Prevalence of risk factors of non-communicable diseases among adolescents in Uasin Gishu County, Kenya

Objective: This study aimed to establish the prevalence of risk factors (tobacco use, alcohol abuse, physical inactivity and unhealthy diet) of non-communicable diseases (NCDs) among secondary school students in a developing country. Design: A descriptive cross-sectional study using the self-administered WHO STEP-wise questionnaire for chronic disease risk factor surveillance on adolescents attending secondary schools in Kenya. The study was carried out in the period between May and July 2018. Setting: Ten secondary schools were randomly selected in Uasin Gishu County, using stratified proportional sampling. Subjects: A total of 1,281 students assented to participate in the study. The mean age of the participants was 16.6 (SD±1.509) with the majority being female (55%, n=704) Results: The prevalence of alcohol abuse was 30.8%(n=394) with males having statistically significant higher rates than females (p < 0.05) and 6.8% of the participants were smokers. Of those that reported smoking, 60.9% were between 15-17 years of age. Adequate intake of three (3) servings of vegetables per day was seen in 13.5% of the respondents and 54.4% (n=697) of the total sample were found to be physically inactive. Conclusion: The prevalence of NCD risk factors among secondary school students in Uasin Gishu County is significant. As a result, health education and targeted interventions should be implemented in order to promote a healthy lifestyle which is important in preventing NCDs in future.

Knowledge of alcohol consumers towards alcoholic liver disease in Afikpo, Ebonyi, Nigeria A community-based cross-sectional study

Background: Daily alcohol consumption above recommended limits is an important cause of Alcoholic Lher Disease. Hence, this study aimed to assess the knowledge of Alcoholic Liver Disease among alcohol consumers and screenfor alcohol misuse, dependence, and disorder. Methods: A community-based cross-sectional survey using simple random sampling technique was conducted on residents ofÅfikpo age 15 and above who consume alcohol using a structured questionnaire to obtain information on alcoholic use disorder and alcohol dependence. The sample size Itas determined Il'ith the aid of a Raosoft sample size calculator. Data obtained was entered into an excel spreadsheetfor data cleaning. The frequency, percentages and mean and Standard deviation was also obtained. Data was exported into IBM SPSS to determine the relationship behre.en knou:ledge of Alcoholic Liver Disease and demographic variables using One-way ANOL4 and Chi-Square Il'here appropriate at P-value <0.05 and 5% significance level. Results: The total number of study participants was 435 with a response rate of 97%. Out of which had a good knowledge of Alcoholic Liver Disease. Adults above the age of 60 had a mean audit score of 12.808 Il'hile male respondents had a mean audit score of 11.395. Adolescents had a mean CAGE test score of 1.89 while adults above 60 scored 2.48. Hou•ever, participants with no education had the highest mean CAGE score of2.27. The males had good knowledge ofAlcoholic Liver Disease. (P 0.006). Conclusion: The residents ofÅfikpo community have a good knowledge ofAlcoholic Lher Disease though there is alcohol use disorder, alcohol misuse and dependence amongst residents in the community. Gender is the only demographic characteristics that influenced the knowledge ofAlcoholic Liver Disease

Assessment of substance use among injured persons seeking emergency care in Nairobi, Kenya

ntroduction: Trauma is a leading cause of morbidity and mortality in Kenya. In many countries, substance use is common among patients presenting with injuries to an emergency center (EC). Objective: To describe the epidemiology of self-reported substance use among adult injured patients seeking ED care in Nairobi, Kenya. Methods: This prospective cross-sectional study, assessed patients presenting with injuries to the Kenyatta Na-tional Hospital ED in Nairobi, Kenya from March through June of 2021. Data on substance use, injury character-istics and ED disposition were collected. Substances of interest were alcohol, stimulants, marijuana, and opiates.The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) tool was used to characterize hazardous alcoholuse. Results: A total of 1,282 patients were screened for participation, of which 646 were enrolled. Among participants,322 (49.8%) reported substance use in the past month (AUDIT-C positive, stimulants, opiates, and/or marijuana). Hazardous alcohol use was reported by 271 (42.0%) patients who screened positive with AUDIT-C. Polysubstance use, (≥2 substances) was reported by 87 participants in the past month. Median time from injury to ED arrival was 13.1 h for all enrolees, and this number was significantly higher among substance users (median 15.4 h, IQR 5.5 - 25.5; p = 0.029). Conclusions: In the population studied, reported substance use was common with a substantial proportion of injured persons screening positive for hazardous alcohol use. Those with substance use had later presentations for injury care. These data suggest that ED programming for substance use disorder screening and care linkagecould be impactful in the study setting.

