Psychoactive substances use and associated factors among middle and high school students in the North Center of Morocco: a cross-sectional questionnaire survey

Psychometric assessment of the Moroccan version of the car, relax, alone, forget, friends, trouble (CRAFFT) scale among adolescent and young adults with a substance use disorder

BACKGROUND

The Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) scale is a widely used screening tool for early identification of alcohol and other drug use, and assessing the risk of substance use disorders in adolescents and young adults. Despite its broad use, translation into several languages, and validation in various settings, no study has yet confirmed the psychometric properties of a Moroccan version. The present research aims to adapt and validate the Moroccan Arabic dialect version of the CRAFFT scale among adolescents and young adults with alcohol and drug use disorder.

METHODS

A total of 302 adolescents and young adults (mean age = 18.36 ± 2.36), including 161 males and 41 females, were recruited from a substance use treatment center in Fez City. Confirmatory Factor Analysis (CFA) was used to assess the factorial structure and model fit, while internal consistency was evaluated using the Kuder-Richardson Formula 20 (KR-20). Convergent validity was examined using gold standard measures, including the International Neuropsychiatric Interview (MINI) and the Hooked-on Nicotine Checklist (HONC). All statistical analyses were performed using JASP software (version 0.17).

RESULTS

CFA revealed a one-factor structure with a good overall fit (χ²/df = 1.91, Root Mean Square Error of Approximation (RMSEA) = 0.06, Standardized Root Mean Square Residual (SRMR) = 0.03, Comparative Fit Index (CFI) = 0.98, Normed Fit Index (NFI) = 0.97. The model had strong reliability with a KR-20 coefficient of 0.80. Convergent validity was confirmed by a high and significant correlation with the MINI gold standard (r = 0.82, p < 0.001), while a low correlation with the HONC gold standard (r = 0.20, p < 0.001) confirmed the scale's convergent validity. A cutoff score of 4 or higher on the CRAFFT was identified as optimal for balancing sensitivity (78.35%) and specificity (91.67%), achieving a Youden index of 0.70.

CONCLUSION

The psychometric properties of the Moroccan version of the CRAFFT confirm that it is a valid tool for screening the early detection of alcohol and drug use and for assessing the risk of substance use disorders in adolescents and young adults.

The prevalence of tobacco, alcohol, stimulant, khat, and cannabis use among school-going students in African and Arab countries: a systematic review and meta-analysis

BACKGROUND

The objectives of this review and meta-analysis were twofold: first, to determine the prevalence of substance use among school-going children in Arab and African countries; and second, to highlight the considerable influence of variables such as the nation's region and the timeframe of the study on the prevalence of substance use.

METHODS

Research was sourced from Science Direct, Scopus, Web of Science, Google Scholar, and PubMed. Thirty-seven articles were incorporated in accordance with the PRISMA guidelines. This review included studies published from 2013 to 2023. The statistical meta-analysis was performed using Comprehensive Meta-Analysis ver. 3 software. Across 37 studies, the total number of study participants was 73,508.

RESULTS

The meta-analysis revealed that tobacco was the most commonly used substance, with a prevalence of 16% (95% confidence interval [CI], 12.7%-20.02%). This was closely followed by alcohol, which had a prevalence of 15% (95% CI, 10.5%-22.8%), stimulants at 11.4% (95% CI, 7.4%-17%), khat at 10% (95% CI, 5.7%-15%), and cannabis at 8% (95% CI, 3.3%-18.4%). Notably, alcohol was the only substance that showed an increasing trend in prevalence from before to after 2019, rising from 13.3% (95% CI, 6.2%-26.1%) to 17% (95% CI, 10.2%-27%) (p<0.001). Additionally, the prevalence of substance use varied significantly between Arab and African countries (p<0.001).

CONCLUSION

Although the prevalence of substance use among school-going populations has significantly decreased over time, with the exception of alcohol, it is imperative that both African and Arab countries implement comprehensive measures and stringent laws to address the production and marketing of substances.

