1
|
Kwagala C, Munube D, Abbo C, Muhwezi WW, Mwesiga EK. Prevalence and factors associated with opioid use disorder among adolescents with sickle cell disease in Mulago hospital, Uganda. Child Adolesc Psychiatry Ment Health 2024; 18:94. [PMID: 39090740 PMCID: PMC11295896 DOI: 10.1186/s13034-024-00790-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Opioid use disorder (OUD) among adolescents with sickle cell disease (SCD) patients increases their risk of complications from sickle cell disease, such as infections, stroke, acute chest syndrome, sudden death, and organ failure. This negatively impacts families, communities, the national health system, and the economy. This study aimed to determine the prevalence and factors associated with opioid use disorder among adolescents with SCD at Mulago Hospital Uganda. METHODS This study was carried out at the Sickle Cell Clinic of Mulago Hospital, the national referral hospital in Uganda. The study participants were adolescents aged 10 to 19 years. Following informed consent/ assent, a sociodemographic questionnaire, the WHO Alcohol, Smoking and Substance Involvement Screening Test - Young (ASSIST-Y), the Beck Depression Inventory-II (BDI II), and Generalized Anxiety Disorder - 7 (GAD-7) questionnaires were used to collect data. Data was entered in EpiInfo and analyzed in STATA 15. RESULTS The prevalence of opioid use disorder was 5.3%. The significant risk factor was increasing depressive score AOR: 1.11(95% CI: 1.01-1.22, p = 0.035), while living with a family was protective against opioid use disorders AOR: 0.01; (95% CI: 0.0004, 0.27, p = 0.007). CONCLUSION There was a significant problem of OUD among adolescents with SCD. There is, therefore, needed to integrate screening of OUD and mental illnesses like depression among adolescents with SCD and to emphasize the importance of family support in their care.
Collapse
Affiliation(s)
- Claire Kwagala
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Deogratias Munube
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Catherine Abbo
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Wilson Winstons Muhwezi
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Emmanuel Kiiza Mwesiga
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| |
Collapse
|
2
|
Hlahla K, Azizi SC, Simms V, Dziva Chikwari C, Dauya E, Bandason T, Tembo M, Mavodza C, Kranzer K, Ferrand R. Prevalence of substance and hazardous alcohol use and their association with risky sexual behaviour among youth: findings from a population-based survey in Zimbabwe. BMJ Open 2024; 14:e080993. [PMID: 38885985 PMCID: PMC11184200 DOI: 10.1136/bmjopen-2023-080993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Hazardous drinking (HD) and substance use (SU) can lead to disinhibited behaviour and are both growing public health problems among Southern African youths. We investigated the prevalence of SU and HD and their association with risky sexual behaviour among youth in Zimbabwe. DESIGN Data analysis from a population-based survey conducted between October 2021 and June 2022 to ascertain the outcomes of a cluster randomised trial (CHIEDZA: Trial registration number:NCT03719521). Trial Stage: Post-results. SETTING 24 communities in three provinces in Zimbabwe. PARTICIPANTS Youth aged 18-24 years living in randomly selected households. OUTCOME MEASURES HD was defined as an Alcohol Use Disorders Identification Test score ≥8, SU was defined as ever use of ≥1 commonly used substances in the local setting. RESULTS Of 17 585 participants eligible for this analysis, 61% were women and the median age was 20 (IQR: 19-22) years. Overall, 4.5% and 7.0% of participants reported HD and SU, respectively. Men had a substantially higher prevalence than women of HD (8.2% vs 1.9%) and SU (15.1% vs 1.5%). Among men, after adjusting for socio-demographic factors, we found increased odds of having >1 sexual partner in those who engaged in SU (adjusted OR (aOR)=2.67, 95% CI: 2.21 to 3.22), HD (aOR=3.40, 95% CI: 2.71 to 4.26) and concurrent HD and SU (aOR=4.57,95% CI: 3.59 to 5.81) compared with those who did not engage in HD or SU. Similarly, there were increased odds of receiving/providing transactional sex among men who engaged in SU (aOR=2.51, 95% CI: 1.68 to 3.74), HD (aOR=3.60, 95% CI: 2.24 to 5.79), and concurrent HD and SU (aOR=7.74, 95% CI: 5.44 to 11.0). SU was associated with 22% increased odds of inconsistent condom use in men (aOR=1.22, 95% CI: 1.03 to 1.47). In women, the odds of having >1 sexual partner and having transactional sex were also increased among those who engaged in SU and HD. CONCLUSION SU and HD are associated with sexual behaviours that increase the risk of HIV acquisition in youth. Sexual and reproductive health interventions must consider HD and SU as potential drivers of risky sexual behaviour in youths.