Development of alcohol control law, Sao Tome and Principe

The World Health Organization (WHO) African Region is struggling with increasing harm associated with alcohol consumption. Legislators of Sao Tome and Principe, concerned about this harm and the high prevalence of alcohol use disorders, designed a comprehensive alcohol control bill to tackle this situation. Input into the design of the bill was obtained through interviews involving many stakeholders. The process had five phases: (i) scoping the problem to understand the social burden of the harm caused by alcohol consumption; (ii) updating the evidence on alcohol policies and identifying areas for legislative interventions; (iii) drafting the bill; (iv) aligning the legislative framework of the bill; and (v) initiating the parliamentary procedure. The new bill scored 92/100 using a standardized alcohol control policy scale. The bill covers all domains of WHO's 2010 global strategy to reduce the harmful use of alcohol, and includes the three most cost-effective interventions for reducing alcohol consumption: increased excise taxes on alcohol; bans or comprehensive restrictions on exposure to alcohol advertising; and restrictions on the availability of retailed alcohol through reduced hours of sale. The National Assembly plenary session upheld the bill, which is now under evaluation of the specialized First Commission on Political, Legal, Constitutional and Ethical Affairs. Approval of the bill requires the final voting once it is back with the National Assembly and its promulgation by the President. Drafting an alcohol control bill which is country-led, inclusive, evidence-based and free of interference by the alcohol industry helps prioritize public health objectives over other interests.

A qualitative study on alcohol and drug abuse among undergraduate (University Students) in the coastal region of Kenya

BACKGROUND: Substance use poses a significant threat to the health, social and economic fabric of families, communities and nations. In Kenya, alcohol and drug abuse has been identified as a hindrance to education, development and by extension, to national development. Alcohol and drug abuse has been associated with crime and indiscipline e.g. poor class attendance, poor performance, school dropout and destructive strikes that lead to damage the institution property or even death. Alcohol and drug abusers are also likely to lower their morals and engage in risky sexual activities that can lead to sexually transmitted diseases including HIV infection and AIDS. OBJECTIVES: The aim of this study therefore was to explore on the perceptions and the magnitude of substance abuse among undergraduate (University students) in the two public Universities in the coastal region of Kenya. Also find amicable solutions to curb the menace that can destroy the future of a generation aged between 18­29 years at the peak of their life. METHODOLOGY: This was a qualitative study involving undergraduate (University students), dean of students and counsellors from Pwani University and Technical University of Mombasa. Focus Group Discussions(FGDs) and Key informant interviews were used to collect data. The number of KIIs was guided by data saturation. Thematic analysis was done by identifying, coding, and categorizing patterns or themes found in the data. RESULTS: The problem of alcohol and substance abuse among undergraduate students was a reality. The commonly abused substances were alcohol, miraa (khat), marijuana (cannabis) and cigarettes. Some of the factors predisposing students to abuse drugs were; easy accessibility to drugs, peer pressure, availability of funds, excess freedom, male gender, stress, not being active in religious activities, poor parenting and the African culture that uphold substances such as alcohol as an acceptable social drink. Participants noted that alcohol and drug abuse had led to various negative effects. The major ones affecting the students being poor performance, risky sexual behaviour, and mental disturbances. Participants suggested that Universities ought to intensify awareness campaigns to sensitize students against substance use. CONCLUSION: The commonly abused substances were alcohol, marijuana, miraa (Khat) and tobacco. Alcohol and drug abuse has left a negative impact among undergraduates (university students). The main consequences being; discontinuation of studies, mental disturbances and risky sexual activities. All stakeholders must take action creating awareness among students on the negative effects of substance abuse. Universities should set up programs with an aim to curb substance abuse in the institutions of higher learning. The government should reinforce the set laws and regulations and deal with trafficking of illicit substances into the country