Substance use among students of two high schools in Yaoundé, Cameroon

Introduction

substance use among adolescents is on the rise, estimated at 15.3% in Buea, Cameroon (2021). However, factors associated with this practice are still understudied in the Cameroonian setting.

Methods

a cross-sectional study (January to May 2022) was conducted to document substance use among students of two high schools in Yaoundé, Cameroon. Socio-demographics, psychosocial parameters, and history of substance use were documented among students via self-administered questionnaires. Validated tools (including the PHQ-4 and the 7-item Weinberger adjustment inventory) were used to assess anxiety, depression, self-esteem, and other youth behavioural risks. Descriptive analyses and multiple logistic regression were performed.

Results

we recruited 373 students (43.0% male, mean age: 16 ± 1.6 years). Overall, 42.4% had already consumed at least one substance, notably alcohol (40.5%), vap/shisha (8.3%), and tobacco/cigarettes (2.7%). Previous tramadol use was reported by 6 (1.6%) participants. The multiple logistic regression analysis found that the following factors were associated with increased odds of lifetime substance use among students: male gender (OR: 2.013, 95% CI: 1.127-3.595), depression (OR: 1.238, 95% CI: 1.031-1.487) and low self-esteem (OR: 1.083, 95% CI: 1.003-1.168). Meanwhile, increased parental concerns about drug use served as a protective factor for substance use among the students (OR: 0.196, 95% CI: 0.078-0.496).

Conclusion

about two-fifths of the enrolled high school students had already consumed one or more psychoactive substances, highlighting the need for urgent preventive interventions. For optimal impact, substance use preventive programs should include self-esteem building among the students and improved parental attitudes towards drugs.

Psychometric properties of the cannabis abuse screening test (CAST) in a sample of Moroccans with cannabis use

BACKGROUND

The Cannabis Abuse Screening Test (CAST) is a widely used screening tool for identifying patterns of cannabis use that have negative health or social consequences for both the user and others involved. This brief screening instrument has been translated into multiple languages, and several studies examining its psychometric properties have been published. However, studies on the factorial validity and psychometric properties of a Moroccan version of the CAST are not yet available. The objective of this study is to validate the CAST, translated, and adapted to the Moroccan Arabic dialect among persons with cannabis use.

METHODS

A total of 370 participants from an addictology center in Fez City, were selected over two phases to form the study sample. First, in phase I, exploratory factor analysis was employed to evaluate the factor structure in the pilot sample (n1 = 150). Subsequently, in the second phase (Phase II), confirmatory factor analysis was utilized to confirm this structure in the validation sample (n2 = 220). All statistical analyses were carried out using the R program.

RESULTS

The CFA unveiled a three-factor structure that showed a good overall fit (χ2/df = 2.23, RMSEA = 0.07, SRMR = 0.02, CFI = 0.99, NFI = 0.98) and satisfactory local parameters (standardized factor loadings between 0.72 and 0.88). The model demonstrates satisfactory reliability and convergent validity, as evidenced by the acceptable values of composite reliability (CR) (0.76-0.88) and average variance extracted (AVE) (0.62-0.78), respectively. The square roots of the AVE exceeded the correlations of the factor pairs, and the heterotrait-monotrait (HTMT) ratio of the correlation values was below 0.85, indicating acceptable discriminant validity.

CONCLUSION

The reliability, convergent validity, and discriminant validity tests all demonstrated that the Moroccan version of the CAST performed well and can be considered a valid tool for screening of problematic cannabis use.

Prevalence of Tobacco Products' Use and Associated Factors Among Adolescents in Morocco: A Systematic Review

Introduction

Tobacco use is the major preventable cause of premature death worldwide, responsible for about 8 million deaths per year, mostly in low- and middle-income countries, such as Morocco. Adolescents' tobacco use is a matter of concern, because early initiation increases the risk of becoming a lifelong user. There exists a notable gap in the synthesis of evidence concerning tobacco use among Moroccan adolescents. Thus, the purpose of this study was to provide a comprehensive view of the prevalence of tobacco products' use and associated factors among adolescents in Morocco.