Collapse
Affiliation(s)
- Kudzai Hlahla
- Biomedical Research and Training Institute, Harare, Zimbabwe
- University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Steven Chifundo Azizi
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Victoria Simms
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Chido Dziva Chikwari
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ethel Dauya
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Mandikudza Tembo
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Constancia Mavodza
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharina Kranzer
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Rashida Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
3
|
Adeleke R, Iyanda AE. Analyzing the geographic influence of financial inclusion on illicit drug use in Nigeria. Spat Spatiotemporal Epidemiol 2024; 49:100655. [PMID: 38876566 DOI: 10.1016/j.sste.2024.100655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 06/16/2024]
Abstract
Nigeria grapples with a formidable public health concern, as approximately 14 million individuals partake in illicit drug use (IDU). This predicament significantly impacts psychiatric disorders, suicides, disability, and mortality rates. Despite previous investigations into predictors and remedies, the role of financial inclusion (FI) remains inadequately explored. Leveraging existing literature on FI and population health, this study asserts that bolstering FI could be instrumental in mitigating IDU prevalence in Nigeria. We employ spatial analysis to scrutinize the influence of FI and other social factors on IDU, revealing a 14.4 % national prevalence with spatial variations ranging from 7 % in Jigawa state to 33 % in Lagos state. Significant IDU hotspots were identified in the southwest states, while cold spots were observed in the Federal Capital Territory and Nassarawa. Multivariate spatial analysis indicates that FI, income, unemployment, and the proportion of the young population are pivotal predictors of IDU nationwide, explaining approximately 67 % of the spatial variance. Given these findings, the study advocates heightened levels of FI and underscores the need for intensified government initiatives to prevent and address illicit drug use.
Collapse
Affiliation(s)
- Richard Adeleke
- Department of Geography and Environmental Management, University of Waterloo, Canada.
| | | |
Collapse
|
4
|
Sæle RH, Ndetei DM, Mutiso VN, Mamah D. Epidemiology of DSM-5 psychiatric disorders in Kenyan Youth with Low and High Psychosis Risk. Compr Psychiatry 2024; 131:152473. [PMID: 38503003 DOI: 10.1016/j.comppsych.2024.152473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 01/30/2024] [Accepted: 03/10/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION There are few psychiatric epidemiology studies among Kenyan youth and fewer among those at high psychosis risk (HR). METHODS This study assessed the epidemiology of DSM-5 psychiatric disorders in HR and low-risk (LR) individuals to inform research and mental health services. 567 participants (aged 15-25) in HR (n = 246) and LR (n = 260) groups based on Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen scores. Diagnostic Interview Schedule, version 5 (DIS-5) assessed DSM-5 psychiatric disorder prevalence. Diagnostic comorbidity and demographic relationships were investigated. RESULTS A higher prevalence was observed for all DSM-5 disorders in the HR group, significantly for gambling disorder (13% vs. 5.8%), major depressive disorder (9.8% vs. 3.8%), antisocial personality disorder (5.7% vs. 2.3%), general anxiety disorder (4.9% vs. 0.4%), oppositional defiant disorder (3.3% vs. 0.4%), panic disorder (2.8% vs. 0.8%), and anorexia nervosa (2.8% vs. 0%). Gambling disorder was the most prevalent and showed significant gender effects (males>females). DISCUSSION Psychiatric disorders occur at increased rates among HR compared to LR. Prevalence rates found are lower than in US studies, except for gambling disorder which was highly prevalent. Large-population-based epidemiology studies in Africa are needed to estimate rates, particularly of disorders such as schizophrenia, accurately.
Collapse
Affiliation(s)
- Rebekka H Sæle
- Departments of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America.
