Consumption and impacts of local brewed alcohol (akpeteshie) in the Upper West Region of Ghana: a public health tragedy

Alcohol misuse as a social determinant of food insecurity among smallholder farmers

The availability and affordability of alcohol in smallholder communities have surged the misuse of alcohol. Misusing alcohol has dire health and nutrition consequences in smallholder communities. Alcohol misuse can divert household resources from essential household needs such as food and also hinder local food production. In the context of multiple stressors on smallholder farmers' livelihoods, it is crucial to assess the relationship between alcohol consumption and smallholder farmers' experience of hunger. Therefore, we used data from a cross-sectional survey involving 1100 smallholder farmers in the Upper West region of Ghana to examine the association between alcohol consumption and household food insecurity. Results showed that daily (OR = 3.81; p ≤ 0.001) and weekly/frequent (OR = 2.32; p ≤ 0.001) consumption of alcohol was significantly associated with higher odds of household food insecurity compared to no consumption. The relationship between alcohol and food insecurity was bidirectional. The experience of food insecurity was also significantly associated with higher odds of occasional or frequent alcohol consumption. While alcohol misuse can transition smallholder households into food insecurity, the household heads of food insecure households may resort to alcohol to cope with underlying stressors such as climate change and food insecurity. This calls for policy interventions to mitigate alcohol misuse through regulations, surveillance, economic disincentives and improving the social mechanisms of resilience to climate change and food insecurity in smallholder communities. However, policy approaches must be cautious not to disrupt the livelihoods of vulnerable smallholder farmers.

Community perceptions of gendered alcohol misuse in a food insecure context: The case of northwestern Benin

In many sub-Saharan African countries there have been concerns about the varied effects of increasing rates of alcohol consumption and misuse. These concerns have led to the need for research on the relationship between alcohol misuse and food insecurity in agrarian contexts where alcohol consumption is rising. We present the findings of a qualitative study involving in-depth interviews and focus groups with men and women, which explores the connection between alcohol misuse and food insecurity in the Atacora region of Benin. Our findings show that farmers are misusing alcohol as a response to hunger and distress resulting from persistent food insecurity. These drinking behaviours are gendered and shaped by the rigid division of labour roles, wherein primarily men are misusing alcohol. The misuse of alcohol subsequently undermines farm labour and diverts household resources, further worsening food insecurity. Importantly, women reported that alcohol misuse as a coping response to food insecurity contributes to intimate partner violence. Given this complex cyclical relationship, food relief policy-makers in Benin must consider the intersection of alcohol misuse and intimate partner violence when implementing policy and programs intended to improve food security.

Prevalence of Substance Use in University Students, Ethiopia

BACKGROUND

Although substance use is a known public health problem and a pressing issue in Ethiopia, its real extent and magnitude are not yet properly explored. The current study aimed to determine the extent and predictors of substance use among regular undergraduate students in the Institute of Technology, Addis Ababa University.

METHODS

An institution-based cross-sectional study was carried among 794 undergraduate regular students at the Institute of Technology, Addis Ababa University, using a self-administered structured questionnaire filled by study participants. Data entry, cleaning, and coding were performed by EPI-INFO version 3.5.1. Statistical Package for Social Sciences; AOR: Adjusted odds ratio (SPSS) SPSS version 21 software was used to analyze data by performing descriptive statistics, bivariate, and multivariate analysis.

RESULTS

73.7% of the study participants used substances at least once. The lifetime use of each substance includes alcohol (68.2%), khat (53.6%), cigarettes (46.1%), and illicit drugs (23.3%). Loss of family (AOR [95%CI], 34.50 [7.569, 157.263]), pocket money between 500 and 999 Ethiopian birr (AOR [95%CI], 9.978 [1.240, 80.280]), and above 1000 Ethiopian birr (AOR [95%CI], 10.831 [1.333, 87.971]) were identified predictors for khat use. The odds of lifetime alcohol use was higher among students coming from a divorced family (AOR [95%CI], 9.346 [3.162, 27.625]), lost one (AOR [95%CI], 37.406 [11.375, 123.008]), or both of their parents (AOR [95%CI], 18.750 [5.798, 60.633]). Students of urban origin (AOR [95%CI], 3.214 [1.950, 5.296]), and students with anxiety symptoms (AOR [95%CI], 2.655 [1.981, 3.557]) have a higher odds of lifetime cigarette smoking. The lifetime exposure to illicit drugs is higher among students in age groups between 20 and 24 years (AOR [95%CI], 5.963 [1.361, 26.135]), students coming from substance user family (AOR [95%CI], 2.172 [1.161, 4.063]), and students of urban origin (AOR [95%CI], 2.661 [1.202, 5.889]).

