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Haddad S, Shawa M, Kane JC, Bwalya B, Sienkiewicz M, Kilbane G, Chibemba V, Chiluba P, Mtongo N, Metz K, Chibwe M, Mushabati N, Zulu A, Paul R, Banda Z, Loongo H, Kamanga M, Greene MC. Alcohol and other drug use patterns and services in an integrated refugee settlement in Northern Zambia: a formative research study. Confl Health 2023; 17:40. [PMID: 37620915 PMCID: PMC10464007 DOI: 10.1186/s13031-023-00538-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Evidence on patterns of alcohol and other drug (AOD) use and how to effectively deliver services to address AOD use in humanitarian settings is limited. This study aimed to qualitatively explore the patterns of AOD use among Congolese refugees in Mantapala Refugee Settlement and members of the surrounding host community and identify potential appropriate intervention and implementation approaches to address AOD use disorders among conflict-affected populations. METHODS Fifty free listing interviews, 25 key informant interviews, and four focus group discussions were conducted among refugees, host community members, humanitarian implementing agency staff, and refugee incentive workers. These participants were selected based on their knowledge of AOD use and related problems in the settlement and the surrounding host community in northern Zambia. RESULTS Cannabis and home-brewed alcohol were the substances that were perceived to be most commonly used and have the greatest impact on the community. Participants reported that self-medication, boredom, and relief of daily stressors associated with lack of housing, safety, and employment were reasons that people used AODs. Participants recommended that programming include components to address the underlying causes of AOD use, such as livelihood activities. Stigma due to the criminalization of and societal ideals and religious beliefs regarding AOD use was identified as a substantial barrier to accessing and seeking treatment. CONCLUSIONS Our study's findings indicate the need for services to address AOD use in Mantapala Refugee Settlement. Interventions should consider the social and structural determinants of AOD use.
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Affiliation(s)
- Stephanie Haddad
- Columbia University Mailman School of Public Health, 60 Haven Avenue, New York, NY, 10032, USA
| | - Mbaita Shawa
- Women in Law and Development in Africa, PO Box 31456, Lusaka, Zambia
| | - Jeremy C Kane
- Columbia University Mailman School of Public Health, 60 Haven Avenue, New York, NY, 10032, USA
| | | | - Megan Sienkiewicz
- Columbia University Mailman School of Public Health, 60 Haven Avenue, New York, NY, 10032, USA
| | - Grace Kilbane
- Columbia University Mailman School of Public Health, 60 Haven Avenue, New York, NY, 10032, USA
| | - Veronica Chibemba
- Women in Law and Development in Africa, PO Box 31456, Lusaka, Zambia
| | - Princess Chiluba
- Women in Law and Development in Africa, PO Box 31456, Lusaka, Zambia
| | - Nkumbu Mtongo
- Women in Law and Development in Africa, PO Box 31456, Lusaka, Zambia
| | - Kristina Metz
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Mildred Chibwe
- Women in Law and Development in Africa, PO Box 31456, Lusaka, Zambia
| | | | - Allan Zulu
- CARE Zambia, PO Box 36238, Lusaka, Zambia
| | - Ravi Paul
- School of Medicine, University of Zambia, University Teaching Hospital, PO Box 50110, Lusaka, Zambia
| | - Zaliwe Banda
- Zambia Ministry of Health, PO Box 30205, Lusaka, Zambia
| | | | - Muzi Kamanga
- Women in Law and Development in Africa, PO Box 31456, Lusaka, Zambia
| | - M Claire Greene
- Columbia University Mailman School of Public Health, 60 Haven Avenue, New York, NY, 10032, USA.