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Kenya
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Daniel Mamah
- Departments of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
| |
Collapse
|
5
|
Seya MKS, Matthews S, Zhu L, Brown C, Lefevre A, Agathis N, Chiang LF, Annor FB, McOwen J, Augusto A, Manuel P, Kamagate MF, Nobah MT, Coomer R, Kambona C, Low A. Parenting-related positive childhood experiences, adverse childhood experiences, and mental health-Four sub-Saharan African countries. CHILD ABUSE & NEGLECT 2024; 150:106493. [PMID: 37839988 PMCID: PMC11264190 DOI: 10.1016/j.chiabu.2023.106493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are associated with poor mental health outcomes and risk-taking behaviors. Positive childhood experiences (PCEs) may mitigate these negative impacts. OBJECTIVE This study 1) assessed the associations between ACEs and negative health outcomes and risk-taking behaviors among young adults, and 2) evaluated whether - and which - PCEs moderate the association between ACEs and these outcomes in sub-Saharan Africa. METHODS This multi-country analysis combined cross-sectional representative survey data from young adults, ages 18-24 years, from the 2019 Kenya, 2018 Lesotho, 2019 Mozambique, and 2019 Namibia Violence Against Children and Youth Surveys. The association between experiencing any ACEs and each health outcome was assessed using Wald's chi-square tests. Multivariable logistic regression analyses assessed the association between each PCE and each outcome of interest. RESULTS Females who experienced any ACEs had higher odds of experiencing moderate to severe mental distress (aOR = 2.7, 95%CI: 1.9, 3.9). Males who experienced any ACEs had higher odds of experiencing suicidal/self-harm behaviors (aOR = 6.7, 95%CI: 2.8, 16.0) and substance use (aOR = 2.5, 95%CI: 1.4, 4.2). In females, strong mother-child relationship was protective against moderate to severe mental distress (aOR = 0.7, 95%CI: 0.6, 0.9), suicidal/self-harm behaviors (aOR = 0.6, 95%CI: 0.4, 0.9), and substance use (aOR = 0.6, 95%CI: 0.4, 0.9). For males, a strong mother-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.5, 95%CI: 0.2, 0.9), and a strong father-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.4, 95%CI: 0.2, 0.7) and substance use (aOR = 0.6, 95%CI: 0.4, 0.8). CONCLUSIONS Strong parenting programs may likely play an important role in improving the psychosocial health of young adults.
Collapse
Affiliation(s)
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Adrienne Lefevre
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Nickolas Agathis
- Division of Global HIV and Tuberculosis, Center for Global Health Centers for Disease Control and Prevention, GA, USA
| | - Laura F Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Jordan McOwen
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | - Maman Fathim Kamagate
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Marie-Therese Nobah
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Rachel Coomer
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia
| | - Caroline Kambona
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya
| | | |
Collapse
|
6
|
Ntho TA, Themane MJ, Sepadi MD, Phochana TS, Sodi T, Quarshie ENB. Prevalence of alcohol use and associated factors since COVID-19 among school-going adolescents within the Southern African Development Community: a systematic review protocol. BMJ Open 2024; 14:e080675. [PMID: 38413145 PMCID: PMC10900308 DOI: 10.1136/bmjopen-2023-080675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has significantly shaped the global landscape and impacted various aspects of individuals' lives, especially the behaviour of school-going adolescents regarding substance use. Among these substances, alcohol is the most predominant substance, particularly among school-going adolescents, who also are highly susceptible to harmful alcohol use, such as poor academic performance, psychiatric disorders and disrupted social lives. This review will synthesise the known prevalence estimates and associated factors of alcohol use among school-going adolescents in the Southern African Development Community (SADC) since the COVID-19 pandemic. METHODS AND ANALYSIS We will perform a systematic review in line with the Cochrane Handbook for Systematic Reviews. We will systematically search for selected global databases (ScienceDirect, EbscoHost, PsycINFO and PubMed) and regional electronic databases (African Index Medicus, Sabinet and African Journals OnLine). Peer-reviewed literature published between 11 March 2020 and 10 March 2024 will be considered for eligibility without language restriction. All 16 countries of the SADC region will be included in the review. The Mixed-Methods Appraisal Tool checklist for quality appraisal will be used to appraise the methodological quality of the included studies. Depending on the level of heterogeneity, prevalence estimates will be pooled in a meta-analysis; narrative synthesis will be applied to describe the reported associated factors of alcohol use. ETHICS AND DISSEMINATION We will not seek ethical approval from an institutional review board since the study will not involve gathering data directly from individual school-going adolescents, nor will it violate their privacy. When completed, the full report of this review will be submitted to a journal for peer-reviewed publication; the key findings will be presented at local and international conferences with a partial or full focus on (adolescent) alcohol (mis)use. PROSPERO REGISTRATION NUMBER CRD42023452765.
