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Mmethi TG, Modjadji P, Mathibe M, Thovhogi N, Sekgala MD, Madiba TK, Ayo-Yusuf O. Substance Use among School-Going Adolescents and Young Adults in Rural Mpumalanga Province, South Africa. Behav Sci (Basel) 2024; 14:543. [PMID: 39062366 PMCID: PMC11274307 DOI: 10.3390/bs14070543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The ongoing public health crisis of substance use among school adolescents and young adults (AYAs) in South Africa is not new in research parlance, amidst the national policy of drug abuse management in schools. In view of no tangible progress to reduce substance use in high schools in the country, we conducted a cross-sectional quantitative study aimed at investigating substance use among adolescents and young adults in the four public high schools selected through multi-stage sampling in rural Mpumalanga province, South Africa. Data on substance use, demographics, household socio-demographics, and related factors were collected via a validated self-administered questionnaire. Hierarchical logistic regression was performed using STATA 18. The study included 402 AYAs aged between 14 and 23 years (18 ± 1 years), and 45% reported substance use in the last twelve months. Alcohol was the most used substance (74%), followed by cigarettes (12%) and cannabis (11%). AYAs used substances out of social influence, curiosity, to find joy, and to eliminate stress, especially in social events, on the streets, and at home, and reported negative physical health outcomes, mainly hallucinations, sleeping disorders, body weakness, and dry mouths. Hierarchical logistic regression showed that the likelihood of substance use was three times in a particular high school (S4) (AOR = 3.93, 95%CI: 1.72-8.99), twice among the grade 12s (AOR = 2.73, 95%CI: 1.46-5.11), over twenty times in the communities with substance availability (AOR = 22.45, 95%CI: 2.75-183.56), almost ten times among AYAs participating in recreational/sports activities (AOR = 9.74, 95%CI: 4.21-22.52), and twice likely to happen in larger households (AOR = 2.96, 95%CI: 1.57-5.58). Prevention and intervention efforts should consider these specific health concerns to develop targeted strategies for mitigating substance use and its adverse consequences in this vulnerable population towards achieving the United Nations' Sustainable Development Goal Target 3.5, which aims to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol.
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Affiliation(s)
- Tabeho Godfrey Mmethi
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (T.G.M.)
- Department of Community Dentistry, School of Dentistry, University of Pretoria, Pretoria 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (T.G.M.)
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Roodepoort, Johannesburg 1709, South Africa
- Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa;
| | - Mmampedi Mathibe
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (T.G.M.)
| | - Ntevhe Thovhogi
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
| | - Machoene Derrick Sekgala
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
| | - Thomas Khomotjo Madiba
- Department of Community Dentistry, School of Dentistry, University of Pretoria, Pretoria 0208, South Africa
| | - Olalekan Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa;
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Londani M, Oladimeji O. Tobacco use and behaviour among South African adolescents and young adults: systematic review and meta-analysis. BMJ Open 2024; 14:e079657. [PMID: 38413155 PMCID: PMC10900320 DOI: 10.1136/bmjopen-2023-079657] [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: 09/08/2023] [Accepted: 01/26/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE Tobacco use, particularly the initiation of smoking during adolescence and young adulthood, represents a significant public health concern in South Africa. This study aims to conduct a comprehensive review of published literature about tobacco use and behaviour among adolescents and young adults and to determine an aggregated prevalence estimate of tobacco use within this demographic. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed/MEDLINE, EMBASE, Cochrane Library, Scopus and Google Scholar were searched from 1 January 2000 through 31 October 2023. ELIGIBILITY CRITERIA Studies were eligible for inclusion if they were cross-sectional studies conducted in South Africa and measured the prevalence and determinants of tobacco use among adolescents and young adults aged 12-24 years. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted information for each article and saved it into an Excel spreadsheet. Risk of bias analysis was conducted using the Risk of Bias Assessment Tool for non-randomised studies. The methodology quality of each selected study was evaluated using the Joanna Briggs Institute checklist. The heterogeneity of prevalence estimates was assessed using I2 statistic (random-effects DerSimonian-Laid approach). RESULTS Out of 73 articles identified, 12 articles were included in the analysis. The pooled prevalence of current tobacco use among South African adolescents and young adults was estimated to be 22%. The pooled prevalence of tobacco use among school dropouts, university students and secondary school learners was 51%, 20% and 16%, respectively. Stratifying using gender, boys (26%) were two times more likely to use tobacco than girls (13%). CONCLUSION The elevated occurrence of tobacco usage among South African adolescents and young adults is a relevant public health concern. There is a need for more population-based prevalence studies at a national level to estimate the burden of tobacco use in South Africa. PROSPERO REGISTRATION NUMBER CRD42023428369.
