Mental health of adolescents who abuse psychoactive substances in Enugu, Nigeria - a cross-sectional study

Effects of the "Unplugged" school-based substance use prevention program in Nigeria: A cluster randomized controlled trial

BACKGROUND

School-based programs are the most convenient interventions to tackle substance use among youth. "Unplugged" is a Social Influence universal school curriculum developed and tested in the "EU-Dap" project. In 2015, Nigeria implemented a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the effectiveness of "Unplugged" was evaluated through a cluster randomized controlled trial.

METHODS

The program was adapted to the Nigerian context, assembling suggestions from monitoring forms and interviews, and performing fidelity checks on content and method. Thirty-two secondary schools were extracted from a list provided by the Federal Ministry of Education, and randomly allocated to intervention and control arms. A self-completed anonymous questionnaire was used for baseline and follow-up surveys. The analysis sample finally included 2685 pupils (mean age 14.2 years). Multilevel models were run to estimate program effects on prevalence of self-reported cigarettes, alcohol, and marijuana use. Mediation analysis was performed to identify possible mediators of program effect on alcohol use.

RESULTS

Unplugged significantly reduced the prevalence of recent alcohol use in intervention vs control pupils. The effect on prevalence of cigarette and marijuana use was not statistically significant. The program prevented progress and encouraged regress across stages of intensity of alcohol use. Negative beliefs, risk perceptions, and class climate mediated the effect of Unplugged on alcohol use.

CONCLUSIONS

Unplugged was effective in preventing alcohol use improving beliefs, class climate and risk perceptions among Nigerian students. The implementation of the program at a larger scale in the country should be supported.

Correlates of alcohol experimentation and drunkenness episodes among secondary-school students in Nigeria

Background: Alcohol is the most used substance among adolescents in Nigeria. While risk factors for alcohol use among adolescents are well documented in Europe and the US, they have received less attention in the literature on African countries. This study aimed to investigate the factors associated with alcohol experimentation and drunkenness episodes in a national sample of Nigerian adolescents. Methods: A total sample of 4,078 secondary-school students participated in the survey during the school year 2015-2016. The survey involved 32 secondary schools of six geopolitical zones (South-South, South-West, South-East, North-Center, North-West, and North-East) and two metropolitan cities (Abuja and Lagos) of Nigeria. Sociodemographic characteristics, parental alcohol use and permissiveness, friends' alcohol use, risk perceptions and beliefs were investigated as correlates of alcohol experimentation and drunkenness episodes through multilevel, mixed-effect logistic regression models. Results: The prevalence of alcohol experimentation was 34.0%, while the prevalence of drunkenness episodes was 13.4%. Results showed that male gender, family structure different from both parents' families, parental and friends' alcohol use, parental permissiveness to drink, low risk perceptions on drinking alcohol, and positive beliefs on consequences of alcohol use were associated with an increased probability of alcohol experimentation and drunkenness episodes. Family affluence and one-parent family structure were related to an increased probability of alcohol experimentation but not of drunkenness episodes. Conclusions: The majority of risk factors analyzed in this study generalize across drinking-behavior outcomes. Since the young population is dominant in Nigeria, alcohol use could become a big public health problem in the near future. High investment in adolescents' well-being by addressing the factors that contribute to drinking behavior might help to reduce the burden of the problem. Evidence-based prevention curriculum addressing knowledge, risk perceptions, beliefs on consequences of alcohol use, and parental behaviors should be implemented as widely and early as possible.

Depressive symptoms and associated factors among left-behind children in China: a cross-sectional study

Background

To investigate the prevalence of depressive symptoms among left-behind children (LBC) in junior and senior secondary schools and examine the significant predictors of depressive symptoms, which might provide practical intervention measures for the schools.

Methods

By using stratified random sampling, 1076 (LBC) in junior and senior secondary schools were investigated in the study. Depressive symptoms were assessed using the depression self-rating scale (SDS). SDS raw scores 40 or higher were categorised as depressive symptoms.

Results

The total prevalence of depressive symptoms was 54.74% for LBC in junior and senior secondary schools, with 73.08% for grade 12 students. The multivariate logistic regression analysis showed that grades, family income, parental relationship, parent-child relationship and teacher-student relationship were significantly associated with depressive symptoms.

Conclusions

Depressive symptoms are acommon health problem among LBC in junior and senior secondary schools, and LBC in grade 12 may be at high risk of depressive symptoms. The parents, teachers and schools should pay more attention to LBC, particularly those in grade 12, and provide prevention and early intervention programs such as individual counsel service to prevent depressive symptoms.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5963-y) contains supplementary material, which is available to authorized users.

Mediating alcohol use in Eastern Nigeria: a qualitative study exploring the role of popular media in young people's recreational drinking

Nigeria has high levels of alcohol consumption, and little or no regulation of the alcohol industry. There is a dearth of studies exploring young adults' drinking in a Nigerian context with only a few predominantly quantitative surveys. These do not explore the social meanings attached to drinking practices nor do they shed light on potential gender differences and how these are mediated by popular media. This qualitative study addresses this gap with semi-structured interviews involving 31 undergraduate students. It identifies that media consumption shapes drinking behaviour in ways which are highly patterned and gendered. Participants with high consumption of both Hollywood films and popular American reality television series associate heavy alcohol consumption with high social status, economic independence and gender equality. By contrast, Nollywood (local) films which are intended to act as moral tales and warn of the dangers of drinking appear paradoxically to support participants' views of alcohol as positive (alleviating anxiety, depression and menstrual discomfort). Nigeria currently has no serious regulation of alcohol on television which is embedded in everyday life. Attempts to develop wider public health campaigns and policies should take this saturated media landscape into account to develop harm reduction strategies which are linked directly to media literacy programmes.

Correlates for psycho-active substance use among boarding secondary school adolescents in Enugu, South East, Nigeria

Background

Psycho-active substance use among adolescents is a national and global problem and its attendant effects on adolescents cannot be overemphasized.

The objectives of this study are to determine the prevalence and pattern of psychoactive substance use among adolescents; the substances involved and the extent of the problem in this locale.

Methods

This is a cross-sectional study that assesses the pattern of psychoactive substance use among secondary school adolescents in Enugu, south East, Nigeria. The study was carried out among adolescents attending six secondary boarding schools in Enugu metropolis of Enugu State of Nigeria.

The WHO Student Drug Use Questionnaire was adapted for this study.

Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 17. Chi-square and multivariate regression were used as a test of significance for qualitative variables. A p-value less than 0.05 were accepted as significant for each statistical test.

Results

Out of 900, a total of 896 respondents, comprising 400 and 82 boys (482) (53.8 %) and 400 and 14 girls (414) (46.2 %) completed the questionnaires. This gave a response rate of 99.6 %.

The study revealed that the prevalence of current use for psychoactive substances ranges from 0.4 to 34.9 % while that for life use ranges from 0.8 to 63.5 %. The least being cannabis and the most being kola nuts.

Kola nut is the most widely used psychoactive substance both for current use, past year use and the respondents’ life time use. It shows a lifetime prevalence of 63.5 % and a current use prevalence of 34.9 %.

More than half of the users of each of the psychoactive substances take it occasionally, using them on 1–5 days in a month. On the other hand, almost one-quarter of the users of each of the substances take it on 20 or more days in a month.

Conclusion

The study revealed that the prevalence of current use for psychoactive substances ranges from 0.4 to 34.9 % while that for life use ranges from 0.8 to 63.5 %. The least being cannabis and the most being kola nuts.

Electronic supplementary material

The online version of this article (doi:10.1186/s12887-016-0615-9) contains supplementary material, which is available to authorized users.