Methods

We systematically searched PubMed, Scopus, Web of Science and ScienceDirect for relevant studies reporting prevalence rates of tobacco products' use among Moroccan adolescents, published until June 2024, using inclusion and exclusion criteria in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Additional searches were completed on other sources to reach unpublished reports. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of included studies.

Results

After the final screening, 22 papers met the inclusion criteria. Life-time prevalence of tobacco use ranged from 7.8% to 20.4% for cigarettes smoking, from 10.6% to 21.9% for waterpipe, from 7.9% to 9.1% for chewing tobacco and from 9.2% to 12.4% for snuff. The last 12-month prevalence of cigarette smoking was comprised between 6.9% and 10.8%. As for the prevalence of current use, ranges of (1.8%-16.4%) and (4.9%-8.4%) were noted for cigarettes and waterpipe, respectively. The most commonly highlighted risk factors for tobacco use included male sex, older age, having friends or family members who use tobacco and low perception of risk associated with tobacco use.

Conclusion

Our findings reveal an alarming situation of tobacco use among Moroccan adolescents. Therefore, it is crucial that all stakeholders engage in concerted efforts to develop and implement evidence-based preventive interventions among early adolescents.

Cannabis and amphetamine use among school-going adolescents in sub-Saharan Africa: a multi-country analysis of prevalence and associated factors

BACKGROUND

Global evidence indicates that early onset of illicit substance use among adolescents and emerging adults is associated with negative mental-health related-outcomes that can persist into adulthood. However, the lack of quality regional data on adolescent illicit substance use and its determinants remains a common barrier to evidence-based policy-making and the development of school-based interventions in Africa. The purpose of our study was to estimate the prevalence and describe the correlates of cannabis and amphetamine use among school-going adolescents in eight sub-Saharan African countries (SSA) - Benin, Ghana, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and Tanzania.

METHODS

We analysed 15,553 school-going adolescents that participated in the Global School-based Student Health Survey. A two-stage sampling approach was used to generate a nationally representative sample of school children (grades 7-12) in each of these countries. Students responded to a self-administered structured questionnaire that contained information on sociodemographic factors, family involvement factors, mental health factors, school environment factors and past-month cannabis and life-time amphetamine use.

RESULTS

The overall prevalence estimates of past-month cannabis use and lifetime amphetamine use among school-going adolescents in the eight SSA countries was 4.39% (95% CI = 4.08, 4.72) and 3.05% (95% CI = 2.79, 3.34) respectively. In the multivariable logistic regression analysis, demographic characteristics (age and male gender), mental health factors (suicide ideation and attempt), lifestyle factors (cigarette smoking, past-month alcohol use, lifetime drunkenness and leisure-time sedentary behaviour) and school level factors (truancy and bullying victimisation) showed strong associations with increased odds of both past-month cannabis use and lifetime amphetamine use. Social support at school was associated with increased odds for lifetime amphetamine, while parental monitoring decreases the odds for lifetime amphetamine use. It was also observed that parental tobacco use was associated with increased odds of both past-month cannabis use and lifetime amphetamine use.

CONCLUSION

The relatively low overall prevalence estimates of past-month cannabis use and lifetime amphetamine use among school-going adolescents in not surprising. However, the identified risk and protective factors associated with cannabis and amphetamine use underscores the need for these eight countries in SSA to develop contextual and multi-sectoral intervention and school-based prevention programmes that could target school-going adolescents who may be at risk of misusing these illicit drugs.

Prevalence and predictors of tobacco, alcohol and illicit drug experimentation among Tunisian middle and high school-adolescents

OBJECTIVES

Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia.

METHODS

We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019-2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors.

RESULTS

Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8-18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1-3.9 %)] and 2 % [CI 95 %: (1.1-2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents.