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Affiliation(s)
- Mukhethwa Londani
- Directorate of Research and Innovation, Tshwane University of Technology, Pretoria, South Africa
| | - Olanrewaju Oladimeji
- Department of Epidemiology and Biostatistics, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Florence GE, Derman WE, Popperwell JM, Kunorozva L, Gomez-Ezeiza J. Prevalence of health risk behaviours related to non-communicable diseases amongst South African university students: a systematic review. J Public Health (Oxf) 2023; 45:1042-1055. [PMID: 37409582 PMCID: PMC10688999 DOI: 10.1093/pubmed/fdad106] [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: 06/09/2022] [Revised: 06/16/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Engagement in risk behaviours adopted during university continues after graduation, increasing the risk of non-communicable diseases (NCDs). This systematic review aimed to investigate the prevalence of NCD risk behaviours amongst South African university students. METHODS PubMed and Scopus databases were searched (January 1990-April 2022) for studies investigating alcohol consumption, cigarette smoking, inadequate consumption of fruits and vegetables and physical inactivity. Study qualities were assessed with the Joanna Briggs Institute critical appraisal and levels of evidence checklists. An overall prevalence percentage was obtained for each risk behaviour. RESULTS A total of 50 studies (n = 26 624 students) were included. A range of 44.8-75.0% of students consumed inadequate servings of fruits and vegetables. Just over 54% consumed alcohol (95% confidence intervals [95%CI]:54.0-55.5%). A significantly higher percentage of males (44.2%) than females (25.8%) drank heavily (P < 0.001). Approximately one-third (34.8%, 95%CI:33.4-36.3%) were sedentary and 39.0% (95%CI:37.5-40.4%) were insufficiently active. Almost one-fifth (17.9%, 95%CI:17.3-18.5%) smoked cigarettes, being significantly more prevalent amongst males (21.8%) than females (13.5%) (P < 0.001). A total of 10% smoked 1-10 cigarettes/day and 1.2% smoked >10 cigarettes/day. CONCLUSION High percentages of South African students eat inadequate servings of fruits and vegetables, consume alcohol are physically inactive and smoke cigarettes. South African universities should implement screening measures and health campaigns.
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Affiliation(s)
- Gabriella E Florence
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Wayne E Derman
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7600, South Africa
- IOC Research Centre, University of Pretoria, Stellenbosch University & South African Medical Research Council, South Africa
| | - Jake M Popperwell
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Lovemore Kunorozva
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Josu Gomez-Ezeiza
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7600, South Africa
- IOC Research Centre, University of Pretoria, Stellenbosch University & South African Medical Research Council, South Africa
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Adolescent Substance Use Behavior Change Through School Intervention Is Improved by Teacher and School Implementation Support Together, Especially for Girls. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1251-1263. [PMID: 35713739 PMCID: PMC9949964 DOI: 10.1007/s11121-022-01394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 01/25/2023]
Abstract
An earlier trial of a school-based, preventative intervention, HealthWise South Africa, demonstrated some efficacy in preventing adolescent drinking and smoking in the Western Cape, South Africa. This was followed by the current implementation trial, which examined how implementation support conditions influenced adolescent drinking and smoking behavior change in the HealthWise intervention. The hybridized implementation-effectiveness trial included 34 schools (n = 2175 students) that provided student data at four waves through Grades 8 to 10. Implementation support conditions included a combination of two components (enhanced school environment and teacher consultation), resulting in four conditions: enhanced school environment, teacher consultation, both components, and standard delivery. Using configural frequency analysis, we examined how drinking and smoking behavior change differed across four configurations of intervention support longitudinally and by gender. For baseline non-smokers, results indicated sustained differences in abstention from smoking and smoking initiation between schools that received both support components and schools in the standard delivery condition. These results were primarily driven by girls. For baseline drinkers and smokers in the both components condition, changes in drinking were delayed until Grade 9 and smoking decayed by Grade 10. Results suggest that providing both school and teacher implementation support synergistically facilitates improved intervention outcomes both immediately following intervention and 2 years later across schools with diverse resource levels. Future iterations of HealthWise, and other interventions, may benefit from a multilevel implementation support strategy to improve student outcomes. More research is needed to understand how to improve HealthWise effectiveness among boys.
