and emergency humanitarian programming to include exposure to armed conflict and gendered decision-making practices.
Collapse
Affiliation(s)
- Jennifer J. Mootz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032 USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Kolb 171, New York, NY 10032 USA
| | | | - Pavel Panko
- Department of Educational Psychology and Leadership, Texas Tech University, 3008 18th Street, Lubbock, TX 79409 USA
| | - Patrick Onyango Mangen
- Transcultural Psychosocial Organization Uganda, Plot 3271 Kansanga off Ggaba Road, P.O.Box 21646, Kampala, Uganda
| | - Milton L. Wainberg
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032 USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Kolb 171, New York, NY 10032 USA
| | - Ilana Pinsky
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032 USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Kolb 171, New York, NY 10032 USA
| | - Kaveh Khoshnood
- School of Public Health, Yale University, 60 College St, New Haven, CT 06510 USA
| |
Collapse
|
57
|
Kuule Y, Dobson AE, Harries AD, Mutahunga B, Stewart AG, Wilkinson E. Screening, Diagnosis, and Management of Patients With Alcohol Use Disorders at Bwindi Community Hospital, Uganda. Front Public Health 2018; 6:148. [PMID: 29881720 PMCID: PMC5978276 DOI: 10.3389/fpubh.2018.00148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/02/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced a program of screening, diagnosis and management of AUD and we assessed how this worked. Methods: This was a cross-sectional study in three departments (out-patients, adult in-patients and sexual & reproductive health) of Bwindi Community Hospital assessing numbers of patients screened, diagnosed and treated with AUD between January 2014 and June 2017. Data sources included the hospital electronic data base and departmental case files. Frequencies and proportions are reported and odds ratios used to compare specific factors associated with medical interventions. Results: Altogether, 82,819 patients attended or were admitted to hospital, of whom 8,627 (10.4%) were screened and 273 (3.2%) diagnosed with AUD. The adult in-patient department recorded the largest number with AUD (n = 206) as well as a consistent increase in numbers in the last 18 months of the study. Of those with AUD, there were 230 (84%) males, 130 (48%) aged 36–60 years, and 131 (48%) with medical non-alcohol related diagnostic categories. Medical/supportive interventions included guidance and counselling to 168 (62%), community social support to 90 (33%), mental health service referrals for 75 (27%), detoxification for 60 (22%) and referral to Alcoholics Anonymous for 41 (15%). There were 36 (15%) patients who received no medical/supportive interventions, with significantly higher proportions in patients with surgical alcohol-related disease and pregnancy-related conditions (P < 0.05). Conclusion: Bwindi Community Hospital has implemented a program for AUD in three departments, with most individuals screened and managed in the adult in-patient department. While a variety of interventions were given to those with AUD, 15% received no intervention and this deficiency must be addressed. Program performance could improve through better screening processes, ensuring that 100% of those with AUD receive a medical/supportive intervention and raising public awareness.
Collapse
Affiliation(s)
- Yusufu Kuule
- Church of Uganda, Bwindi Community Hospital, Kanungu, Uganda
| | - Andrew E Dobson
- Church of Uganda, Bwindi Community Hospital, Kanungu, Uganda
| | - Anthony D Harries
- Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Alex G Stewart
- College of Life and Environmental Science, University of Exeter, Exeter, United Kingdom
| | - Ewan Wilkinson
- The Institute of Medicine, University of Chester, Chester, United Kingdom
| |
Collapse
|
58
|
Ruark A, Kajubi P, Ruteikara S, Green EC, Hearst N. Couple Relationship Functioning as a Source or Mitigator of HIV Risk: Associations Between Relationship Quality and Sexual Risk Behavior in Peri-urban Uganda. AIDS Behav 2018; 22:1273-1287. [PMID: 29090396 DOI: 10.1007/s10461-017-1937-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Despite evidence that a greater focus on couples could strengthen HIV prevention efforts, little health-related research has explored relationship functioning and relationship quality among couples in Africa. Using data from 162 couples (324 individuals) resident in a peri-urban Ugandan community, we assessed actor and partner effects of sexual risk behaviors on relationship quality, using psychometric measures of dyadic adjustment, sexual satisfaction, commitment, intimacy, and communication. For women and men, poor relationship quality was associated with having concurrent sexual partners and suspecting that one's partner had concurrent sexual partners (actor effects). Women's poor relationship quality was also associated with men's sexual risk behaviors (partner effects), although the inverse partner effect was not observed. These findings suggest that relationship quality is linked to HIV risk, particularly through the pathway of concurrent sexual partnerships, and that positive relationship attributes such as sexual satisfaction, intimacy, and constructive communication can help couples to avoid risk.