CONCLUSIONS

A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed.

Magnitude and Associated Factors of Psychoactive Substance Use among Youths at Selected Administrative Towns of North Shewa Zone, Amhara Region, Ethiopia

Youth and adolescent psychoactive substance use is a major public health problem worldwide which affects the health of individuals, families, and the community as a whole. This study was aimed at assessing the level of psychoactive substance use and the associated factors among the youths of North Sowa zone, Amhara region, Ethiopia, 2020/21. Community based cross-sectional study design with a multistage sampling technique was used. A total of 632 youths were involved in the study. Linear logistic regression analysis was used for both bivariate and multivariate analysis. The prevalence of life time and current psychoactive substance use was found to be 66.1% and 65%, respectively. Male sex and history of substance use from family members and friends were significantly associated with psychoactive substance use. In this study, the prevalence of life time and current psychoactive substance use was high as compared to other studies conducted in Ethiopia.

Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study

Introduction

Psychoactive substance use is a growing health problem in both developing and developed countries. Despite adolescents being at high risk of practicing risky behaviors including substance use, there is no adequate information on the problem in the Harari Region, in the Eastern part of Ethiopia. Hence, the present study aimed to identify the burden of current substance use in high school adolescent students of Harari Region, Ethiopia, from 10th April to 10th May 2022.

Methods

A school-based cross-sectional study was employed on a total of 1498 randomly selected adolescent students. Poisson regression was used for the assessment of substance use over the last three months among adolescent students. The substance use burden was reported by IRR (incidence rate ratio) at a 95% Confidence interval. The final model fitness was checked using Akaike information criterion (AIC) and Bayesian information criterion (BIC) reports. The variables that had less than 0.05 P-value were declared to be statistically significant.

Results

The overall psychoactive substance use was 373 (24.9%, 95% Confidence Interval (CI); 22.8-27.1%). The substances included khat (21.6%, 95% CI; 18.6-23.6%), alcohol drinking (1.8%; 95% CI; 1.3-2.6%), and smoking (1.2%, 95% CI; 0.75-1.9%). Being male (IRR (Incidence Rate ratio) = 1.21, 95% CI; 1.11-1.38), availability of the substance (IRR (Incidence Rate ratio) = 2.02, 95%; 1.53-2.66), having substance user friends (IRR=1.60: 95% CI: 1.30-2.01), and being at a younger age (IRR = 1.21; 95% CI: 1.02-1.44) increased the psychoactive substance use rate in the adolescents.

Conclusion and Recommendation

One out of four adolescents was a current psychoactive substance user. Being male, substance availability, having substance-user friends, and being at younger age increased the psychoactive substance use rate in school adolescents in Eastern Ethiopia. The intervention that involves the schools' community, students' families, and executive bodies should be strengthened to overcome the substance use-related burdens among high school adolescent students.

Exposure to substance and current substance among school-going adolescents in Timor-Leste

Few studies have examined how exposure to substance influences adolescent's use of substance in Timor-Leste. We assessed this relationship using nationally representative data from Timor-Leste to address this gap. Data was pulled from the 2015 Timor-Leste Global school-based student health survey. Data of students aged 13-17years (N = 3700) from class 7-11 across schools in Timor-Leste were analyzed for this study. Second-hand smoking exposure (AOR = 1.57 [1.31, 1.89] and parental tobacco use, AOR = 1.94 [1.54, 2.44]) was significantly related to in-school adolescent's current use of substance after adjusting for covariates. Current substance use was also positively associated with being male, being in class 10-12, and being food insecure and negatively associated with having at least three close friends and benefiting from parental supervision. To reduce substance use among in-school adolescents, policymakers must consider the inclusion of all models in the social learning environment of adolescents in Timor-Leste.

