Current alcohol, tobacco, and khat use and associated factors among adults living in Harari regional state, eastern Ethiopia: A community-based cross-sectional study

Exploring prevention and control mechanisms of youth substance use: a case of North Wollo and Waghimra, Northeast Ethiopia

Background

Substance use among youths is a significant global and local issue. Youth who engage in substance use often experience various psychosocial, health, economic, and other problems. While governmental and non-governmental organizations in North Wollo and Waghimra Zones offer social services, their effectiveness in preventing and controlling substance use remains largely unstudied. This research aims to explore youth substance use prevention techniques and control mechanisms, youth participation, and potential challenges encountered by social service organizations.

Methods

A qualitative case study design was employed in North Wollo and Waghimra Zones, Northeast Ethiopia. Purposive sampling was used to recruit participants. A total of 40 participants were involved, including 10 key informant interviews and 5 focus group discussions (FGDs) of youths (6 participants per group). The data collection instrument included a pre-tested semi-structured in-depth interview, an FGD guide, and an observation checklist. The collected data were analyzed thematically.

Findings

Prevention efforts primarily focused on awareness-raising campaigns and advocacy programs. Control mechanisms were predominantly reactive, including measures such as regulating the substance trade, punishing drug dealers, destroying and burning drug paraphernalia, and closing substance trade centers. The study found limited youth involvement in substance use prevention and control initiatives. Several key challenges were identified in the prevention and control of youth substance use: limited government involvement, reliance only on reactive measures, low youth engagement, insufficient intersectoral collaboration, lack of community commitment, gaps in social institutions, absence of planned interventions, the economic role of substances, government ignorance, and the absence of comprehensive legal frameworks for prevention and control.

Conclusion and recommendation

This study highlights a gap in prevention and control mechanisms, and engagement of youths, non-governmental as well as governmental bodies. This study recommends making evidence-based interventions and installing functional networks among sectors to deal with common issues. This issue also should not be left to a single organization and government agencies, families, religious, and educational institutions should play a leading role in tackling substance use burdens at the grassroots level.

Scoping review of assessment tools for, magnitudes of and factors associated with problem drinking in population-based studies

BACKGROUND

The term "problem drinking" includes a spectrum of alcohol problems ranging from excessive or heavy drinking to alcohol use disorder. Problem drinking is a leading risk factor for death and disability globally. It has been measured and conceptualised in different ways, which has made it difficult to identify common risk factors for problem alcohol use. This scoping review aims to synthesise what is known about the assessment of problem drinking, its magnitude and associated factors.

METHODS

Four databases (PubMed, Embase, PsycINFO, Global Index Medicus) and Google Scholar were searched from inception to 25 November 2023. Studies were eligible if they focused on people aged 15 and above, were population-based studies reporting problem alcohol use and published in the English language. This review was reported based on guidelines from the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist'. Critical appraisal was done using the Newcastle-Ottawa Scale.

RESULTS

From the 14 296 records identified, 10 749 underwent title/abstract screening, of which 352 full-text articles were assessed, and 81 articles were included for data extraction. Included studies assessed alcohol use with self-report quantity/frequency questionnaires, criteria to determine risky single occasion drinking, validated screening tools, or structured clinical and diagnostic interviews. The most widely used screening tool was the Alcohol Use Disorder Identification Test. Studies defined problem drinking in various ways, including excessive/heavy drinking, binge drinking, alcohol use disorder, alcohol abuse and alcohol dependence. Across studies, the prevalence of heavy drinking ranged from <1.0% to 53.0%, binge drinking from 2.7% to 48.2%, alcohol abuse from 4.0% to 19.0%, alcohol dependence from 0.1% to 39.0% and alcohol use disorder from 2.0% to 66.6%. Factors associated with problem drinking varied across studies. These included sociodemographic and economic factors (age, sex, relationship status, education, employment, income level, religion, race, location and alcohol outlet density) and clinical factors (like medical problems, mental disorders, other substance use and quality of life).

CONCLUSIONS

Due to differences in measurement, study designs and assessed risk factors, the prevalence of and factors associated with problem drinking varied widely across studies and settings. The alcohol field would benefit from harmonised measurements of alcohol use and problem drinking as this would allow for comparisons to be made across countries and for meta-analyses to be conducted.

TRIAL REGISTRATION NUMBER

Open Science Framework ID: https://osf.io/2anj3.

Suicidal Behaviors and Associated Factors Among Adult Psychiatric Patients Attending Psychiatric Clinic at Public Hospitals in Ethiopia: A Cross-Sectional Study

Suicidal behaviors in persons with mental illnesses are the most prevalent psychiatric crises, requiring scholars and mental health task teams to prioritize public health concerns. However, there is a scarcity of data in Ethiopia, particularly for patients with mental illness. As a result, the goal of this study was to assess the prevalence of suicidal behaviors and associated factors among individuals with mental illness visiting public hospital psychiatric clinic units in eastern Ethiopia. A facility-based cross-sectional study was conducted from October 15 to November 15, 2022, with 411 individuals with mental illness visiting psychiatric clinic units at public hospitals in eastern Ethiopia. To select participants in the study, a systematic random sampling method was used. A structured face-to-face interview was used to gather data. The Suicidal Behavior Questionnaire-Revised (SBQ-R) was used to measure suicidal behaviors. Epidata 3.1 version was used to enter the data, and SPSS version 24 was used to analyze it. Both bivariable and multivariable logistic regression analyses were employed. In the final model, variables with p-values less than 0.05 were considered statistically significant. To identify variables associated with suicidal behavior, the adjusted odds ratio (AOR) and 95% confidence interval (CI) were utilized. Out of a total of 411 eligible participants, 402 involved in this study, giving a response rate of 97.8%. The prevalence of suicidal behavior was 46.3%, (95% CI: 41-50.7). Depression (AOR = 2.21,95% CI: 1.04, 4.69), medication non-adherence (AOR = 1.95, 95% CI: 1.19, 3.18), bipolar disorders (AOR = 1.79, 95% CI: 1.55, 3.53), and current alcohol use (AOR = 1.81, 95% CI: 1.01, 3.28) were variables associated with suicidal behaviors. This study found a high rate of suicidal behaviors among adult individuals with mental illness in public hospitals in eastern Ethiopia. Suicidal behavior was highly associated with depression, bipolar disorders, current alcohol use, and medication non-adherence. Psychiatric professionals should assess patient suicidal risk assessment routinely and should put the diagnosis with suicidal if the client is suicidal so that every professional focuses on treatment besides the medication. Special attention is required for individuals who present associated features, such as history of medication non adherence, depression, and overall bipolar disorders.

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.