Collapse
Affiliation(s)
- Tshepo A Ntho
- Nursing Science, University of Limpopo, Polokwane, Limpopo, South Africa
| | | | - Medwin D Sepadi
- Department of Education Studies, University of Limpopo, Polokwane, Limpopo, South Africa
| | - Talamo S Phochana
- SAMRC-DSI/NRF-UL SARChI Research Chair in Mental Health and Society, Faculty of Humanities, University of Limpopo, Polokwane, Limpopo, South Africa
| | - Tholene Sodi
- SAMRC-DSI/NRF-UL SARChI Research Chair in Mental Health and Society, Faculty of Humanities, University of Limpopo, Polokwane, Limpopo, South Africa
| | - Emmanuel Nii-Boye Quarshie
- Psychology, University of Ghana College of Humanities, Accra, Ghana
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| |
Collapse
|
7
|
Stowe MJ, Gatonye R, Maharjan I, Kehinde S, Arya S, Valderrábano JH, Mcbride A, Scheibein F, Igonya EK, Fast D. The war on drugs is a war on us: young people who use drugs and the fight for harm reduction in the Global South. Harm Reduct J 2024; 21:43. [PMID: 38368391 PMCID: PMC10874574 DOI: 10.1186/s12954-023-00914-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 02/19/2024] Open
Abstract
In the Global South, young people who use drugs (YPWUD) are exposed to multiple interconnected social and health harms, with many low- and middle-income countries enforcing racist, prohibitionist-based drug policies that generate physical and structural violence. While harm reduction coverage for YPWUD is suboptimal globally, in low- and middle-income countries youth-focused harm reduction programs are particularly lacking. Those that do exist are often powerfully shaped by global health funding regimes that restrict progressive approaches and reach. In this commentary we highlight the efforts of young people, activists, allies, and organisations across some Global South settings to enact programs such as those focused on peer-to-peer information sharing and advocacy, overdose monitoring and response, and drug checking. We draw on our experiential knowledge and expertise to identify and discuss key challenges, opportunities, and recommendations for youth harm reduction movements, programs and practices in low- to middle-income countries and beyond, focusing on the need for youth-driven interventions. We conclude this commentary with several calls to action to advance harm reduction for YPWUD within and across Global South settings.
Collapse
Affiliation(s)
- M-J Stowe
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Sydney, NSW, 2052, Australia.
- South African Network of People Who Use Drugs (SANPUD), Cape Town, South Africa.
- Community Orientated Substance Use Program, University of Pretoria, Pretoria, South Africa.
| | - Rita Gatonye
- Women in Response to HIV/AIDS and Drug Addiction, Umuahia, Nigeria
| | | | - Seyi Kehinde
- Youth RISE Nigeria, Federal Capital Territory, Nigeria
| | - Sidarth Arya
- State Drug Dependence Treatment Centre, Institute of Mental Health, Pt B.D.S University of Health Sciences, Rohtak, India
| | | | - Angela Mcbride
- South African Network of People Who Use Drugs (SANPUD), Cape Town, South Africa
| | - Florian Scheibein
- School of Health Sciences, South East Technological University, Waterford, Ireland
| | | | - Danya Fast
- University of British Columbia and British Columbia Centre On Substance Use, Vancouver, Canada
| |
Collapse
|
8
|
Cooke LM, Moodley S, Paruk L. The profile of adolescent patients presenting to a tertiary maternal mental health clinic. S Afr J Psychiatr 2023; 29:2185. [PMID: 38223306 PMCID: PMC10784263 DOI: 10.4102/sajpsychiatry.v29i0.2185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024] Open
Abstract
Background Between March 2021 and April 2022, there were 90 037 documented adolescent pregnancies in South Africa. Statistics SA reports that this number is growing. Pregnancy places adolescents at greater risk of psychiatry-related morbidity and may have far-reaching consequences for their children. To date, there is no published data describing the patient profile of adolescent pregnancies in Gauteng Province, South Africa. Aim To describe the patient profile (demographics, schooling history and type of accommodation), pregnancy-related factors, substance use habits and contraceptive use in pregnant adolescents seen at a tertiary care maternal mental health clinic (MMHC). Setting The MMHC at Chris Hani Baragwanath Academic Hospital, Soweto, Johannesburg, South Africa. Methods A retrospective file review of all pregnant adolescents referred to the MMHC between January and June 2022. Results The mean age of the patients was 15.2 years; 72% attended school and 97.4% planned to return. Most pregnancies were unplanned (97.9%), wanted (84%) and presented in the second (41.24%) and third (51.55%) trimesters. Most did not report using substances (76.7%). Fifty percent of the participants met the criteria for a major depressive disorder. Repeating a grade was an identifiable risk factor for an increased Edinburgh depression score. An unplanned pregnancy was associated with a higher risk factor assessment. Conclusion Pregnant adolescents represent a vulnerable population group. A greater understanding of this patient profile may inform early psychiatric and psychosocial interventions, improved service delivery and help-seeking behaviour. Contribution This study gives significant insights into the challenges faced, as well as the health and social needs of pregnant adolescents. This contributes to wholistic care and opportunities for early intervention, including awareness of contraceptive use and the risks of substance use and adolescent pregnancy on mental health, benefiting all South African adolescents.