Psychological distress in a sample of Moroccan prisoners with drug-dependence

Research regarding mental illness and drug addiction among inmates in Morocco requires increased knowledge; previous literature reported that prisoners suffer from severe psychological distress. The present study aimed to provide information about Moroccan prisoners' psychological distress and define the differences in psychological distress levels among inmates with and without drug-dependence. A sample of 177 male inmates completed a set of surveys, including the Drug Use Disorders Identification Test (DUDIT) and the Brief Symptom Inventory (BSI). The "Drug dependence" group scored significantly higher psychological distress levels in each of the BSI domains. The strongest differences were measured in the General Severity Index (GSI), hostility, and depression scales. Moroccan prison inmates have high psychological distress, and those with drug-dependence have even higher. There is a need of psychiatric assessment, selection, and care possibilities in prison inmate populations.

Cannabis and schizophrenia: characterisation of a risk factor in a sample of Moroccan patients hospitalised for psychosis

Background

In addition to the biological plausibility widely described through a very large number of studies, the causal link between cannabis uses and schizophrenia disorders has become illicit internationally and given the scarcity of similar studies in Morocco. Our study consists of a prospective descriptive study in the psychiatric department of the Moulay ben Abdallah Hospital in Essaouira. The sample consisted of 95 patients diagnosed with schizophrenia according to the DSM5 criteria. The diagnostic assessment included the Positive and Negative Syndrome Scale to assess the severity of positive and negative symptoms of schizophrenia as well as the patient’s general psychopathology, the Clinician-Rated Dimensions of Psychosis Symptom Severity to assess the symptom severity of the psychotic dimensions according, and the Cannabis Abuse Screening Test to assess the extent of cannabis use.

Results

The mean age of the patients recruited in the study was 33.7 ± 9.37 years with a clear male predominance (p < 0.0001). Cannabis users compared to non-users were younger and comprised only men. Cannabis users also have a lower educational and economic level than non-users. Furthermore, a clear dose effect of cannabis uses on the onset of positive and negative symptoms of schizophrenia. The temporality criterion is clear in our study, since the predictivity of the parameter: “age of onset of cannabis use” is highly significant (p = 0.000). These results suggest that cannabis use can be considered as the most illicit risk factor for the development and/or onset of schizophrenia.

Conclusions

These results suggest that there is a causal relationship between cannabis use and/or dependence (problematic use) and the onset and/or worsening of schizophrenic disorder. This means that problematic cannabis use can be considered as a real risk factor for the emergence and development of schizophrenic disorder.

Knowledge of health effects and determinants of psychoactive substance use among secondary school students in Sokoto Metropolis, Nigeria

Introduction

psychoactive substance use (PSU) is a patterned use of a drug in which the user consumes the substance in amounts or methods which are harmful to themselves or others. Psychoactive substance use takes a considerable toll on financial status, academic achievement and health status of addicts. In Nigeria, PSU is on the increase, one of the most disturbing health-related problems and a leading cause of premature death among school aged population worldwide. We therefore, determined the knowledge of health effects and determinants of psychoactive substance use among secondary school students in Sokoto Metropolis, Nigeria.

Methods

we conducted a cross-sectional study among 430 secondary school students that were selected using multistage sampling in Sokoto, Northwestern, Nigeria from April to May 2019. We collected data using a semi-structured, interviewer-administered questionnaire. We calculated proportions and adjusted odds ratios (OR) with 95% confidence intervals (CI) in a binary logistic regression model.

Results

knowledge of health effects of PSU was good in 38.1% of the respondents with a mean score of 19.6 ± 10.0. The overall prevalence of PSU was high among current users (16.3%), male participants (78.6%) and those aged 17-years or more (68.6%). Independent predictors of current use of psychoactive substances were poor knowledge of health effects (aOR: 4.1, 95% CI: 1.7-10.0) and father´s use of psychoactive substances (aOR: 10.3, 95% CI= 1.9-57.1).