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Kane JC, Kamanga M, Skavenski S, Murray LK, Shawa M, Bwalya B, Metz K, Paul R, Mushabati N, Ventevogel P, Haddad S, Kilbane G, Sienkiewicz M, Chibemba V, Chiluba P, Mtongo N, Chibwe M, Figge CJ, Alto M, Mwanza D, Mupinde E, Kakumbi S, Tol WA, Vaughan K, Banda Z, Busse A, Ezard N, Zulu A, Loongo H, Greene MC. Testing a Screening, Brief Intervention, and Referral to Treatment Intervention Approach for Addressing Unhealthy Alcohol and Other Drug Use in Humanitarian Settings: Protocol of the Ukuundapwa Chapamo Randomised Controlled Trial. Intervention (Amstelveen) 2023; 21:58-69. [PMID: 37228642 PMCID: PMC10206531 DOI: 10.4103/intv.intv_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Refugees and other displaced persons are exposed to many risk factors for unhealthy alcohol and other drug (AOD) use and concomitant mental health problems. Evidence-based services for AOD use and mental health comorbidities are rarely available in humanitarian settings. In high income countries, screening, brief intervention and referral to treatment (SBIRT) systems can provide appropriate care for AOD use but have rarely been used in low- and middle-income countries and to our knowledge never tested in a humanitarian setting. This paper describes the protocol for a randomised controlled trial to compare the effectiveness of an SBIRT system featuring the Common Elements Treatment Approach (CETA) to treatment as usual in reducing unhealthy AOD use and mental health comorbidities among refugees from the Democratic Republic of the Congo and host community members in an integrated settlement in northern Zambia. The trial is an individually randomised, single-blind, parallel design with outcomes assessed at 6-months (primary) and 12-months post-baseline. Participants are Congolese refugees and Zambians in the host community, 15 years of age or older with unhealthy alcohol use. Outcomes are: unhealthy alcohol use (primary), other drug use, depression, anxiety and traumatic stress. The trial will explore SBIRT acceptability, appropriateness, cost-effectiveness, feasibility, and reach.
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Affiliation(s)
- Jeremy C. Kane
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - Muzi Kamanga
- Women in Law and Development in Africa, Lusaka, Zambia
| | | | - Laura K. Murray
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mbaita Shawa
- Women in Law and Development in Africa, Lusaka, Zambia
| | | | - Kristina Metz
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ravi Paul
- University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia
| | | | - Peter Ventevogel
- Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Stephanie Haddad
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - Grace Kilbane
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - Megan Sienkiewicz
- Columbia University Mailman School of Public Health, New York, New York, USA
| | | | | | - Nkumbu Mtongo
- Women in Law and Development in Africa, Lusaka, Zambia
| | | | - Caleb J. Figge
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michelle Alto
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David Mwanza
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth Mupinde
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shira Kakumbi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wietse A. Tol
- University of Copenhagen, Copenhagen, Denmark
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | - Anja Busse
- United Nations Office on Drug Use and Crime, Vienna, Austria
| | - Nadine Ezard
- University of New South Wales, Sydney, Australia
| | | | | | - M. Claire Greene
- Columbia University Mailman School of Public Health, New York, New York, USA
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Abstract
Titanium silicalite is an effective molecular-sieve catalyst for the selective oxidation of alkanes, the hydroxylation of phenol and the epoxidation of alkenes in the presence of H2O2 (refs 1-3). The range of organic compounds that can be oxidized is greatly limited, however, by the relatively small pore size (about 0.6 nm) of the host framework. Large-pore (mesoporous) silica-based molecular sieves have been prepared recently by Kresge et al. and Kuroda et al.; the former used a templating approach in which the formation of an inorganic mesoporous structure is assisted by self-organization of surfactants, and the latter involved topochemical rearrangement of a layered silica precursor. Here we describe the use of the templating approach to synthesize mesoporous silica-based molecular sieves partly substituted with titanium--large-pore analogues of titanium silicalite. We find that these materials show selective catalytic activity towards the oxidation of 2,6-di-tert-butyl phenol to the corresponding quinone and the conversion of benzene to phenol.
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Affiliation(s)
- P T Tanev
- Department of Chemistry, Michigan State University, East Lansing 48824
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