Alcohol use and alcohol use disorders in sub-Saharan Africa: A systematic review and meta-analysis.

alcohol alcohol use disorder low‐income population prevalence sub‐Saharan Africa

Journal

Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118

Informations de publication

Date de publication:
07 May 2024
Historique:
received: 19 10 2023
accepted: 27 03 2024
medline: 8 5 2024
pubmed: 8 5 2024
entrez: 7 5 2024
Statut: aheadofprint

Résumé

Population-level alcohol use data are available from high-income countries, but limited research has been conducted in sub-Saharan Africa. This systematic review and meta-analysis aimed to summarize population-level alcohol use in sub-Saharan Africa. Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'substance-related disorders' and 'prevalence' and 'sub-Saharan Africa'. We included general population studies on alcohol use (including any use, high-risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub-Saharan African adolescents (10-17) and adults (18+) were extracted. Analyses included life-time and past 12- and 6-month alcohol use. We included 141 papers. Among adolescents, the life-time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3-37.1%], 36.2% (CI = 18.4-56.1%) in the past year and 11.3% (CI = 4.5-20.4%) in the past 6 months. Among adolescents, 12-month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0-27.8%) and 4.1% (CI = 1.4-7.9%), respectively. Among adults, the life-time prevalence of alcohol use was 34.9% (CI = 17.7-54.1%), 27.1% (CI = 5.0-56.4%) in the past year and 32.2% (CI = 19.8-46.0%) in the past 6 months. Among adults, the 12-month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0-30.4%) and 4.3% (CI = 0.8-9.8%), respectively. The highest weighted life-time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6-month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents. Alcohol use patterns vary across countries and subregions within sub-Saharan Africa, and comprehensive population-level data on alcohol use remain scarce in numerous sub-Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub-Saharan Africa.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Population-level alcohol use data are available from high-income countries, but limited research has been conducted in sub-Saharan Africa. This systematic review and meta-analysis aimed to summarize population-level alcohol use in sub-Saharan Africa.
METHOD METHODS
Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'substance-related disorders' and 'prevalence' and 'sub-Saharan Africa'. We included general population studies on alcohol use (including any use, high-risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub-Saharan African adolescents (10-17) and adults (18+) were extracted. Analyses included life-time and past 12- and 6-month alcohol use.
RESULTS RESULTS
We included 141 papers. Among adolescents, the life-time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3-37.1%], 36.2% (CI = 18.4-56.1%) in the past year and 11.3% (CI = 4.5-20.4%) in the past 6 months. Among adolescents, 12-month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0-27.8%) and 4.1% (CI = 1.4-7.9%), respectively. Among adults, the life-time prevalence of alcohol use was 34.9% (CI = 17.7-54.1%), 27.1% (CI = 5.0-56.4%) in the past year and 32.2% (CI = 19.8-46.0%) in the past 6 months. Among adults, the 12-month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0-30.4%) and 4.3% (CI = 0.8-9.8%), respectively. The highest weighted life-time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6-month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents.
CONCLUSION CONCLUSIONS
Alcohol use patterns vary across countries and subregions within sub-Saharan Africa, and comprehensive population-level data on alcohol use remain scarce in numerous sub-Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub-Saharan Africa.

Identifiants

pubmed: 38715159
doi: 10.1111/add.16514
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : The University of Queensland