Conclusion

knowledge of health effects of psychoactive substances was generally poor among the participants with an associated high prevalence among current users. Poor knowledge of its health effects determines the use of psychoactive substances. We conducted awareness campaigns and health talk on health effects of PSU to secondary school students in the State. The Federal Ministry of Education should ensure that PSU-related topics are incorporated in the secondary school curriculum.

Associations of childhood experiences and methamphetamine use among Akha and Lahu hill tribe youths in northern Thailand: A cross-sectional study

Background

Methamphetamine (MA) is a commonly used substance among youths, particularly those who are living in poor economic conditions with low levels of education and who have had bad childhood experiences. The Akha and Lahu hill tribe youths living on the Thailand-Myanmar-Laos border are identified as the group most vulnerable to MA use in Thailand. The study aimed to estimate the prevalence of MA use and determine its associations with childhood experiences among Akha and Lahu youths aged 15–24 years in northern Thailand.

Methods

A cross-sectional study was performed. Validated and sealed questionnaires were used to gather information from participants after obtaining the informed consent form. Questionnaires were completed by participants and their parents at home. Logistic regression was used to identify the associations between variables at the α = 0.05 level.

Results

A total of 710 participants participated in the study: 54.2% were Akha, 52.5% were females, 50.6% were aged 15–17 years, and 11.4% did not have Thai identification card (ID) cards. The overall prevalence of MA use at least once among Akha and Lahu youths was 14.5%. After controlling for all potential confounding factors, 8 variables were found to be associated with MA use. Males had a greater chance of MA use than females (AOR = 4.75; 95% CI = 2.27–9.95). Participants aged 21–24 years had a greater chance of MA use than those aged 15–17 years (AOR = 2.51; 95% CI = 1.11–5.71). Those who had a family member who used MA had a greater chance of MA use than those who did not (AOR = 5.04; 95% CI = 1.66–15.32). Those who had been physically assaulted by a family member while aged 0–5 years had a greater chance of MA use than those who had not (AOR = 2.29; 95% CI = 1.02–5.12). Those who had been physically assaulted by a family member while aged 6–14 years had a greater chance of MA use than those who had not (AOR = 3.15; 95% CI = 1.32–7.54). Those who had a close friend who used alcohol had a greater chance of MA use than those who did not (AOR = 2.24; 95% CI = 1.24–4.72). Those who had a highly confident personality had a greater chance of MA use than those who did not (AOR = 2.35; 95% CI = 1.17–4.69), and those who smoked had a greater chance of MA use than those who did not (AOR = 8.27; 95% CI = 4.42–15.46).

Conclusions

All relevant government and nongovernment agencies together with the Ministry of Public Health Thailand should address MA use among Akha and Lahu youths by properly developing a community health intervention that lowers risk of MA use by addressing family relationships, male youth behaviors, and focused on those individuals with a highly confident personality.

Cannabis and amphetamine use and its psychosocial correlates among school-going adolescents in Ghana

BACKGROUND

The aim of this study was to examine the prevalence of cannabis and amphetamine use and to determine its associated factors among school-going adolescents in Ghana.

METHOD

The 2012 Ghanaian Global School-based Student Health Survey on 3632 adolescents aged 11-19 years (mean = 15.1 years; SD = 1.4) was used. Participants for this study were sampled from selected junior (JHS) and senior high schools (SHS) in all the 10 administrative regions of Ghana. A two-stage cluster sampling design was used to select 25 senior high schools to represent all the 10 regions of Ghana. Information was collected with a self-administered structured questionnaire that contained information on demographics, alcohol, tobacco and other drug use, violence, and a range of other health-related behaviours.

RESULTS

The result showed that past-month cannabis use was 5.3% and lifetime amphetamine use was 7.1% among students. In multivariate model, after controlling for other variables, school truancy and current cigarette smoking were associated with both past-month cannabis and lifetime amphetamine use. The number of close friends was associated with only past-month cannabis use. School environment factors (bullying victimisation and having been attacked) and parental substance use were associated with lifetime amphetamine use.