Collapse
Affiliation(s)
- Allison Ruark
- Department of Medicine, Brown University, Providence, RI, USA.
- , Private Bag 2095, Matieland, 7601, South Africa.
| | - Phoebe Kajubi
- Child Health and Development Centre, College of Health Sciences, School of Medicine, Makerere University, Kampala, Uganda
| | | | - Edward C Green
- Department of Anthropology, The George Washington University, Washington, DC, USA
| | - Norman Hearst
- Department of Family and Community Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
59
|
Vancampfort D, Van Damme T, Probst M, Vandael H, Hallgren M, Mutamba BB, Nabanoba J, Basangwa D, Mugisha J. Motives for physical activity in the adoption and maintenance of physical activity in men with alcohol use disorders. Psychiatry Res 2018; 261:522-526. [PMID: 29395875 DOI: 10.1016/j.psychres.2018.01.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 02/07/2023]
Abstract
Within the self-determination theory and the trans-theoretical model (stages of change) frameworks, we investigated motives for physical activity adoption and maintenance in men with alcohol use disorder (AUD). Fifty Ugandan patients completed the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) to assess exercise motives, the Patient-centred Assessment and Counselling for Exercise (PACE) to determine stage of change and the Alcohol Use Disorders Identification Test. The relationship between motives for physical activity and stage of change was investigated using ANOVA with post-hoc Scheffe tests. Multivariate analyses found significantly higher levels of introjected, identified and integrated motivation in the action and maintenance stage versus the pre-action stage. There were no differences in intrinsic motivation between the stages of change. Our results suggest that in order to adopt and maintain an active lifestyle the most important source of motivation comes from the benefits that may be obtained rather than from the inherent pleasure or challenge associated with it. The study provides a platform for future research to investigate the importance of autonomous motivation within physical activity interventions for people with AUD.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium.
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Michel Probst
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | | | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Justine Nabanoba
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - David Basangwa
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda; Kyambogo University, Kampala, Uganda
| |
Collapse
|
60
|
Kalema D, Vindevogel S, Derluyn I, Baguma PK, Bannink F, Vanderplasschen W. Perspectives of alcohol treatment providers and users on alcohol addiction and its facilitating factors in Uganda and Belgium. DRUGS: EDUCATION, PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1381667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- David Kalema
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- School of Psychology, Makerere University, Kampala, Uganda
| | - Sofie Vindevogel
- Department of Orthopedagogics, University College Ghent, Ghent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | | | - Femke Bannink
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Wouter Vanderplasschen
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
61
|
Takahashi R, Wilunda C, Magutah K, Mwaura-Tenambergen W, Wilunda B, Perngparn U. Correlates of alcohol consumption in rural western Kenya: A cross-sectional study. BMC Psychiatry 2017; 17:175. [PMID: 28486959 PMCID: PMC5424353 DOI: 10.1186/s12888-017-1344-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies on alcohol consumption in rural areas in sub-Saharan Africa are scarce. This study aimed to determine the prevalence and determinants of alcohol consumption in rural western Kenya. The study was conducted as a preliminary stage of a community-based intervention to reduce hazardous alcohol consumption. METHODS A cross-sectional survey of 478 participants aged 18-65 years residing in Ikolomani Sub-county, Kakamega County was conducted in April 2015. Data were collected using an interviewer-administered questionnaire. We defined current drinkers as participants who consumed any alcoholic product in the preceding one month, and hazardous/high-risk drinkers as participants with an Alcohol Use Disorders Identification Test (AUDIT) score of 8 and above. We summarised data using descriptive statistics and used logistic regression to explore for the correlates of each of current alcohol consumption and hazardous/high-risk alcohol consumption. RESULTS The sex-standardized prevalence of current alcohol drinkers was 31.7% (95% confidence interval (CI): 26.8%-37.2%). The prevalence was higher in men (54.6%) than in women (8.9%). The mean AUDIT score among current drinkers was 16.9 (SD 8.2) and the sex-standardized prevalence of hazardous/high-risk alcohol drinking was 28.7% (95% CI: 24.1%-34.0%). Traditional brews were the most commonly consumed types of alcohol and most drinkers took alcohol in the homes of alcohol sellers/brewers. In multivariate analyses, the number of drinkers in the family, the number of friends who are drinkers and the attitude towards alcohol intake were positively associated with current alcohol drinking status, and with hazardous/high-risk alcohol consumption. Women were less likely to be current drinkers and hazardous/high-risk drinkers than were men. Other socio-demographic factors were not significantly associated with alcohol consumption. CONCLUSIONS The prevalence of alcohol consumption in the study area was higher than the national level estimate of 13.3%. The results suggest that the social environment is the main determinant of alcohol consumption in this setting. These findings imply that interventions to mitigate alcohol consumption in this area will have to target the social networks of the alcohol consumers, change the drinkers' attitude towards alcohol, and tackle the issue of availability of unlicensed homemade brews.
