Socioeconomic inequalities in alcohol use and some related consequences from a household perspective in Vietnam

National and regional prevalence of interpersonal violence from others' alcohol use: a systematic review and modelling study

Background

While alcohol use is an established risk factor for interpersonal violence, the extent to which people are affected by interpersonal violence from others' drinking has not yet been quantified for different world regions. This modelling study aims to provide the first estimates of the national and regional prevalence of interpersonal violence from others' drinking.

Methods

An international systematic literature search (02/28/2023, Prospero: CRD42022337364) was conducted to identify general adult population studies assessing the prevalence of interpersonal violence from others' drinking with no restrictions to publication date or language. Reports that did not provide data on interpersonal violence from others' drinking (primary outcome), were no original research studies, or captured a selected group of people only, were excluded. Observed prevalence data were extracted and used to build fractional response regression models to predict past-year prevalence of emotional and physical violence from others' drinking in 2019. Random-effects meta-regression models were used to aggregate the observed prevalence of sexual and intimate partner violence. Study risk of bias (ROB) was assessed using a modified version of the Newcastle-Ottawa Scale.

Findings

Out of 13,835 identified reports, 50 were included covering just under 830,000 individuals (women: 347,112; men: 322,331; men/women combined: 160,057) from 61 countries. With an average prevalence of 16·8% (95% CI: 15·2-18·3%) and 28·3% (95% CI: 23·9-32·4%) in men and women combined in the GBD super regions High Income and Central Europe, Eastern Europe, & Central Asia, respectively, emotional violence was the most common form of interpersonal violence from others' drinking. Physical violence averaged around 3% (women) and 5% (men) in both regions. The pooled prevalence of sexual violence from others' drinking in men and women was 1·3% (95% CI: 0·5-3·3%, 95% PI: 0·1-16·9%) and 3·4% (95% CI: 1·4-8·3%, 95% PI: 0·2-35·3%), respectively, and ranged between 0·4% (95% CI: 0·1-1·6%, 95% PI: 0·0-7·3%) and 2·7% (95% CI: 1·1-6·3%, 95% PI: 0·2-30·0%) for different forms of intimate partner violence. ROB was moderate or critical for most reports; accounting for critical ROB did not substantially alter our results.

Interpretation

The share of the population experiencing harms from others' drinking is significant and should be an integral part of public health strategies.

Funding

Research reported in this publication was supported by the Canadian Institutes of Health Research (CIHR; grant: CIHR FRN 477887).

Value of Some Scoring Systems for the Prognosis of Rebleeding and In-Hospital Mortality in Liver Cirrhosis with Acute Variceal Bleeding

Background: Upper gastrointestinal (GI) hemorrhage, caused by acute esophageal variceal bleeding, is a common complication and a leading cause of death in patients with cirrhosis. Therefore, predicting the risk in order to employ an active management to prevent rebleeding and death is crucial. Currently, there are many prognostic scoring systems that have been proposed, but research is needed to find a valid score which can be applied in clinical practice in each country and population. Aims: To compare the value of ALBI (Albumin-Bilirubin), PALBI (Platelet Albumin-Bilirubin), AIMS65, model for end-stage liver disease (MELD), and Child–Pugh scores (CPS) approaches in predicting early rebleeding and in-hospital mortality of acute variceal bleeding in patients with cirrhosis. Subjects and methods: We performed a cross-sectional descriptive study on cirrhotic patients with acute variceal bleeding who were being treated at the Department of Gastroenterology, Intensive care unit—Military Hospital 103 and the Institute for Treatment of Digestive Diseases—108 Military Central Hospital from September 2020 to May 2022. We calculated ALBI, PALBI, AIMS65, MELD, Child–Pugh values and compared them with the rates of early rebleeding and in-hospital mortality. Then, determined and compared the prognostic value through an analysis of the area under the curve (AUC). Results: 222 patients with acute esophageal variceal bleeding were eligible for inclusion in the study. The rates of rebleeding and in-hospital mortality were 9.0% and 6.8%, respectively. Regarding the prognosis of early rebleeding, the ALBI and PALBI scores have good prognostic value (AUROC 0.74; 95% CI: 0.63–0.85 and AUROC 0.7; 95% CI: 0.59–0.81; p = 0.004, respectively), while the Child–Pugh, MELD, AIMS65 scores have little prognostic value, with AUROC < 0.70. Regarding prognosis of in-hospital mortality: the ALBI, PALBI, MELD and AIMS65 all have good value in predicting in-hospital mortality, with AUROC of 0.81 (95% CI: 0.68–0.93, respectively; p < 0.001); 0.8 (95% CI: 0.69–0.91; p <0.001); 0.83 (95% CI: 0.72–0.93; p < 0.001); and 0.82 (95% CI: 0.76–0.87, p < 0.001), respectively. While Child–Pugh score only has medium prognostic value, with AUROC 0.79 (95% CI: 0.66–0.92; p < 0.05). However, there was no significant difference between these prognostic scoring systems. Conclusion: the ALBI, PALBI, MELD and AIMS65 scores all had similar good value in predicting in-hospital mortality, but with early rebleeding prognosis, only ALBI and PALBI had good value. CPS does not show prognostic value like other scores, both in predicting early rebleeding and in-hospital mortality.