CONCLUSION

This study identified a number of risk factors, including parental substance use and various risk behaviours, for both past-month cannabis and lifetime amphetamine use. School-based health intervention programmes should be developed taking into consideration the risk factors associated with cannabis and amphetamine use among school-going adolescents.

Risk and protective factors for drug dependence in two Moroccan high-risk male populations

BACKGROUND

Substance use is linked to biological, environmental, and social factors. This study provides insights on protective and risk factors for drug dependence in two Moroccan, high-risk, male samples.

METHODS

Data from the "Mental and Somatic Health without borders" (MeSHe) survey were utilized in the present study. The MeSHe survey assesses somatic and mental health parameters by self-report from prison inmates (n = 177) and outpatients from an addiction institution (n = 54). The "Drug dependence" and the "No drug dependence" groups were identified based on the Arabic version of the Drug Use Disorder Identification Test's (DUDIT) validated cutoff for identifying individuals with drug dependence, specifically in Morocco.

RESULTS

The majority of participants who had at least high school competence (67.6%), were living in a partnership (53.7%), were a parent (43.1%), and/or had a job (86.8%) belonged to the "No drug dependence" group, while the presence of mental health problems was typical among the "Drug dependence" group (47.4%). A multivariable regression model (χ2 (df = 5, N = 156) = 63.90, p < 0.001) revealed that the presence of depression diagnosis remains a significant risk factor, while a higher level of education, having a child, and being employed are protective factors from drug dependence.

DISCUSSION

Findings support the importance of increasing academic competence and treating depression as prevention from the persistence of drug addiction in male high-risk populations.

Adolescents, parents and teachers' perceptions of risk and protective factors of substance use in Moroccan adolescents: a qualitative study

Background

Substance use in adolescents is a global public health concern that continues to draw attention from academics, policy experts, and government officials. In Morocco, few studies have investigated the influencing factors of substance use in adolescents. Here, we aimed to fill this gap and to better understand factors that protect or influence substance use in adolescents.

Methods

We conducted a qualitative study using focus group discussions. The semi-structured interview guides were based on the socio-ecological model as a theoretical framework to explore perceptions of students, parents, and teachers regarding substance use risks and protective factors in adolescents. Data from each group were audio-recorded, transcribed, and analyzed using thematic analysis.

Results

From May to July 2016, 17 focus group discussions were conducted at two middle schools in Taza city, Morocco, which included 8 groups of 7 adolescents (28 boys and 28 girls) aged 14 to 16 years, 5 groups of parents (5 females and 21 males), and 4 groups of teachers (13 males and 5 females). Thematic analysis resulted in six common themes that represented the most salient perceived risk and protective factors regarding substance use among adolescents: perceived benefits of substance use, awareness and beliefs, family influence, peer influence, easy accessibility of substances, and social norms.

Conclusions

Our results demonstrate that multilevel prevention programs in adolescents should address influencing factors from the individual to the societal level, including social norms and the government’s policy toward substance use. Health education programs included as part of the school curriculum can contribute to promoting awareness and reducing risky behaviors of Moroccan adolescents.

Notes on the Recent History of Neuroscience in Africa

Neuroscience began with neuroanatomy and neurosurgery in Egypt more than 5000 years ago. Knowledge grew over time and specialized neurosurgery centers were established in north Africa in the eleventh century. However, it was not until the twentieth century that neuroscience research became established in sub-Saharan Africa. In most African countries, clinical research focused on understanding the rationale and improving treatment of epilepsy, infections, nutritional neuropathies, stroke and tumors. Significant advances were made. In the twenty-first century, African knowledge expanded to include all branches of neuroscience, contributing to genetic, biochemical and inflammatory determinants of brain disorders. A major focus of basic neuroscience research has been, and is, investigation of plant extracts, drugs and stress in animal models, providing insight and identifying potential novel therapies. A significant event in the history of African neuroscience was the founding of the Society of Neuroscientists of Africa (SONA) in 1993. The International Brain Research Organization (IBRO) supported SONA conferences, as well as workshops and neuroscience training schools in Africa. Thanks to their investment, as well as that of funding agencies, such as the National Institutes of Health (NIH), International Society for Neurochemistry (ISN), World Federation of Neurosurgical Societies (WFNS), World Federation of Neurology (WFN) and the International League Against Epilepsy (ILAE), neuroscience research is well-established in Africa today. However, in order to continue to develop, African neuroscience needs continued international support and African neuroscientists need to engage in policy and decision-making to persuade governments to fund studies that address the unique regional needs in Africa.