CONCLUSION

A higher prevalence of substance use requiring administrative and educational interventions was observed. Awareness creation interventions on the potential impacts of substance abuse should be performed.

Alcohol consumption and fruits and vegetable intake among older adults in Ghana: a cross-sectional survey based on WHO-SAGE Wave 2 data

BACKGROUND

Alcohol consumption and inadequate fruits and vegetable (FnV) intake are major reasons for the shift from communicable to non-communicable diseases (NCDs) over the years. The older Ghanaian adult is at high risk of NCD and data on alcohol and FnV consumption are required to guide policy to mitigate its effect. This analysis aimed to determine the factors associated with alcohol consumption and assess the relationship between alcohol consumption and FnV intake among Ghanaians aged 50 years and older.

METHODS

This analysis used WHO Study on Global Ageing and Adult Health (SAGE) Wave 2, Ghana data set conducted between 2014 and 2015. Data on demographic characteristics, FnV intake, and alcohol consumption were collated and analysed. Multivariable Poisson, logistic and probit regression analyses were performed to assess the associations between alcohol consumption and inadequate FnV intake.

RESULTS

A total of 3533 Ghanaians aged 50 years and older, 41.0% men and 59.0% women, were included in this study. The prevalence of lifetime alcohol consumption was 22.8% (95% CI 20.7% to 25.1%). Alcohol consumption was significantly associated with sex, age group, marital status, religion, place of residence and history of smoking. The prevalence of adequate FnV intake was 52.6% with a mean daily intake of 6.45 servings: 2.98 for fruits and 3.47 for vegetables. There was a significant positive correlation between inadequate FnV intake and alcohol consumption. Inadequate FnV consumption was significantly higher among lifetime alcohol consumers compared with non-alcohol consumers. (Poisson estimate; adjusted Prevalence Ratio (aPR) (95% CI)=1.35 (1.12 to 1.63), logistic estimate; adjusted Old Ratio (aOR) (95% CI)=1.13 (1.05 to 1.21) and probit estimate; adjusted normalized coefficient (aβ) (95% CI)=0.19 (0.07 to 0.31)).

CONCLUSION

About a quarter and nearly half of older Ghanaian adults consume alcohol and inadequate FnV, respectively. Alcohol consumption is significantly associated with inadequate FnV intake. Interventions to address inadequate FnV intake among older adults in Ghana should also include policies that regulate the use of alcohol in this population.

Sociodemographic Correlates of Alcohol Abuse in Kassena-Nankana Municipality, Ghana

The main aim of the study was to assess the level of alcohol abuse and related factors in Kassena-Nankana Municipal of Ghana. The study was conducted using a cross-sectional survey with 397 participants, using AUDIT to assess alcohol use. Data entry and analysis was done using SPSS. Bivariate analysis was done using chi-square and multivariate analysis was done using the multinomial logistics regression model. Lifetime alcohol use among the study participants was 96.0%; out of this, 51.7% were engaged in possibly dependent drinking, 23.4% involved in harmful drinking, and 24.9% involved in moderate drinking. Males were more likely to engage in harmful drinking than moderate (AOR = 2.4, 95% CI: 1.175-4.776). Males again were more likely to engage in dependent drinking than moderate (AOR = 2.7, 95% CI: 1.489-5.068). Christians as compared to traditionalists were less likely engage in dependent drinking than moderate drinking (AOR = 0.03, 95% CI: 0.223-0.940). Those with tertiary education were less likely to engage in dependent drinking than moderate as compare to those without formal education (AOR = 0.2, 95% CI: 0.076-0.670). Also employed civil servants were more likely to engage in dependent drinking than moderate as compared to those without employment (AOR = 4.4, 95% CI: 1.187-16.646). This study revealed a high prevalence of alcohol abuse among the residents of Kassena-Nankana municipality that was predicted by gender, educational level, and religious practice; therefore, there is a need for a public campaign on the harmful effects of alcohol abuse in the municipality.

Road safety implications of the blood alcohol concentrations among alcohol users exiting bars in northern Ghana

OBJECTIVE

The main objective of this study was to establish the blood alcohol concentrations (BACs) of bar patrons relative to the legal (BAC) limit for Ghana and the international guideline on alcohol consumption.

METHOD

A cross-sectional study design and a convenience sampling technique were used to collect data at selected bars in 2 cities, namely; Bolgatanga and Wa, in northern Ghana. A breathalyzer was used to measure the breath alcohol concentrations of participants exiting bars and face-to-face questionnaires were administered to participants to capture their accident histories, alcohol consumption patterns, and modes of transport they usually use to travel to their next destination after alcohol consumption.