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Hoare J, Fouche JP, Phillips N, Heany SJ, Myer L, Zar HJ, Stein DJ. Alcohol use is associated with mental health problems and brain structural alterations in adolescents with perinatally acquired HIV infection on ART. Alcohol 2021; 97:59-66. [PMID: 34536544 DOI: 10.1016/j.alcohol.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
Alcohol use, presents unique challenges for HIV-1 treatment in adolescents with perinatally acquired infection. The effects of alcohol on host-virus interaction in the brain and the immune system remains understudied in this population. Adolescents with perinatally acquired HIV infection (PHIV) well established on ART, from the Cape Town Adolescent Antiretroviral Cohort who self-reported alcohol use (PHIV + alcohol) (n = 26) were compared to age matched 26 PHIV (PHIV-alcohol) and 26 healthy controls (HC) who reported no use of alcohol. Participants completed clinical investigations including highly-sensitive CRP (hs-CRP), a comprehensive neurocognitive test battery and mental health measures. In addition, we investigated the relationship between alcohol use in PHIV and diffusion tensor imaging (DTI) and structural brain magnetic resonance imaging (MRI) to determine fractional anisotropy (FA), mean diffusivity (MD), grey and white matter volumes and cortical thickness. PHIV (mean age 12,5 years; mean age of ART initiation 3.15 years) reported an occasional weekend drinking pattern of alcohol use. hs-CRP was significantly different between groups, with PHIV + alcohol higher than PHIV-alcohol and HC. General intelligence, attention, working memory, processing speed and executive function were more impaired in the PHIV + alcohol than PHIV alone, with HC having the highest scores. In addition, self-concept was significantly lower in PHIV + alcohol. The Child Behavior Checklist (CBCL) Externalizing behaviour, internalising behaviour and CBCL Total problems were significantly higher in PHIV + alcohol. FA of the superior corona radiata, superior fronto-occipital fasciculus and corpus callosum was significantly lower in PHIV + alcohol compared to PHIV-alcohol and MD of the corona radiata was significantly increased in PHIV + alcohol. The cortical thickness of the lateral orbitofrontal, middle frontal and precentral gyri were significantly lower in PHIV + alcohol compared to PHIV-alcohol and HC. In conclusion PHIV associated impairments in systemic inflammation, cognitive function, mental health and changes in brain structure may be exacerbated by alcohol use, even if only occasional use. However, the study is cross-sectional, which is not able to distinguish between cause and effect.
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Carney A, Kaaya S, Kajula L, Ibitoye M, Marwerwe G, Sommer M. ‘Most of the Youth Are Drinking Because They Have Nothing to Do’: How Idle Time Facilitates Adolescent Alcohol Use in Urban Tanzania. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2021. [DOI: 10.1080/1067828x.2021.1888169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Allison Carney
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sylvia Kaaya
- Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lusajo Kajula
- Office of Research – Innocenti, UNICEF, Dar es Salaam, Tanzania
| | - Mobolaji Ibitoye
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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Fagbamigbe AF, Desai R, Sewpaul R, Kandala NB, Sekgala D, Reddy P. Age at the onset of tobacco smoking in South Africa: a discrete-time survival analysis of the prognostic factors. ACTA ACUST UNITED AC 2020; 78:128. [PMID: 33292586 PMCID: PMC7709430 DOI: 10.1186/s13690-020-00503-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/05/2020] [Indexed: 11/18/2022]
Abstract
Background While knowledge of onset of smoking tobacco, and associated risk factors can aid the formulation of evidence-based policy and interventions, such information is scarce in South Africa. We assessed age at onset of tobacco smoking in South Africa and identified its risk factors. Methods We analysed data of 15,316 respondents aged 15–98 years from the 2012 South African National Health and Nutrition Examination Survey. Descriptive statistics and survival analysis techniques were used alongside weighted percentages. Results Overall lifetime prevalence of smoking was 20.5%. Among the 3360 ever-smoked respondents, the overall median age at smoking onset was 18 years (Inter-quartile range (IQR) =5) with 2% starting before age 10 while 60% had smoked before age 20. Likelihood of tobacco smoking was higher among adolescents (<=20 years) and those aged 20–29 years than those aged > = 60 years, thrice higher among males, 29% higher among urban dwellers and thrice higher in Western Cape and Free State than in North West Province. The onset of tobacco smoking was earlier among males, wealthier and “coloured” people from Northern and Eastern Capes. Conclusion The onset of tobacco smoking peaked at 15–22 years and varied by province, sex, location, race and other characteristics. The age restrictions on smoking in South Africa has changed over time, coupled with the recent open and electronic advertisement of tobacco, and social media could have influenced the earlier onset of tobacco smoking in South Africa. Stricter regulations on tobacco-related advertisement and sales should be implemented.