Collapse
Affiliation(s)
- Risa Takahashi
- Department of Nursing Science, Faculty of Health Care, Tenri Health Care University, 80-1 Bessho-cho, Tenri City, Nara 632-0018 Japan
- College of Public Health Sciences, Chulalongkorn University, Chulalongkorn soi 62, Phyathai Rd, Bangkok, 10330 Thailand
| | - Calistus Wilunda
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoe-cho, Sakyoku, Kyoto, 606-8501 Japan
| | - Karani Magutah
- Department of Medical Physiology, Moi University, P.O Box 4606-30100, Eldoret, Kenya
| | - Wanja Mwaura-Tenambergen
- Department of Health Systems Management, Kenya Methodist University, P.O. Box 45240-00100, Nairobi, Kenya
| | - Boniface Wilunda
- United Nations Office on Drugs and Crime, Regional Office for Eastern Africa, P.O. Box 30218-00100, Nairobi, Kenya
| | - Usaneya Perngparn
- College of Public Health Sciences, Chulalongkorn University, Chulalongkorn soi 62, Phyathai Rd, Bangkok, 10330 Thailand
| |
Collapse
|
62
|
Wesonga R, Guwatudde D, Bahendeka SK, Mutungi G, Nabugoomu F, Muwonge J. Burden of cumulative risk factors associated with non-communicable diseases among adults in Uganda: evidence from a national baseline survey. Int J Equity Health 2016; 15:195. [PMID: 27905949 PMCID: PMC5133748 DOI: 10.1186/s12939-016-0486-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 11/25/2016] [Indexed: 12/20/2022] Open
Abstract
Background Modification of known risk factors has been the most tested strategy for dealing with non-communicable diseases (NCDs). The cumulative number of NCD risk factors exhibited by an individual depicts a disease burden. However, understanding the risk factors associated with increased NCD burden has been constrained by scarcity of nationally representative data, especially in the developing countries and not well explored in the developed countries as well. Methods Assessment of key risk factors for NCDs using population data drawn from 3987 participants in a nationally representative baseline survey in Uganda was made. Five key risk factors considered for the indicator variable included: high frequency of tobacco smoking, less than five servings of fruit and vegetables per day, low physical activity levels, high body mass index and raised blood pressure. We developed a composite indicator dependent variable with counts of number of risk factors associated with NCDs per participant. A statistical modeling framework was developed and a multinomial logistic regression model was fitted. The endogenous and exogenous predictors of NCD cumulative risk factors were assessed. Results A novel model framework for cumulative number of NCD risk factors was developed. Most respondents, 38 · 6% exhibited one or two NCD risk factors each. Of the total sample, 56 · 4% had at least two risk factors whereas only 5.3% showed no risk factor at all. Body mass index, systolic blood pressure, diastolic blood pressure, consumption of fruit and vegetables, age, region, residence, type of residence and land tenure system were statistically significant predictors of number of NCD risk factors (p < 0 · 05). With exception to diastolic blood pressure, increase in age, body mass index, systolic blood pressure and reduction in daily fruit and vegetable servings were found to significantly increase the relative risks of exhibiting cumulative NCD risk factors. Compared to the urban residence status, the relative risk of living in a rural area significantly increased the risk of having 1 or 2 risk factors by a multiple of 1.55. Conclusions The non-communicable disease burden is on the increase, with more participants reporting to have at least two risk factors. Our findings imply that, besides endogenous factors, exogenous factors such as region, residence status, land tenure system and behavioral characteristics have significant causal effects on the cumulative NCD risk factors. Subsequently, while developing interventions to combat cumulative risk factors of NCDs, the Ministry of Health needs to employ a more holistic approach to facilitate equitable health and sensitization across age, residence and regional divide.
Collapse
Affiliation(s)
- Ronald Wesonga
- School of Statistics and Planning, Makerere University, Kampala, Uganda. .,East African Statistics Institute, Kampala, East Africa, Uganda.
| | - David Guwatudde
- School of Public Health, Makerere University, Kampala, Uganda
| | - Silver K Bahendeka
- Department of Internal Medicine St. Francis Hospital Nsambya, Kampala, Uganda
| | - Gerald Mutungi
- Control of Non-communicable Diseases Desk, Ministry of Health, Kampala, Uganda
| | - Fabian Nabugoomu
- Office of DVC, Kyambogo University, Kampala, Uganda.,East African Statistics Institute, Kampala, East Africa, Uganda
| | - James Muwonge
- Division of Socioeconomic Surveys, Uganda Bureau of Statistics, Kampala, Uganda
| |
Collapse
|