The Prevalence of Suicidal Behaviour and Associated Risk Factors in Grade 8 Learners in Durban

Objectives: Most of the research on suicidal behaviour in youth focuses on developed countries. Less is known about the prevalence of suicidal behaviour and associated risk factors in community samples of youth who do not present for mental health care in developing countries. This study investigated the prevalence of suicidal behaviour and associated risk factors in grade 8 learners in Durban. Setting and subjects: Grade 8 learners in a government-run; co-educational school were approached to participate in the study after parental consent and child assent were obtained. A descriptive; cross-sectional method was used to gather quantitative data. The grade 8 learners were asked to complete demographic questionnaires and various psychometric assessment scales. Design: The gathered data were divided into two groups; i.e. those who reported personal suicidal behaviour and those who did not. The various variables in these two groups were compared using bivariate and multivariate statistical analyses. Results: The study established that 22 participants (33.8; n = 75) reported suicidal behaviour (thoughts; plans or attempts in this regard). They also had higher levels of depression; perceived stress; hopelessness and anger (p-value 0.01) than those who did not report any suicidal behaviour. The same participants had lower scores on scales that assessed self-esteem and perceived social support from family (p-value 0.01); compared to those who did not report any suicidal behaviour. Logistic regression analysis that was undertaken indicated that a friend's suicidal thoughts [odds ratio (OR) 4.27; p-value 0.01]; alcohol use (OR 3.08; p-value 0.01); perceived stress (OR 1.05; p-value 0.01) and depression (OR 1.04; p-value 0.01); were strong predictors of personal suicidal behaviour in this sample. Conclusion: There is a high prevalence of suicidal behaviour in grade 8 learners in Durban. The identified risk factors were similar to those found in developed countries. Healthcare providers and other professionals; such as school counsellors; should consider the identified risk factors when assessing suicidality and planning interventions for youth

Healthcare Professionals' Perceptions of Alcohol-Intoxicated Trauma Patients: Implications for Healthcare Delivery at South Rand Hospital Emergency Department

Objectives: The objectives of this study were to explore healthcare professionals' (HCPs) perceptions about patients who had been assaulted; who consult under the influence of alcohol; and to make them aware of their attitudes towards these patients; with a view to improving their care. Design: An explorative; descriptive study with 15 HCPs purposively selected across professional categories; qualifications; work experience; gender and age. These HCPs participated in four focus group interviews on intoxicated patients who had been assaulted. The interviews were audio-taped and supplemented with field and observational notes. Themes were identified using the cut-and-paste method and grouped into categories. Findings were subjected to mental triangulation; peer review and member check; and were compared with those in the literature. Settings and subjects: HCPs who treat assault patients within the emergency department (ED) of South Rand Hospital; Rosettenville; comprised the study population. They expressed their perceptions and inner feeling about patients under the influence of alcohol who had been assaulted. Interviews were carried out in the boardroom of the hospital. Outcome measures: HCPs' awareness of their attitudes towards assaulted patients under the influence of alcohol. Results: Frustration; anger; a desire to punish intoxicated patients and concern about wastage of hospital resources were some of the stressors experienced by HCPs. Exposure to health hazards and a poor security system were concerns that arose following intimidation; aggression and verbal abuse from alcohol-intoxicated patients who had been assaulted. Conclusion: HCPs experience negative emotions and develop negative attitudes in response to alcohol-intoxicated patients who have been assaulted

Socio-Demographic Characteristics of Alcohol Abusers in a Rural Ijaw Community in Bayelsa State; South-South Nigeria