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Affiliation(s)
- Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Division of Population and Behavioural Sciences, School of Medicine, St Andrews University, Fife, UK. .,Division of Health Sciences, Populations, Evidence and Technologies Group, University of Warwick, Coventry, UK.
| | - Rachana Desai
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ronel Sewpaul
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council (HSRC), 116 - 118 Merchant House, Buitengracht Street, Cape Town, 8001, South Africa
| | - Ngianga-Bakwin Kandala
- Division of Epidemiology and Biostatistics, University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
| | - Derrick Sekgala
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council (HSRC), 116 - 118 Merchant House, Buitengracht Street, Cape Town, 8001, South Africa
| | - Priscilla Reddy
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council (HSRC), 116 - 118 Merchant House, Buitengracht Street, Cape Town, 8001, South Africa.,Nelson Mandela University, Port Elizabeth, South Africa
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Naidoo P, Nyembezi A, Thomas E, Lachman A, Kagee A. Perceived barriers and facilitators for healthy behaviours among parents of adolescents receiving mental health care in a public hospital in Cape Town, South Africa: A qualitative study. J Child Adolesc Ment Health 2019; 31:39-50. [PMID: 30961448 DOI: 10.2989/17280583.2019.1584107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To explore the perceived barriers and facilitators for healthy behaviours among parents and caregivers of adolescents receiving mental health care in Cape Town, South Africa. Method: Thirty-five qualitative in-depth interviews were conducted with parents and caregivers of adolescents receiving mental health treatment by six facilitators matched for language. The data was analysed using thematic analysis. Results: The participants were predominantly female (n = 28, 80%) and parents (n = 29, 83%) of the adolescents. Personal barriers to good health included unhealthy eating, substance use and physical inactivity. Environmental barriers were inherited medical conditions, the easy availability of unhealthy foods and the absence of recreational facilities in communities. Perceived facilitators to good health were parental role modelling, planning and preparing healthy meals, exercise opportunities providing by walking long distances to work, and doing physically demanding jobs and household chores. Conclusion: Parents and caregivers are essential to adolescents' healthy development as they may influence adolescent health behaviours. It is likely that the promotion of positive health behaviours may be achieved though family-based interventions.
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Affiliation(s)
- Pamela Naidoo
- a Department of Psychiatry , Stellenbosch University , Tygerberg , South Africa
| | - Anam Nyembezi
- b School of Public Health , University of the Western Cape , Bellville , South Africa
| | - Eileen Thomas
- a Department of Psychiatry , Stellenbosch University , Tygerberg , South Africa
| | - Anusha Lachman
- a Department of Psychiatry , Stellenbosch University , Tygerberg , South Africa
| | - Ashraf Kagee
- c Department of Psychology , Stellenbosch University , Stellenbosch , South Africa
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Ware LJ, Charlton K, Kruger R, Breet Y, van Rooyen J, Huisman H, Botha S, Uys AS, Rennie KL, Naidoo N, Kowal P, Schutte AE. Assessing tobacco use in an African population: Serum and urine cotinine cut-offs from South Africa. Drug Alcohol Depend 2019; 195:82-89. [PMID: 30593984 PMCID: PMC6424978 DOI: 10.1016/j.drugalcdep.2018.11.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/24/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cotinine, a nicotine metabolite, is used to measure tobacco use and exposure, but recommended cut-offs to differentiate tobacco users from those exposed through the environment range from 3 to 58 ng/ml in serum, and 2.5 to 550 ng/ml in urine. Cut-offs may differ by ethnicity, sex and age. As data from adults in Africa are scarce, our aim was to evaluate cut-offs for serum and urine cotinine that best predict self-reported tobacco use in South African adults. METHODS Two datasets were explored: African-PREDICT (n = 941 black and white healthy young adults, 20-30 years, serum cotinine); and WHO SAGE Wave 2 (n = 604 adults, 18-102 years, urine cotinine). Population specific cut-offs (ROC analyses) were compared with published cut-offs and self-reported tobacco use. RESULTS Overall, 19% (293 of 1545) reported current tobacco use. The following cotinine cut-offs showed the highest sensitivity and specificity: serum ≥15 ng/ml in black and white men, and white women; serum ≥10 ng/ml in black women; urine ≥300 ng/ml for black, mixed ancestry, and older adults (50-plus years); urine ≥500 ng/ml for younger adults (18-49 years). Specificity was lower for urine than for serum cotinine. CONCLUSION Our study suggests that a serum cotinine level of ≥15 ng/ml and a urine cotinine level of ≥300 ng/ml best distinguish current tobacco users from non-users generally in the South African adult population.