Harms to children from the financial effects of others' drinking

BACKGROUND

Many children live with parents who drink and experience little impact, but risky or heavy drinking by caregivers can result in a range of harms to children. Alcohol-related financial harms which directly impact children's needs in general populations have been seldom studied.

OBJECTIVE

The study aims to identify the prevalence and correlates of financial harms from others' drinking affecting children's needs in nine lower- and middle-income (LMICs) and high-income countries (HICs).

METHODS

Participants (n = 7,669) from Brazil, Chile, Ireland, Lao PDR, Nigeria, Sri Lanka, Thailand, USA and Viet Nam were aged 18-64 years and living with children. Logistic regression and meta-analyses explored differences in financial harm affecting children among LMICs and HICs, adjusting for gender, education, rurality and drinking pattern.

RESULTS

In around one-tenth to a third of households in the nine countries, children lived with people who drank riskily. Less than 1% to 8% of respondents reported that their children's needs had not been met because of financial harm from others' drinking. Women reported significantly greater harm to children due to the financial effects of others' drinking than men in the USA, Nigeria and Viet Nam. When the participant reported drinking riskily, and particularly when families included someone who drank heavily, increased odds of financial harm from others' drinking affecting children were identified.

CONCLUSION

That children's needs were not met due to financial harm from others' drinking was reported by three percent (<1 to 8%) of caregivers across the nine countries, representing a problem for large numbers of children, particularly in the low and middle-income countries studied. When a person's drinking was reported to be heavy or harmful within the family, the risk that children's needs were affected by the financial impacts of others' drinking was significantly greater.

Trends in inequalities of alcohol-related harms among Thai households: 2007-2017

BACKGROUND

To estimate and compare the socio-economic inequities in alcohol-related harms among households in Thailand between 2007 and 2017 adjusted for socioeconomic status with the proportions of current and binge drinkers in each household.

METHODS

A secondary data analysis of the 2007 and 2017 National Cigarette and Alcohol Consumption Survey was conducted. The unit of analysis was household-level. Concentration index (CI) was used to measure household income-based inequalities in alcohol-related harms (i.e., workplace, domestic, non-domestic, financial, and drinking-and-driving) in the previous 12 months.

RESULTS

Based on data from two waves of survey (n = 66,776 in 2007 and 39,630 in 2017), the prevalence of households that had at least one member who had an alcohol-related harm event was 21.8% and 26.2% in 2007 and 2017, respectively. The highest prevalence was the drinking-and-driving domain (about 20%). The prevalence increased between 2007 and 2017 with an annual rate of change ranged from 1.2 to 4.4%. All of the CI values were negative for both survey waves, except the drink-and-driving domain in 2007. The CI values for all domains in 2017 had a larger magnitude than in 2007, except the domestic domain. For any alcohol-related harm, the CI value was not significant at +0.002 (Standard error [SE] 0.004) in 2007, but significant at -0.014 (SE 0.004) in 2017. So, the index changed around -0.016.

CONCLUSIONS

The poor households had a slightly greater tendency to incur harms from alcohol and there existed more inequality in the prevalence of harms in 2017 compared with 2007.