Background: Causal relationship has been established between alcohol and more than 60 types of disease and injury. Despite this, alcohol is still widely consumed in several communities in Nigeria, and sometimes considered a health tonic. This study described the pattern, prevalence, and factors associated with alcohol abuse in a typical Ijaw community, where alcohol is produced and consumed in large quantities. Materials and Methods: The study was carried out in Okoloba, a rural community in Bayelsa State, South-South Nigeria using an analytical cross-sectional study design. The data were collected from members of the community aged 16 to 65 years, using the Alcohol Use Disorders Identification Test questionnaire and clinical examination for hepatomegaly, tongue tremor, and hand tremor. Results: A total of 322 subjects, comprising 166 men and 156 women were studied. They had an average age of 41.4 ± 2.5 years, were mostly farmers (43.17%), married (66.15%), and had at most primary school education (62.42%). More than 90% of the subjects took alcohol in the preceding year, with more of them (43%) preferring the locally produced drinks. About 33% of the subjects had harmful drinking, while 12.73% had alcohol dependence problem. There is no significant age difference between the alcohol abusers and abstainers/social drinkers (P > 0.05), but alcohol abusers were significantly more likely to be males (P < 0.001), in polygamous marriages (P < 0.00001), had lower educational status (P < 0.0001), likely to be practitioners of the traditional religion (P < 0.0001), and more likely to be engaged in palm wine tapping. Conclusion: Alcohol is widely consumed in the community, but the prevalence of abuse was moderate, mainly due to cultural restrictions. Sales restrictions might be needed as the drinking habits of members of the community change with urbanization

Early Alcohol Use and Problem Drinking among Students in Zambia and Uganda

Excessive alcohol use is a serious public health concern worldwide; but less attention has been given to the prevalence; risk and protective factors; and consequences of early alcohol use in low-income; developing countries.The purpose of this study was to determine the associations between early alcohol use; before age 13; and problem drinking among adolescents in Uganda and Zambia. Data from students in Zambia (n=2257; 2004) and Uganda (n=3215; 2003) were obtained from the cross-sectional Global School-Based Student Health Survey (GSHS). The self-administered questionnaires were completed by students primarily 13 to 16 years of age. Multiple statistical models were computed using logistic regression analyses to test the associations between early alcohol initiation and problem drinking; while controlling for possible confounding factors (e.g.; current alcohol use; bullying victimization; sadness; lack of friends; missing school; lack of parental monitoring; and drug use). Results show that early alcohol initiation was associated with problem drinking in both Zambia (AOR=1.28; 95CI:1.02-1.61) and Uganda (AOR=1.48; 95CI: 1.11- 1.98) among youth after controlling for demographic characteristics; risky behaviors; and other possible confounders.The study shows that there is a significant association between alcohol initiation before 13 years of age and problem drinking among youth in these two countries. These findings underscore the need for interventions and strict alcohol controls as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth

Trends in sociodemographic and drug abuse variables in patients with alcohol and drug use disorders in a Nigerian treatment facility

"BACKGROUND: Globally; patterns of the use of psychoactive substances have been changing. OBJECTIVE: To evaluate the trend in two five-year periods; 1992-1997 versus 2002 - 2007; of alcohol and substance use disorders and associated variables in patients admitted to a drug abuse treatment facility. METHODS: This was a comparative cross-sectional study involving all patients admitted into Drug Abuse Treatment; Education; and Research (DATER); Unit of the Neuropsychiatric Hospital; Aro; Nigeria within the study period. All subjects had a structured psychiatric interview; a physical examination; laboratory investigations and ""DATER"" Questionnaire protocols that elicited socio-demographic; drug and family variables. RESULTS: The patients in 2002-2007 versus those of 1992-1997 were younger (c2 13.29; p=0.01). More last borns were using drugs by 2002-2007 (c2 11.37; p=0.01). Cannabis was the most abused drug in 2002-2007 (53.5) as compared to cocaine (44) in 1992-1997 (c2 35.5; p"

Coma alcoolique a Antananarivo : aspects epidemio-cliniques et facteurs de gravite