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Affiliation(s)
- Lisa J. Ware
- South African MRC Developmental Pathways for Health
Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South Africa;
,Hypertension in Africa Research Team (HART), North-West
University, Potchefstroom, South Africa; ;
; ;
; ;
| | - Karen Charlton
- School of Medicine, University of Wollongong, and Illawarra Health and Medical Research Institute, New South Wales, Australia.
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, South Africa.
| | - Yolandi Breet
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Johannes van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Hugo Huisman
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Shani Botha
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, South Africa.
| | - Aletta S. Uys
- Hypertension in Africa Research Team (HART), North-West
University, Potchefstroom, South Africa; ;
; ;
; ;
| | - Kirsten L. Rennie
- Centre for Lifespan and Chronic Illness Research,
University of Hertfordshire, United Kingdom;
| | | | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland; University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, Australia.
| | - Aletta E. Schutte
- Hypertension in Africa Research Team (HART), North-West
University, Potchefstroom, South Africa; ;
; ;
; ;
,MRC Research Unit for Hypertension and Cardiovascular
Disease, North-West University, South Africa
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Hogarth L, Martin L, Seedat S. Relationship between childhood abuse and substance misuse problems is mediated by substance use coping motives, in school attending South African adolescents. Drug Alcohol Depend 2019; 194:69-74. [PMID: 30412899 PMCID: PMC6327152 DOI: 10.1016/j.drugalcdep.2018.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/17/2018] [Accepted: 10/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND In adults, it has been shown that the relationship between childhood abuse and substance misuse problems is mediated by the belief that substance use helps cope with negative affective states. By contrast, in adolescents, it is unknown whether drug use coping motives play this same mediating role. METHODS Secondary analysis of 1149 school attending adolescents in Cape Town, South Africa (average age = 16.24 years, range = 13-23; 60% female). Questionnaire measures obtained during a single test session (among a larger battery) assessed childhood trauma (CTQ), alcohol (AUDIT) and drug problems (DUDIT), and coping orientation (A-COPE) which contained three items assessing drug use to cope with negative affect. RESULTS The three types of childhood abuse measured by the CTQ - emotional, physical and sexual - were positively associated with greater alcohol/drug problems, and drug use coping motives. Drug use coping motives mediated the relationships between childhood abuse types and alcohol/drug problems, and these mediational pathways remained significant when gender and other subscales of the A-COPE were included as covariates. CONCLUSIONS These data are preliminary insofar as drug use coping motives were assessed with a non-validated subscale of the A-COPE. Nevertheless, drug use to cope with negative affect mediated the relationship between all three types of childhood abuse (emotional, physical, sexual) and alcohol/drug problems in school attending adolescents. The implication is that drug prevention programs for this risk group should seek to mitigate drug use coping motives.