Collapse
Affiliation(s)
- Luzaan M Cooke
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sanushka Moodley
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laila Paruk
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
9
|
David I, Wegner L, Majee W. "We Want to See Youth That Would Be Better People Than Us": A Case Report on Addressing Adolescent Substance Use in Rural South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3493. [PMID: 36834188 PMCID: PMC9962676 DOI: 10.3390/ijerph20043493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Research suggests that substance use, particularly among adolescents may lead to increased illegal activities as well as physical and social health consequences. Around the world, communities, overburdened with adolescent and youth substance use, are finding ways to address this public health threat. Using a case study based on a focus group discussion with nine founding members, this paper reports on the case of Sibanye-a rural community coalition whose mission is to reduce the burden of adolescent substance use on families in rural South Africa. The focus group discussions were audio-recorded, transcribed verbatim, and analyzed using Nvivo 12. This work highlights the power of an engaged collective effort in addressing key community issues, even in rural areas of emerging economies where health and community infrastructure may be limited. The Sibanye coalition taps into its collective wealth of community knowledge to provide social contributions and aesthetics to help adolescents abstain from substance use and sexual risk behaviors. These activities offer adolescents safe places to meet each other, health education, and the ability to structure their free time meaningfully. Engaging community residents, particularly disadvantaged groups, should be central to any local and national strategies for promoting health and well-being.
Collapse
Affiliation(s)
- Ifeolu David
- Department of Health and Rehabilitation Science, School of Health Professions, University of Missouri, Columbia, MO 65211, USA
| | - Lisa Wegner
- Department of Occupational Therapy, Faculty of Community & Health Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Wilson Majee
- Department of Occupational Therapy, Faculty of Community & Health Sciences, University of the Western Cape, Cape Town 7535, South Africa
- Department of Health Sciences and Public Health, University of Missouri, Columbia, MO 65211, USA
| |
Collapse
|
10
|
Baldé MSA, Diallo ML. Prevalence and factors associated with alcohol consumption in a high school in northern Guinea. Drug Alcohol Rev 2023; 42:450-455. [PMID: 36267008 DOI: 10.1111/dar.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The objective of this study was to determine the prevalence and factors associated with alcohol use in a high school in the Middle Guinea region in West Africa. METHODS An analytical cross-sectional study involving 342 high school students was conducted in November 2019 at the Mali centre high school. A questionnaire adapted from the standardised questionnaire validated by the World Health Organization as part of the Global Student Health Surveys was used for data collection. Students were asked about their alcohol use in the 30 days preceding the survey. Using logistic regression, we performed a multivariate analysis that controlled for independent variables to identify factors associated with alcohol use. RESULTS The age range was 14-27 years. The prevalence of alcohol consumption was 12.28% (95% confidence interval [CI] 8.80, 16.10). Note that 89.80% of the sample studied did not know of any harmful effects of alcohol on health. In a multivariate analysis, we showed that alcohol use was associated with tobacco use (adjusted odds ratio 24.82, 95% CI 20.73, 26.30) and having close friends who also consume alcohol (adjusted odds ratio 4.16, 95% CI 3.63, 6.37). DISCUSSION AND CONCLUSION The substantial prevalence of alcohol use, the high proportion of ignorance of the harmful effects of alcohol, and the reasons for the initial motivation for alcohol use found in this study should attract the attention of stakeholders. An action plan based on the two factors associated found could fight alcohol use at Mali centre high school.
