Alcohol use among emergency medicine department patients in Tanzania: A comparative analysis of injury versus non-injury patients.


Journal

PLOS global public health
ISSN: 2767-3375
Titre abrégé: PLOS Glob Public Health
Pays: United States
ID NLM: 9918283779606676

Informations de publication

Date de publication:
2023
Historique:
received: 16 04 2023
accepted: 19 09 2023
medline: 1 11 2023
pubmed: 1 11 2023
entrez: 1 11 2023
Statut: epublish

Résumé

Alcohol is a leading behavioral risk factor for death and disability worldwide. Tanzania has few trained personnel and resources for treating unhealthy alcohol use. In Emergency Medicine Departments (EMDs), alcohol is a well-known risk factor for injury patients. At Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania, 30% of EMD injury patients (IP) test positive for alcohol upon arrival to the ED. While the IP population is prime for EMD-based interventions, there is limited data on if non-injury patients (NIP) have similar alcohol use behavior and potentially benefit from screening and intervention as well. This was a secondary analysis of a systematic random sampling of adult (≥18 years old), KiSwahili speaking, KCMC EMD patients surveyed between October 2021 and May 2022. When medically stable and clinically sober, participants provided informed consent. Information on demographics (sex, age, years of education, type of employment, income, marital status, tribe, and religion), injury status, self-reported alcohol use, and Alcohol Use Disorder (AUD) Identification Test (AUDIT) scores were collected. Descriptive statistics were analyzed in RStudio using frequencies and proportions. Of the 376 patients enrolled, 59 (15.7%) presented with an injury. The IP and NIP groups did not differ in any demographics except sex, an expected difference as females were intentionally oversampled in the original study design. The mean [SD] AUDIT score (IP: 5.8 [6.6]; NIP: 3.9 [6.1]), drinks per week, and proportion of AUDIT ≥8 was higher for IP (IP:37%; NIP: 21%). However, alcohol preferences, drinking quantity, weekly expenditure on alcohol, perceptions of unhealthy alcohol use, attempts and reasons to quit, and treatment seeking were comparable between IPs and NIPs. Our data suggests 37% of injury and 20% of non-injury patients screen positive for harmful or hazardous drinking in our setting. An EMD-based alcohol treatment and referral process could be beneficial to reduce this growing behavioral risk factor in non-injury as well as injury populations.

Sections du résumé

BACKGROUND BACKGROUND
Alcohol is a leading behavioral risk factor for death and disability worldwide. Tanzania has few trained personnel and resources for treating unhealthy alcohol use. In Emergency Medicine Departments (EMDs), alcohol is a well-known risk factor for injury patients. At Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania, 30% of EMD injury patients (IP) test positive for alcohol upon arrival to the ED. While the IP population is prime for EMD-based interventions, there is limited data on if non-injury patients (NIP) have similar alcohol use behavior and potentially benefit from screening and intervention as well.
METHODS METHODS
This was a secondary analysis of a systematic random sampling of adult (≥18 years old), KiSwahili speaking, KCMC EMD patients surveyed between October 2021 and May 2022. When medically stable and clinically sober, participants provided informed consent. Information on demographics (sex, age, years of education, type of employment, income, marital status, tribe, and religion), injury status, self-reported alcohol use, and Alcohol Use Disorder (AUD) Identification Test (AUDIT) scores were collected. Descriptive statistics were analyzed in RStudio using frequencies and proportions.
RESULTS RESULTS
Of the 376 patients enrolled, 59 (15.7%) presented with an injury. The IP and NIP groups did not differ in any demographics except sex, an expected difference as females were intentionally oversampled in the original study design. The mean [SD] AUDIT score (IP: 5.8 [6.6]; NIP: 3.9 [6.1]), drinks per week, and proportion of AUDIT ≥8 was higher for IP (IP:37%; NIP: 21%). However, alcohol preferences, drinking quantity, weekly expenditure on alcohol, perceptions of unhealthy alcohol use, attempts and reasons to quit, and treatment seeking were comparable between IPs and NIPs.
CONCLUSION CONCLUSIONS
Our data suggests 37% of injury and 20% of non-injury patients screen positive for harmful or hazardous drinking in our setting. An EMD-based alcohol treatment and referral process could be beneficial to reduce this growing behavioral risk factor in non-injury as well as injury populations.

Identifiants

pubmed: 37910469
doi: 10.1371/journal.pgph.0001900
pii: PGPH-D-23-00562
pmc: PMC10619788
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e0001900

Informations de copyright

Copyright: © 2023 Pauley et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Alena Pauley (A)

Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.

Emily C Thatcher (EC)

Duke Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America.

Joshua T Sarafian (JT)

Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.

Siddhesh Zadey (S)

Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Duke Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America.

Frida Shayo (F)

Kilimanjaro Christian Medical Center, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Blandina T Mmbaga (BT)

Kilimanjaro Christian Medical Center, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Kilimanjaro Clinical Research Institute, Moshi, Tanzania.

Francis Sakita (F)

Kilimanjaro Christian Medical Center, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Judith Boshe (J)

Kilimanjaro Christian Medical Center, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.

João Ricardo Nickenig Vissoci (JRN)

Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Duke Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America.

Catherine A Staton (CA)

Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Duke Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America.

Classifications MeSH