RESULTS

The mean BAC of bar patrons was 0.143 ± 0.096% (95% confidence interval, 0.127 to 0.160%). The mean BAC of males (0.156%) was significantly higher than the mean BAC of females (0.103%; p = 0.004). Sixty-two percent of participants were exiting the bars with BACs of more than the legal BAC limit and 44% of this proportion was at 0.150% or more. Fifty-one percent of participants indicated that they usually consume a mixture of alcoholic beverages consisting of homemade and factory-made drinks. Fifty-seven percent of participants who usually consume a mixture of drinks had BACs of 0.150% or above. Only 22% of females and 6% of males consume alcohol within their respective recommended low risk of 1 to 2 units and 1 to 4 units, respectively. A vast majority of participants (96%) reported that they usually engage in risky behaviors such as riding, walking, or driving to their next destination after consuming alcohol.

CONCLUSION

Motorists were more likely to exit the bars with very high BACs. It is recommended that police should enforce the BAC law. In addition, in order to prevent harmful use of alcohol, the introduction of an alcohol consumption guideline in Ghana is recommended. Because alcohol consumption is increasing currently with motorization, it is also necessary to educate alcohol users about the number of drinks required to stay below the legal limit if they are motorists as well as other road users or to prevent long-term illnesses associated with excessive alcohol use.

Differences in alcohol consumption and drinking patterns in Ghanaians in Europe and Africa: The RODAM Study

BACKGROUND

Little is known about alcohol consumption among Africans living in rural and urban Africa compared to African migrants in Europe. We compared the patterns of alcohol consumption in a group of Ghanaians living in different locations in Ghana and in Europe and examined the factors associated with drinking alcohol.

METHODS

Data were from a cross-sectional study (RODAM) of Ghanaians aged 25-70 years living in rural and urban Ghana and in Amsterdam, Berlin and London. Information on how often participants consumed at least one standard alcoholic drink in the preceding 12 months, the type of alcoholic beverage and the average serving size was obtained using a food propensity questionnaire. The associations between drinking alcohol and socio-demographic variables, and frequency of attending religious services were investigated using logistic regression models stratified by site and sex. For Ghanaians living in Europe, the number of years since migration and acculturation were also included in the model as covariates.

RESULTS

4280 participants (62.2% women) were included in the analyses. In both men and women, the prevalence of drinking and amount of alcohol consumed per day was highest in Berlin (prevalence of drinking 71.0% and 61.7%) and lowest in urban Ghana (41.4% and 26.8%). After adjustment for age and education in both men and women in Europe, those attending religious services less frequently reported higher levels of drinking alcohol than non-attendants (never attend/no religion compared to attending service at least once a week men OR 4.60 95% CI 2.85, 7.44; women OR 1.80 95% CI 1.12, 2.90) p-trend with frequency <0.001 in men; 0.002 in women); this association was seen also in men in rural Ghana (p-trend = 0.001) and women in urban Ghana (p-trend = 0.02). The prevalence of drinking was positively associated with years since migration in both men and women in Europe ((OR per years increase in time lived in Europe 1.25 (95% CI 1.02,1.53) test for trend p = 0.03 in women; OR 1.29 (95% CI 1.03, 1.62 p = 0.03 in men) but no association was found with self-reported measures of acculturation (ethnic identity, cultural orientation or social networks).

CONCLUSION

There are marked differences in alcohol consumption between Ghanaians living in Europe and in Ghana suggesting migration has an important influence of drinking patterns and also suggesting the possibility of requiring different strategies in alcohol reduction campaigns among Ghanaians in different locations.

Consumption and drinking frequency of alcoholic beverage among women in Ghana: a cross-sectional study

Background

The consumption and drinking frequency of alcoholic beverage are identified with various individual factors. The aim of this study was to identify background characteristics of women associated with the consumption and drinking frequency of alcoholic beverage.

Methods

Data was extracted from the 2008 Ghana Demographic and Health Survey. The data consisted of women’s (aged 15–49 years) background characteristics and their reported history of consumption and drinking frequency of alcoholic beverage. A weighted sample size of 4916 women was used in the present study. Binary logistic regression and multinomial logistic regression were applied to examine the independent association between the covariates and the consumption and drinking frequency of alcoholic beverage respectively.