Informations de copyright

© 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Références

Rehm J, Gmel GE Sr, Gmel G, Hasan OS, Imtiaz S, Popova S, et al. The relationship between different dimensions of alcohol use and the burden of disease—an update. Addiction. 2017;112:968–1001.
Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, Tymeson HD, et al. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392:1015–1035.
Probst C, Kilian C, Sanchez S, Lange S, Rehm J. The role of alcohol use and drinking patterns in socioeconomic inequalities in mortality: a systematic review. Lancet Public Health. 2020;5:e324–e332.
Connor JP, Haber PS, Hall WD. Alcohol use disorders. Lancet. 2016;387:988–998.
Glantz MD, Bharat C, Degenhardt L, Sampson NA, Scott KM, Lim CC, et al. The epidemiology of alcohol use disorders cross‐nationally: findings from the World Mental Health Surveys. Addict Behav. 2020;102:106128.
World Health Organization (WHO). Status Report on Alcohol Consumption, Harm and Policy Responses in 30 European Countries 2019. Geneva, Switzerland: WHO; Regional Office for Europe; 2019.
Allen L, Townsend N, Williams J, Mikkelsen B, Roberts N, Wickramasinghe K. Socioeconomic status and alcohol use in low‐ and lower‐middle income countries: a systematic review. Alcohol. 2018;70:23–31.
Jayathilaka R, Athukorala O, Ishara S, Silva D, Pathirage T. Alcohol brings burdens: a global and continent wise study on alcohol consumption and global burden of diseases. PLoS ONE. 2022;17:e0270998.
World Health Organization (WHO). Global Status Report on Alcohol and Health 2018 Geneva, Switzerland: World Health Organization; 2019.
Kiwango G, Francis F, Moshiro C, Möller J, Hasselberg M. Association between alcohol consumption, marijuana use and road traffic injuries among commercial motorcycle riders: a population‐based, case‐control study in Dar es Salaam, Tanzania. Accid Anal Prev. 2021;160:106325.
Chrystoja BR, Rehm J, Manthey J, Probst C, Wettlaufer A, Shield KD. A systematic comparison of the global comparative risk assessments for alcohol. Addiction. 2021;116:2026–2038.
Ferreira‐Borges C, Parry CD, Babor TF. Harmful use of alcohol: a shadow over sub‐Saharan Africa in need of workable solutions. Int J Environ Res Public Health. 2017;14:346.
Degenhardt L, Charlson F, Ferrari A, Santomauro D, Erskine H, Mantilla‐Herrara A, et al. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018;5:987–1012.
Bryazka D, Reitsma MB, Griswold MG, Abate KH, Abbafati C, Abbasi‐Kangevari M, et al. Population‐level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet. 2022;400:185–235.
Olawole‐Isaac A, Ogundipe O, Amoo EO, Adeloye DO. Substance use among adolescents in sub‐Saharan Africa: a systematic review and meta‐analysis. South African Journal of Child Health. 2018;12:s79–s84.
World Health Organization (WHO). Health Literacy Development for the Prevention and Control of Noncommunicable Diseases: volume 4. Case Studies From WHO National Health Literacy Demonstration Projects. Geneva, Switzerland: WHO; 2022.
World Health Organization (WHO). Life Skills Education School Handbook: Prevention of Noncommunicable Diseases: Approaches For Schools. Geneva, Switzerland: WHO; 2020.
Ferreira‐Borges C, Esser MB, Dias S, Babor T, Parry CD. Alcohol control policies in 46 African countries: opportunities for improvement. Alcohol Alcohol. 2015;50:470–476.
Oleribe OO, Momoh J, Uzochukwu BS, Mbofana F, Adebiyi A, Barbera T, et al. Identifying key challenges facing healthcare systems in Africa and potential solutions. Int J Gen Med. 2019;12:395–403.
Moher D, Liberati A, Tetzlaff J, Altman DG, the PRISMA Group. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
Tacconelli E. Systematic reviews: CRD's guidance for undertaking reviews in health care. Lancet Infect Dis. 2010;10:226.
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65:934–939.
Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta‐analysis of prevalence. J Epidemiol Community Health. 2013;67:974–978.
StataCorp Ltd. Stata statistical software: release vol. 16. College Station, TX: StataCorp Ltd; 2019.
Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13:147–153.
Huedo‐Medina TB, Sánchez‐Meca J, Marín‐Martínez F, Botella J. Assessing heterogeneity in meta‐analysis: Q statistic or I2 index? Psychol Methods. 2006;11:193–206.
Migliavaca CB, Stein C, Colpani V, Barker TH, Ziegelmann PK, Munn Z, et al. Meta‐analysis of prevalence: I2 statistic and how to deal with heterogeneity. Res Synth Methods. 2022;13:363–367.
United Nations (UN). Annex II: classification of SDG regions and income groups. New York, NY: UN; 2019.
Manthey J, Shield KD, Rylett M, Hasan OS, Probst C, Rehm J. Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study. Lancet. 2019;393:2493–2502.