Collapse
Affiliation(s)
- Mamadou S A Baldé
- Planning, Training and Research Section, Mali Health District, Guinea
| | - Mamadou L Diallo
- Disease Prevention and Control Section, Mali Health District, Guinea
| |
Collapse
|
11
|
Onaolapo OJ, Olofinnade AT, Ojo FO, Adeleye O, Falade J, Onaolapo AY. Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature. World J Psychiatry 2022; 12:1268-1286. [PMID: 36389088 PMCID: PMC9641378 DOI: 10.5498/wjp.v12.i10.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/01/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023] Open
Abstract
The relationship between man and substances that have abuse potentials, and whose use has been associated with the development or progression of substance use disorders has continued to evolve in terms of geography, economic implications, and time. History shows that local plants with psychoactive constituents can get exported worldwide through global travel, commerce, or even conquest. Time and globalization also change people’s relationship with substances of abuse; hence, an area that was initially alien to certain substances might evolve to becoming a trafficking hub, and then a destination. A case in point is Africa where a rapidly increasing prevalence of substance use/abuse and substance use disorder among adolescents and young adults is putting enormous strain on the economy, healthcare system, and society at large. However, there appears to be a paucity of scientific literature and data on the epidemiology, risk assessment, and contributing factors to substance use and the development of substance use disorders across Africa. In this narrative review, we examine extant literature (PubMed, Google scholar, Medline) for information on the prevalence, trends, and influencers of substance use and the development of substance use disorders. This is with a view of understanding the determinants of substance use and factors that influence the development of substance use disorders in the region, and how this information can be channeled towards developing a comprehensive intervention and treatment program.
Collapse
Affiliation(s)
- Olakunle James Onaolapo
- Behavioral Neuroscience Unit, Neuropharmacology Subdivision, Department of Pharmacology, Ladoke Akintola University of Technology, Ogbomoso 210214 Oyo, Nigeria
| | - Anthony Tope Olofinnade
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University, Ikeja 100001, Lagos, Nigeria
| | - Foluso Olamide Ojo
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| | - Olufunto Adeleye
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| | - Joshua Falade
- Department of Mental Health, Afe Babalola University, Ado-Ekiti 360282, Ekiti, Nigeria
| | - Adejoke Yetunde Onaolapo
- Behavioral Neuroscience Unit, Neurobiology Subdivision, Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| |
Collapse
|
12
|
Olashore AA, Paruk S, Maphorisa T, Mosupiemang B. Pattern of substance use and substance use disorder in adolescent learners at public secondary schools in Gaborone, Botswana. PLoS One 2022; 17:e0268961. [PMID: 36084095 PMCID: PMC9462716 DOI: 10.1371/journal.pone.0268961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Substance use amongst adolescents remains a global public health challenge. The potential negative health outcomes of substance use suggest the need to understand the pattern of use and the associated factors among adolescents. This study aimed to describe the prevalence of substance use, SUDs, and PD and the associated factors in adolescent learners at public schools in Gaborone, Botswana. METHODS A cross-sectional study was conducted at 13 public secondary schools in Gaborone among 742 students. Assessment tools included the World Health Organization drug questionnaire, DSM-5 interview for SUD, and the General Health Questionnaire-12. RESULTS The mean age (SD) of the participants was 15.26 (1.57) years, and there were more females (55.5%). Over two-fifths (44.6%) of learners reported psychoactive substance use in the past 12 months, and 31.5% meeting DSM 5 criteria for a SUD. Alcohol was the most used psychoactive substance (25.1%). Male gender (AOR = 1.94; 95% CI: 1.26-2.995), having a friend (AOR = 4.27; 95% CI: 2.68-6.78), or father (AOR = 1.87; 95% CI: 1.14-3.04), who uses substance, and higher levels of PD (AOR = 1.09; 95% CI: 1.03-1.17) remained significantly associated with SUD. Regular participation in religious activities negatively correlated with SUD (AOR = 0.61; 95% CI: 0.38-0.96). CONCLUSION The high prevalence of substance use and SUDs among in-school adolescents is concerning. Substance use programs need to include family-focused and religious-based therapy and youth empowerment in developing positive peer relationships. Also, they should be integrated with mental health screening to assess comorbid PD.