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Affiliation(s)
- Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
| | - Lindi Martin
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
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Prevalence of Alcohol and Tobacco Use among Men and Women in Namibia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010059. [PMID: 30587825 PMCID: PMC6338963 DOI: 10.3390/ijerph16010059] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 11/16/2022]
Abstract
Namibia is known to have a high prevalence of tobacco smoking and alcohol consumption. Individuals who smoke are more likely to drink, and vice versa. It was reported that the individual rewarding effect of drinking and smoking were reported to be higher than when they are used at the same time. In this study our objective was to examine the individual and combined prevalence of drinking and smoking and investigate their sociodemographic correlates among adolescent and adult men and women in Namibia. This study was based on data from Namibia Demographic and Health Survey (NDHS 2013). Sample population were 14,185 men and women aged between 15 and 64 years. Self-reported tobacco smoking and alcohol consumption patterns were the outcome variables. Data were analysed using complex sampling techniques to account for survey design. Bivariate and multivariate techniques were used to measure the association between drinking and smoking with the sociodemographic factors. The prevalence of alcohol and tobacco use was, respectively, 53.1% (51.5–54.6) and 8.8% (8.1–9.5), and that of both drinking and smoking was 6.9% (6.3–7.6). In the regression analysis, several sociodemographic factors were found to be significantly associated with alcohol and tobacco use including age, area of residence, religion and educational status. Overall, women had higher rates of drinking alcohol; however, men had higher rates of engaging in high risk drinking. Men and women who reported drinking alcohol had, respectively, 2.57 and 4.60 times higher odds of smoking. Findings suggest that the prevalence of drinking was higher than that of smoking, with men having higher prevalence of high risk drinking. Men and women who drink alcohol were more likely to be smokers. The prevalence of both alcohol and tobacco use showed important sociodemographic patterns which need to be taken into consideration in designing prevention and intervention programs. Strategic tobacco control and smoking cessation approaches should pay particular attention to alcohol users.
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Brittain K, Myer L, Phillips N, Cluver LD, Zar HJ, Stein DJ, Hoare J. Behavioural health risks during early adolescence among perinatally HIV-infected South African adolescents and same-age, HIV-uninfected peers. AIDS Care 2018; 31:131-140. [PMID: 30340446 DOI: 10.1080/09540121.2018.1533233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Behavioural health risks, including substance use, early sexual debut, bullying and suicidality, are common during adolescence, but may be complicated among perinatally HIV-infected adolescents. However, there are few data exploring these behaviours in sub-Saharan Africa. We compared behavioural health risks (any self-report of substance use, sexual activity, bullying others or suicidality, or a positive urine toxicology screen) among perinatally-infected adolescents ages 9-14 years to that of an HIV-uninfected comparator group; and explored the effect of behavioural health risks on adolescent and caregiver report of adolescent suboptimal adherence (missed antiretroviral therapy dose(s) on ≥1 day during the preceding 30 days) and elevated HIV viral load (≥50 and ≥1000 copies/mL in sensitivity analyses) in multivariable logistic regression models. Among 506 HIV-infected and 110 HIV-uninfected adolescents (median age overall: 12 years), 15% and 25% reported any behavioural health risk (p = 0.018), respectively. Tobacco and other drug use was uncommon, while alcohol use was reported by 8% of HIV-infected versus 12% of HIV-uninfected adolescents (p = 0.185). One HIV-infected (0.2%) and 3 HIV-uninfected adolescents (3%) reported any sexual activity (p = 0.019). Among HIV-infected adolescents, report of any behavioural health risk was more common among male adolescents [adjusted odds ratio (aOR): 1.78; 95% confidence interval (CI): 1.08-2.95] and was associated with adolescent report of suboptimal adherence (aOR: 1.66; 95% CI: 0.99-2.78) but not with caregiver report of suboptimal adherence or with elevated viral load. In this group of perinatally-infected youth entering early adolescence, the prevalence of behavioural health risks was lower than that among same-age, HIV-uninfected peers. Longitudinal data are needed to explore the reasons underlying these differences, for example the possibility of more protective caregiving and supportive family environments, or of emotional and physical immaturity, as well as the emergence of risk behaviours over time in this population.
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Affiliation(s)
- Kirsty Brittain
- a Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa.,b Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Landon Myer
- a Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa.,b Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Nicole Phillips
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa
| | - Lucie D Cluver
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa.,d Centre for Evidence-Based Intervention, Department of Social Policy & Intervention , University of Oxford , Oxford , United Kingdom
| | - Heather J Zar
- e Department of Paediatrics & Child Health , University of Cape Town , Cape Town , South Africa.,f Medical Research Council Unit on Child & Adolescent Health , Cape Town , South Africa
| | - Dan J Stein
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa
| | - Jacqueline Hoare
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa
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