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Mupara LM, Tapera R, Selemogwe-Matsetse M, Kehumile JT, Gaogane L, Tsholofelo E, Murambiwa P. Alcohol and substance use prevention in Africa: systematic scoping review. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2021.1941356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lucia M. Mupara
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
- Department of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Roy Tapera
- Department of Environmental Health, School of Public health, Faculty of Health Sciences, Gaborone, Botswana
| | - Morekwe Selemogwe-Matsetse
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Johanne T. Kehumile
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Lebogang Gaogane
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Ellen Tsholofelo
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Pretty Murambiwa
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
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Kalema D, Van Damme L, Vindevogel S, Derluyn I, Baguma P, Vanderplasschen W. Correlates of motivation for treatment among alcohol service users in Uganda. THERAPEUTIC COMMUNITIES 2021. [DOI: 10.1108/tc-04-2020-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Given the scarce literature on alcohol use disorders (AUD) and their treatment in developing countries, this paper aims to explore motivation levels and their correlates among alcohol service users in two residential treatment centres in Kampala, Uganda. This study how motivation levels of Ugandan alcohol service users compare with those from American studies; and the specific factors affecting internal and external motivation in the Ugandan context.
Design/methodology/approach
The motivation for treatment was measured among 100 individuals entering AUD treatment using the Texas Christian University (TCU) Treatment needs and Motivation scale. The WHOQoL–BREF, Addiction Severity Index–6 and Hopkins Symptoms Check List–37 were used to measure addiction severity, quality of life (QoL) and psychopathology, respectively. Correlates of motivation were identified using linear regression analyses.
Findings
Ugandan service users demonstrated low treatment motivation in the treatment needs a domain. While addiction severity (recent heavy alcohol use) and participating in private treatment were associated with higher internal and external motivation, deterioration in physical and environmental QoL, depressive symptoms and lower education were linked with higher internal motivation.
Research limitations/implications
Different elements affect domains of treatment motivation, requiring attention for clients’ unique needs as influenced by their background, addiction severity, QoL, psychological needs and contextual factors (e.g. treatment setting). Further studies are needed to explore additional correlates of motivation for treatment among alcohol service users in Uganda and to assess the longitudinal impact of motivation on treatment outcomes.
Originality/value
Although motivation has been extensively studied, clinicians are challenged in understanding and explaining motivational dynamics given the multiplicity of factors influencing change-related decisions and behaviours and the diversity in substance-using populations. This need is even bigger in non-Western societies as cultural differences may require differential therapeutic management. This is one of the first studies measuring motivation for AUD treatment in a low-income country and offers insight for understanding motivation dynamics in similar settings.
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Kuteesa MO, Webb EL, Kawuma R, Naluwugge J, Thadeus K, Ndekezi D, Seeley J. 'We shall drink until Lake Victoria dries up': Drivers of heavy drinking and illicit drug use among young Ugandans in fishing communities. Glob Public Health 2021; 17:538-554. [PMID: 33460355 DOI: 10.1080/17441692.2021.1873399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated patterns and drivers of alcohol misuse and illicit drug use among young fisherfolk. We undertook this study in fishing communities on Koome Island, Lake Victoria, Uganda, from December 2017-July 2018. We conducted six group discussions with men (3) and women (3) and 33 in-depth interviews with: young people [users (n = 10); non-users (n = 2)], local leaders (n = 3), health workers (n = 2), parents (n = 5), alcohol/illicit drugs sellers/distributors (n = 5), law enforcement officers (n = 5). We sampled participants using purposive and snowball strategies. Interview themes included: knowledge, experiences and perceptions of alcohol use/illicit drug use, HIV risk behaviour and harm reduction. We mapped alcohol/illicit drug use outlets using a Geographic Information System to capture density, distribution and proximity to young people's homes. We coded and analysed qualitative data using thematic content analysis. Motivations for heavy drinking and illicit drug use were multifaceted and largely beyond individual control. Key contextual determinants included social norms around consumption (acceptability), price (affordability), and ease of purchase (availability). Prevention and harm reduction interventions to tackle alcohol misuse and illicit drug use should be aimed at the structural rather than individual level and must be conducted in tandem with strategies to control poverty and HIV.