Le coma alcoolique est un coma a la fois toxique et metabolique. Ce coma est declenche par une alcoolemie superieure a 3 g/l. Il s'agit d'une urgence diagnostique et therapeutique. Objectif: Les objectifs de cette etude sont de decrire les aspects epidemiocliniques du coma alcoolique a Antananarivo et de determiner les facteurs de gravite de ce coma. Materiels et methodes: Cette etude retrospective se base sur les comptes rendus des fiches d'observation medicale des comateux alcooliques admis dans le service des urgences et de reanimation medicale du CHUA/Hopital Joseph Raseta Befelatanana du janvier 2005 au mars 2006. Resultats: Au terme de cette etude; 104 cas de coma alcoolique ont ete retenus. On note une predominance masculine; la moyenne d'age est de 48 ans. Les facteurs socio-economiques ont favorise l'alcoolisme. Les facteurs de gravite retrouves sont: l'alcoolisme chronique; le tabagisme associe; la qualite inferieure de l'alcool; la dose-ingeree; le score de Glasgow tres bas; l'hypothermie et l'hyperthermie; la tachycardie; la valeur de SpO2 inferieure a 90; l'hypoglycemie moins de 0;50g/l ainsi que tout retard de prise en charge et retard du reveil du patient. Conclusion: Malgre la gravite; une prise en charge precoce et adequate permet d'ameliorer le pronostic du coma alcoolique

Injury Profile in KwaZulu-Natal; South Africa: Implications for Prevention

Background: Prevention and control of injuries require generating relevant information on the magnitude; characteristics and determinants of injuries. Objective: The objective of this study was to describe the characteristics of injuries and predict the severity of injury with other variables. Design: A cross - sectional descriptive study was conducted at the hospitals of KwaZulu - Natal. Information was gathered from a total of 428 injured patients randomly selected from hospital attendances. Multivariate logistic regression analysis was performed to identify the risk factors for severity of injury. Results: Over 60of injury victims were below the age of 30 years. The economically active group (21 - 60 years) also constituted about 60of injury victims. Over half of the victims reported that the scene of incidence was private house; yard and road. One fifth was transport related injury whereas majority was violence (50). Unintentional injury was 28.8. Most of the injuries were minor (42.3) to moderate (41.1) in severity. Odds Ratio for alcohol related violence was 11. Conclusion: In order to reduce injuries appropriate multisectoral interventions; broader policies and strategies; regulating transport and alcohol use; routine testing of alcohol to identify the problem-drinkers for rehabilitation. Interventions should also include health education and health promotion and law enforcement

Family predictors of adolescent substance use: the case of high school students in the Cape Metropolitan Area, Cape Town, South Africa

Family predictors of tobacco and alcohol use were studied in random samples of school-going Black; Coloured; and White adolescents (total N=1;800) in the Cape Town Metropolitan Area. The subjects ranged in age from 14 to 17 years; with a mean age of 15.95 years. Logistic regression analysis of the data showed invariance across the three racial groups in terms of the specific family variables that were predictive; as well as their direction and magnitude of association with substance use. Essentially; higher rates of substance use for all three groups were predicted by parental behavioural control; parental monitoring/knowledge and limit setting; marital relations and family stress. The findings extend the work on South African adolescent substance use by providing a view into the proximal (family) socialising forces that are related to substance use. The findings also extend the broader work on identifying specialised effects of dimensions of socialization on adolescent functioning. The discussion section includes commentary on the cultural invariance found when measuring socialising forces at this level of generality