Deeks JJ, Higgins JP, Altman DG, Cochrane Statistical Methods Group. Analysing data and undertaking meta‐analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editorsCochrane Handbook for Systematic Reviews of Interventions Chichester, UK: John Wiley & Sons; 2019. p. 241–284.
Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.
Egger M, Smith GD, Altman D. Systematic reviews in health care: meta‐analysis in context Chichester, UK: John Wiley & Sons; 2008.
Mavridis D, Salanti G. Exploring and accounting for publication bias in mental health: a brief overview of methods. BMJ Ment Health. 2014;17:11–15.
Ma C, Bovet P, Yang L, Zhao M, Liang Y, Xi B. Alcohol use among young adolescents in low‐income and middle‐income countries: a population‐based study. Lancet Child Adolesc Health. 2018;2:415–429.
Jones CM, Clayton HB, Deputy NP, Roehler DR, Ko JY, Esser MB, et al. Prescription opioid misuse and use of alcohol and other substances among high school students—Youth Risk Behavior Survey, United States, 2019. MMWR Suppl. 2020;69:38–46.
Goh CMJ, Asharani P, Abdin E, Shahwan S, Zhang Y, Sambasivam R, et al. Gender differences in alcohol use: a nationwide study in a multiethnic population. Int J Ment Health Addict. 2022;1–15. https://doi.org/10.1007/s11469-022-00921-y
Agabio R, Pisanu C, Gessa GL, Franconi F. Sex differences in alcohol use disorder. Curr Med Chem. 2017;24:2661–2670.
White AM. Gender differences in the epidemiology of alcohol use and related harms in the United States. Alcohol Res 2020;40:01.
Kim SY, Kim HJ. Trends in alcohol consumption for Korean adults from 1998 to 2018: Korea National Health and Nutritional Examination Survey. Nutrients. 2021;13:609.
Odejide A. Status of drug use/abuse in Africa: a review. Int J Ment Health Addict. 2006;4:87–102.
Yuen WS, Bruno R, Chan GC, McCambridge J, Slade T, Clare PJ, et al. The experience of physiological and psychosocial alcohol‐related harms across adolescence and its association with alcohol use disorder in early adulthood: a prospective cohort study. Alcohol Clin Exp Res. 2021;45:2518–2527.
Murali V, Jayaraman S. Substance use disorders and sexually transmitted infections: a public health perspective. BJPsych Adv. 2018;24:161–166.
Thørrisen MM, Bonsaksen T, Hashemi N, Kjeken I, Van Mechelen W, Aas RW. Association between alcohol consumption and impaired work performance (presenteeism): a systematic review. BMJ Open. 2019;9:e029184.
Rathinam B, Ezhumalai S. Perceived social support among abstinent individuals with substance use disorder. J Psychosoc Rehabil Ment Health. 2022;9:81–87.
Bamberger PA, Koopmann J, Wang M, Larimer M, Nahum‐Shani I, Geisner I, et al. Does college alcohol consumption impact employment upon graduation? Findings from a prospective study. J Appl Psychol. 2018;103:111–121.
Ali I, Behairy H, Abugroun A, Beaney T, Kobeissi E, Abdalla A, et al. May measurement month 2017: an analysis of blood pressure screening in Sudan—northern Africa and Middle East. Eur Heart J Suppl. 2019;21:D111–D114.
Al‐Ansari B, Thow AM, Day CA, Conigrave KM. Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization. Addiction. 2016;111:1703–1713.
Morojele NK, Dumbili EW, Obot IS, Parry CD. Alcohol consumption, harms and policy developments in sub‐Saharan Africa: the case for stronger national and regional responses. Drug Alcohol Rev. 2021;40:402–419.
Ghosh A, Singh P, Das N, Pandit PM, Das S, Sarkar S. Efficacy of brief intervention for harmful and hazardous alcohol use: a systematic review and meta‐analysis of studies from low middle‐income countries. Addiction. 2022;117:545–558.
Sileo KM, Miller AP, Wagman JA, Kiene SM. Psychosocial interventions for reducing alcohol consumption in sub‐Saharan African settings: a systematic review and meta‐analysis. Addiction. 2021;116:457–473.

Auteurs

Habte Belete (H)

Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia.
School of Psychology, The University of Queensland, Brisbane, Australia.

Tesfa Mekonen Yimer (TM)

Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia.
School of Psychology, The University of Queensland, Brisbane, Australia.

Danielle Dawson (D)

School of Psychology, The University of Queensland, Brisbane, Australia.
National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia.

Dorothy C Espinosa (DC)

School of Psychology, The University of Queensland, Brisbane, Australia.

Fentie Ambaw (F)

School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.

Jason P Connor (JP)

National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia.
Discipline of Psychiatry, The University of Queensland, Brisbane, Australia.

Gary Chan (G)

National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia.

Leanne Hides (L)

School of Psychology, The University of Queensland, Brisbane, Australia.
National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia.

Janni Leung (J)

School of Psychology, The University of Queensland, Brisbane, Australia.
National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia.

Classifications MeSH