Collapse
Affiliation(s)
- Anthony A. Olashore
- Faculty of Medicine, Department of Psychiatry, University of Botswana, Gaborone, Botswana
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Taboka Maphorisa
- Faculty of Medicine, Department of Psychiatry, University of Botswana, Gaborone, Botswana
| | | |
Collapse
|
13
|
Alcohol Use among High School Learners in the Peri-Urban Areas, South Africa: A Descriptive Study on Accessibility, Motivations and Effects. CHILDREN 2022; 9:children9091342. [PMID: 36138651 PMCID: PMC9498139 DOI: 10.3390/children9091342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 11/17/2022]
Abstract
Learners are vulnerable to alcohol use and its negative effects, largely due to accessibility of alcohol products, especially in the localities with poor socioeconomic status and infrastructure. This study aimed to determine the accessibility, motivations and effects of alcohol use among high school learners (n = 403) in Tshwane North and West, South Africa, using a descriptive, cross-sectional design. Data were collected using a validated questionnaire and analysed using STATA 17. Learners (16 ± 2 years) had poor demographic status and lifestyle behaviors. Availability of alcohol outlets (54%) near schools was reported, and learners indicated easy access (65%) to taverns and bottle stores (30%), and purchasing alcohol without a proof of identity document (70%). Motivations for alcohol use were self-pleasure (36%), coping with stress (24%) and increasing self-esteem (19%). Almost half of the learners (49%) introduced themselves to alcohol use, while others were influenced by friends (36%) and family (14%). Reported alcohol related effects were a negative impact on health (56%), brain function (25%) and school work (12%), in addition to social harms, including problems with friends (25%) and parents (17%), physical fights (19%) and engaging in risky sexual behaviour (11%). Effective strategies are necessary to address underage alcohol use and should include regulating the proximity of alcohol outlets to schools, life skills training to address learners’ drinking motives and constantly alerting parents about the relevance of modeling behaviour.
Collapse
|
14
|
Soliman SS, Allam HK, Habib NM, Abdallah AR, Hassan OM. Work schedule and substance abuse in vocational students. J Public Health Res 2021; 11. [PMID: 34351099 PMCID: PMC8883556 DOI: 10.4081/jphr.2021.2395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Drug abuse is one of the world's most serious and rapidly rising problems, causing a wide variety of health issues with significant morbidity and mortality. This study aimed to explore the association between part-time work and substance abuse among vocational students. DESIGN AND METHODS We conducted a cross-sectional analytical study that included all part-time working male students from five vocational male schools, and we used a standardized pretested questionnaire after obtaining written informed consent. A One-Step Multi-Drug Screen Test was used to assess the substances that were abused. RESULTS A total of 316 out of the 400 invited students participated in our study. Of the total screened subjects, 26.6 % were abusing substances. Twenty-five (36.2%) day working adolescents, nine (14.0%) night working adolescents, and forty (36.0%) day and night working adolescents were abusers.Tobacco was the most widely abused drug (68%) in the form of smoking, followed by cannabis (24%), marijuana (16.4%), alcohol (10%), and opioid (6.3%). Night workers had significantly lower rates of smoking, cannabis, Marijuana, alcohol, or opioids abuse, and Logistic regression was performed to ascertain the effects of the work schedule on the likelihood that participants have substance abuse; Night workers were 7.14 times less likely to have substance abuse than day workers, while day and night work did not differ from day work. CONCLUSIONS The prevalence of drug abuse in vocational students is considered high and a serious problem that damages the youth and the community.
Collapse
Affiliation(s)
- Shaimaa Sherif Soliman
- Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University.
| | - Heba Khodary Allam
- Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University.
| | - Nagwa Mahmoud Habib
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University.
| | - Ayat Roushdy Abdallah
- Epidemiology and preventive medicine department, National liver Institute, Menoufia University.
| | - Omayma M Hassan
- Community, Environmental and Occupational Health Department, Faculty of Medicine, Benha University.
| |
Collapse
|