Results

Out of the 4916 women that were included in the study, 17.5% consumed alcoholic beverage in the past week. Factors that were found to be associated with women who consumed alcoholic beverage in a binary logistic regression model were age (15–19 years up to 45–49 years), region (Central, Greater Accra, Volta, Ashanti, Northern, Upper East, and Upper West), ethnicity (Ga or Dangme, Mole-Dagbani, Grussi, Gruma or Mande), wealth quintile (middle), and employment status [past 12 months] (those employed). In the multinomial logistic regression model, drinking frequency of alcoholic beverage was associated with women in the Central (none), Greater Accra Region (none and 4 or more times), Eastern (none and 2–3 times), Brong Ahafo (none), Upper East (none), those who attained primary education (4 or more times), Ga/Dangme ethnic group (none), those of middle wealth quintile (none), and those employed (4 or more times).

Conclusions

In the country, about 2 in 10 women consume alcoholic beverage and the drinking frequency of alcoholic beverage varied among women in the country. Hence, the maintenance of moderate alcoholic beverage consumption among women, where applicable, should be encouraged.

A systematic review of the epidemiology of unrecorded alcohol consumption and the chemical composition of unrecorded alcohol

BACKGROUND AND AIMS

Unrecorded alcohol constitutes about 30% of all alcohol consumed globally. The aims of this systematic review were to determine the epidemiology (occurrence, types, prevalence) of unrecorded alcohol consumption in different countries/regions, analyse the chemical composition of unrecorded alcohol and examine health outcomes caused by the consumption of unrecorded alcohol, based on either epidemiology or toxicology.

METHODS

A systematic search for, and qualitative analysis of, papers with empirical results on the different categories of unrecorded alcohol, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Unrecorded alcohol was widespread in all regions of the world. Artisanal fermented beverages and spirits were the most common categories of unrecorded alcohol globally, and were available on all continents. In India, industrially produced spirits (country spirits) were most prevalent. In Russia and countries of the former Soviet Union, surrogate alcohols complemented artisanal spirits. Cross-border shopping was the most prevalent method of obtaining unrecorded alcohol in parts of Europe. Ethanol was the most harmful ingredient of unrecorded alcohol, and health consequences due to other ingredients found in unrecorded alcohol were scarce. However, as unrecorded alcohol is usually the least expensive form of alcohol available in many countries, it may contribute to higher rates of chronic and irregular heavy drinking.

CONCLUSIONS

Very large amounts of alcohol are produced globally that go unrecorded. The primary harm from this kind of alcohol arises from the fact that it is typically much cheaper than licit alcohol.

"Now if you have only sons you are dead": migration, gender, and family economy in twentieth century northwestern Ghana

This article explores the interconnectedness between labor migration, gender, and the family economy in northwestern Ghana in the 20th century. It focuses specifically on the Dagaaba of the Nadowli and Jirapa administrative districts of what is now the Upper West Region (UWR). It examines how the relationships between men and women in terms of roles, status, access to productive resources and inheritance, changed in tandem with broader changes in society in the 20th century; changes that over time produced enhanced value and elevated status for women in the family. These changes in gender relations are reflected increasingly in the belief among elderly men that ‘now if you have only sons, you are dead’. By focusing on the lived experiences of ordinary women and men in the migration process, it argues that even though indigenous social structures privileged men over women in almost all spheres of life, Dagaaba women were nonetheless significantly active in shaping the history of their communities and that gender relations in Dagaaba communities were not static — they changed over time and generation. This article contributes to the ongoing discussion of the internal migration phenomenon in West Africa, which has so far attracted scant historical analysis.

Are post-menopausal women "half-a-man"?: sexual beliefs, attitudes and concerns among midlife Chinese women

The objective of this study was to explore the concerns and issues specific to sexual behaviors and interests among postmenopausal women in a metropolitan urban city in Southern China. This was a qualitative study using semi-structured focus group discussions (FGDs). Twenty-two informants aged 50 and above recruited through an ongoing research project on early post-menopausal women under the purview of the School of Public Health at the Chinese University of Hong Kong. The main outcome measures were themes identified as health concerns towards sex among postmenopausal women. Contrary to prior expectations and stereotypes, we found that the respondents were very open in discussing their sexual concerns and shared extensively from their personal experiences. Our respondents perceived significant differences in sexual needs between older men and women. Many respondents identified the effects of menopause and general health problems, as well as environmental limitations and communication problems between spouses as barrier to healthy sexual relationships within their marriages. Conversely, sexual disharmony was seen as an important cause of marital strife among older couples. There is a growing need in studying health concerns among the fast-growing, Chinese middle-aged and older population. Our qualitative study revealed a wide gap in the knowledge regarding general and sexual health issues among post-menopausal Chinese women. Raising awareness among health professionals of these issues is essential in addressing health concerns regarding this traditionally taboo subject within the Chinese context.