Alcohol use and related problems in sub-saharan africa

Data from the World Health Organization Global Alcohol Database (GAD) show a wide variation in per capita consumption of recorded alcohol in African countries; ranging from less than 1 litre ofpure alcohol in some (mostly Muslim) countries to more than 10 litres in a couple of others. For all countries; a pattern of increasing per capita consumption emerged in the 1960s; continuedthroughout the 70s; and peaked around 1979 at about 4.5 litres. The steady rise in consumption paralleled post-independence economic boom in many countries; just as the slight decline in percapita consumption in the past two decades might be associated with worsening economic conditions. Today; the average per capita consumption is a little under 4 litres; less than half of theEuropean average. These figures do not account for much (in many cases the larger part) of the alcohol consumed in the form of traditional beverages since these are not reflected in officialrecords. Though a lot remains to be known about drinking and alcohol-related problems in Africa; there are a few consistent finding from survey research. Abstention rates are high; especially amongwomen; but high levels of (often episodic) consumption are common among male and female drinkers. Studies in several countries have shown an association between harmful consumption ofalcohol and health and social consequences; including death from road traffic accidents; domestic violence; HIV infection; and disorders requiring demand for treatment. Consumption of commercial beverages is expected to rise in the coming years as the economic conditions continue to improve in some countries and as a result of increasing marketing and promotion activities by the industry.National responses to these problems will require better research evidence on the health and social problems attributable to alcohol consumption; and the implementation of effective policies toaddress these problems in countries across the continent

Alcohol and Drug Problems and Sexual and Physical Abuse at three Urban high Schools in Mthatha

Background: Alcohol is the most important substance of abuse in South Africa. There are; however; reports of an increase in the use of other drugs among adolescents. The aim of this study was to assess the use of alcohol and other drugs of abuse and their association with physical or sexual abuse in three urban high schools in Mthatha.Method: The Alcohol Use Disorders Identification Test (AUDIT); embedded in a broader questionnaire; was used as a screening tool to assess primary and secondary objectives among the student population (N=1 424) attending school on a given day at three urban high schools in Mthatha (a cut-off point of 8 was selected).Results: Of the 266 (18.6) students who tested AUDIT positive; 63 (4.42) were female and 203 (14.26) were male (P less than 0.01). AUDIT-positive students between the ages of 15 and 17 years represent 10.18 of the total number of students tested. A total of 169 (11.87) students showed symptoms of dependence; while 355 students (24.93) reported drug-related problems in their families. Two hundred and twenty-five (15.8) of the students admitted using dagga (cannabis) at some point; while 69 (4.85) had used mandrax and 64 (4.49) had used cocaine. A total of 149 (10.46) students had been victims of physical abuse and 91 (6.39) of sexual abuse. Sexual and physical abuses were statistically significantly correlated with alcohol-related problems

Pneumopathies communautaires de l'adulte dans un milieu hospitalier a Douala: epidemiologie et clinique

Les caracteristiques epidemiologiques et cliniques de 43 malades ages de 15 a 81 ans (moyenne = 45) admis consecutivement de mars a juin 1992 pour pneumopathie communautaire dans un hopital de 200 lits a Douala sont rapportees par les auteurs. La pneumopathie communautaire de l'adulte represente 4;6 pour cent des admissions dans cet hopital avec un sex-ratio de 2;3 et un taux eleve de population urbaine (70 pour cent). Les facteurs de risque les plus frequents etaient l'alcoolisme (67;4 pour cent); le tabagisme (44;5 pour cent) et l'infection a VIH (20;9 pour cent). [abstract terminated]

Pancreatite chronique calcifiante et diabete sucre

La pancreatite chronique calcifiante (P.C.C.) est decrite comme une cause relativement frequente du diabete sucre (D.S.) en zone tropicale. L'etiologie dominante de cette P.C.C. est la malnutrition suivie de l'alcoolisme. Un seul element aide au diagnostic: c'est le cliche de l'abdomen sans preparation. 24 dossiers ont ete selectionnes parmi les malades hospitalises dans le service des maladies metaboliques et endocriniennes du C.H.U. de Brazzaville

Public health aspects of a refugee camp

The explosion in the number of refugees throughout the world has led to the development of a new medical speciality; Migration Medicine. Such a speciality has a strong public health dimension. Addressing the public health needs of refugees especially in developing countries is one of the few challenges of practising public medicine which gives measurable results in weeks rather than years. Whilst I was a trainee in Public Health Medicine in Glasgow; UK; I was seconded to Medecins Sans Frontieres ('doctors without borders') to act as Medical Co-ordinator of a relief operation for refugees from Sudan. This paper discusses some of the lessons that the experience taught me which have application to many refugee situations throughout the world