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Affiliation(s)
- Monica O Kuteesa
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Racheal Kawuma
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Josephine Naluwugge
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Kiwanuka Thadeus
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Denis Ndekezi
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Janet Seeley
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Kalema D, Van Damme L, Vindevogel S, Derluyn I, Meulewaeter F, Vanderplasschen W. Predictors of Early Recovery after Treatment for Alcohol use Disorders in Uganda. ALCOHOLISM TREATMENT QUARTERLY 2019. [DOI: 10.1080/07347324.2019.1692639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- David Kalema
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Lore Van Damme
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Sofie Vindevogel
- Department of Orthopedagogics, University College Ghent, Ghent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Florien Meulewaeter
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Wouter Vanderplasschen
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Kibicho J, Campbell JK. Community perspectives of second-generation alcohol misuse and HIV risk in rural Kenya: A gendered syndemic lens. Glob Public Health 2019; 14:1733-1743. [PMID: 31291832 DOI: 10.1080/17441692.2019.1638958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Sub-Saharan Africa is at the intersection of the HIV epidemic and the highest burden of alcohol-related disease and injury. Alcohol consumption is associated with an increased likelihood of HIV infection, high rates of intimate partner violence and is considered both a cause and a contributor of economic stress and poverty. Our study integrates the syndemic and socio-ecological system theoretical frameworks to qualitatively explore the effect of second-generation alcohol consumption on sexual risk behaviours, alcohol misuse, violence and economic stress (SAVE) factors and HIV infection risk. We recruited 80 people from rural Kenya to participate in 12 focus groups. Consistent with the literature, we found evidence of syndemic associations of second-generation alcohol consumption with SAVE factors, including HIV infection risk. Structural-level factors including availability of cheap second-generation alcohol and widespread unemployment are the biggest risk factors for alcohol misuse. Because of the psychological effect of women's increasing economic independence on men, gendered syndemic programming - that includes both men and women - and addresses the complex web of risk factors for second-generation alcohol misuse can interrupt the vicious cycle of poverty, violence, sexual risk behaviours and mitigate HIV infection risk in rural Kenya.
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Affiliation(s)
- Jennifer Kibicho
- College of Nursing, University of Wisconsin-Milwaukee , Milwaukee , WI , USA
| | - Julie Kieffer Campbell
- College of Nursing, University of Wisconsin-Milwaukee , Milwaukee , WI , USA.,School of Nursing, Lee University , Cleveland , TN , USA
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Otim O, Juma T, Otunnu O. Assessing the health risks of consuming 'sachet' alcohol in Acoli, Uganda. PLoS One 2019; 14:e0212938. [PMID: 30811520 PMCID: PMC6392317 DOI: 10.1371/journal.pone.0212938] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
Abstract
The increased mortality rate among the Acoli people of northern Uganda is anecdotally blamed on excessive consumption of cheap and widely available sachet-packaged alcohol in the region. In this paper, we quantify this perceived association by determining statistically the health risks associated with ingesting 20 heavy metals in 17 popular spirits products consumed in Acoli. Thirteen of these products were industrially packaged in sachets (locally known as 'sachet,' waragi, arege or moo lyec) and four were locally produced Lira-Lira spirits from Bolo, Awere and Teso Bar in the region and Nsambya in southern Uganda. A Scottish whisky purchased in San Diego (USA) was our reference. Risk assessment was performed according to standardized protocols developed by the United States Environmental Protection Agency (US EPA). Our results show that a strong correlation indeed exists between health risks and ingestion of spirits in Acoli. At >2.5 sachets/day for 240 day/year over a lifetime for example, the risk of developing cancer due to exposure to As, Pb and Cr alone is 1 in 102,041. This estimate excludes ethanol, a known carcinogen, and 17 heavy metals also studied due to lack of their cancer slope factors. The primary non-cancer related health risk factor in all samples tested is ethanol with unacceptably high health index of four. The Lira-Lira spirits, with 100-6000% copper above the US EPA limit for intake by oral ingestion in water, would be the 'cleanest' without copper and at par with the Scottish whisky. Collectively, we find that no amount of alcohol consumed in Acoli is safe. Preventive measures are therefore recommended to reduce mortality in Acoli in particular, and in Uganda in general. These measures should include public education, better public policies, creating productive economic activities other than brewing alcohol, and social activities that engage people away from drinking.
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Affiliation(s)
- Ochan Otim
- Department of Humanities and Sciences, University of California-Los Angeles, Los Angeles, California, United States of America.,Environmental Monitoring Division, City of Los Angeles, Playa Del Rey, California, United States of America
| | - Tom Juma
- Environmental Monitoring Division, City of Los Angeles, Playa Del Rey, California, United States of America
| | - Olara Otunnu
- Former Under-Secretary-General of the United Nations, New York, New York, United States of America
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Kalema D, Vindevogel S, Derluyn I, Baguma PK, Bannink F, Vanderplasschen W. Perspectives of alcohol treatment providers and users on alcohol addiction and its facilitating factors in Uganda and Belgium. DRUGS: EDUCATION, PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1381667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- David Kalema
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- School of Psychology, Makerere University, Kampala, Uganda
| | - Sofie Vindevogel
- Department of Orthopedagogics, University College Ghent, Ghent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | | | - Femke Bannink
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Wouter Vanderplasschen
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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