Ambiente ocupacional e o consumo de substâncias psicoativas entre enfermeiros

Resumo Objetivo Analisar a relação entre o ambiente de trabalho e o consumo de substâncias psicoativas entre enfermeiros hospitalares. Métodos Estudo transversal e descritivo, realizado com enfermeiros de três instituições hospitalares públicas localizados em um município da Região Sul do Brasil, sendo duas de média complexidade e uma de alta complexidade. A população deste estudo foi composta por 221 enfermeiros. Com base nesse número, calculou-se o tamanho amostral por estratos, considerando-se a proporção de 50%, nível de confiança de 95% e erro máximo de 5%, o que resultou no número mínimo de 175 participantes. Mediante a estratificação proporcional por instituição definiu-se o mínimo de 103 enfermeiros da alta complexidade e 36 de cada instituição de média complexidade. Adotou-se como critérios de inclusão: trabalhar na instituição há pelo menos um ano e não estar afastado por licença. A coleta de dados foi realizada entre outubro de 2015 e abril de 2016. Na coleta de dados utilizaram-se informações sociodemográficas e ocupacionais, o Nursing Work Index - Revised e o Alcohol, Smoking and Substance Involvement Screening Test. Os dados foram analisados no programa Statistical Package for Social Sciences, versão 20.0. Inicialmente, verificou-se a normalidade pelo teste de Kolmogorov-Smirnov. Foram realizadas análises descritivas, por frequências absoluta e relativa para as variáveis categóricas; e medianas e medidas de dispersão para as numéricas. Resultados Álcool, tabaco e sedativos foram as substâncias mais consumidas. Renda mensal apresentou correlação positiva com o consumo de álcool entre enfermeiros dos hospitais de média complexidade (p=0,01). No hospital de alta complexidade, o consumo de álcool relacionou-se negativamente a relação médico-enfermeiro (p=0,03). Autonomia, relação médico-enfermeiro e suporte organizacional estiveram correlacionados negativamente ao uso de sedativos (p<0,01; p<0,01; p=0,02, respectivamente). Conclusão Quanto mais desfavorável o ambiente de trabalho do enfermeiro, sobretudo na relação com médicos, suporte organizacional e autonomia, maior foi o consumo de substâncias psicoativas.

Health risk behaviours amongst school adolescents: protocol for a mixed methods study

BACKGROUND

Determining risky behaviours of adolescents provides valuable information for designing appropriate intervention programmes for advancing adolescent's health. However, these behaviours are not fully addressed by researchers in a comprehensive approach. We report the protocol of a mixed methods study designed to investigate the health risk behaviours of Moroccan adolescents with the goal of identifying suitable strategies to address their health concerns.

METHODS

We used a sequential two-phase explanatory mixed method study design. The approach begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. In the first phase, the global school-based student health survey (GSHS) was administered to 800 students who were between 14 and 19 years of age. The second phase engaged adolescents, parents and teachers in focus groups and assessed education documents to explore the level of coverage of health education in the programme learnt in the middle school. To obtain opinions about strategies to reduce Moroccan adolescents' health risk behaviours, a nominal group technique will be used.

DISCUSSION

The findings of this mixed methods sequential explanatory study provide insights into the risk behaviours that need to be considered if intervention programmes and preventive strategies are to be designed to promote adolescent's health in the Moroccan school.