Child alcohol use disorder in Eastern Uganda: screening, diagnostics, risk factors and management of children drinking alcohol in Uganda (TREAT C-AUD): a mixed-methods research protocol

BackgroundFollowing a finding of alcohol use among children aged 5–8 years old in Mbale, Uganda, this project investigates the magnitude of alcohol and substance use among children ged 6–13 years old and related household, community, school, health system and clinical factors.MethodsThe project includes four larger work packages (WPs). WP1 comprises management, WP2 and 3 include the scientific components and WP4 includes integration of results, dissemination, policy and implementation advice. This protocol presents the planned research work in WP 2 and 3. WP2 comprises the adaptation and validation of the alcohol use screening tool Car-Relax-Alone-Forget-Family and Friends-Trouble (CRAFFT) to the age group and setting. WP3 comprises four substudies (SS). SS1 is a cross-sectional community household survey with an estimated sample size of 3500 children aged 6–13 years and their caregivers. We apply cluster sampling and systematic sampling within the clusters. Data collection includes a structured questionnaire for caregiver and child, measuring social and demographic factors, mental health status, alcohol and substance use, nutrition history and anthropometry. Urine samples from children will be collected to measure ethyl glucuronide (EtG), a biological marker of alcohol intake. Further, facilitators, barriers and response mechanisms in the health system (SS2) and the school system (SS3) is explored with surveys and qualitative assessments. SS4 includes qualitative interviews with children. Analysis will apply descriptive statistics for the primary outcome of establishing the magnitude of alcohol drinking and substance use, and associated factors will be assessed using appropriate regression models. The substudies will be analysed independently, as well as inform each other through mixed methods strategies at the stages of design, analysis, and dissemination.Ethics and disseminationData protection and ethical approvals have been obtained in Uganda and Norway, and referral procedures developed. Dissemination comprises peer-reviewed, open access research papers, policy recommendations and intersectoral dialogues.Trial registration numberClinicaltrials.gov 29.10.2020 (#NCT04743024).

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Patterns And Correlates Of Substance Use: Cross Sectional Exploratory Study Among Health Care Workers In Bungoma County, Kenya

10.21203/rs.3.rs-15770/v1 ◽

2020 ◽

Author(s):

Titus Kipchirchir Kolongei ◽

Justus Osero ◽

Albert Gachau

Keyword(s):

Health Care ◽

Substance Use ◽

Peer Influence ◽

Health Care Workers ◽

Exploratory Study ◽

Health Workers ◽

Systematic Sampling ◽

Cluster Sampling ◽

Cross Sectional ◽

Care Workers

Abstract Background: This was a cross sectional exploratory study that examined data obtained from health care workers on substance use in Bungoma County Kenya. Methods: This was a cross sectional exploratory study in selected health facilities in three sub counties of Bungoma County. This study used a two-stage cluster sampling technique and systematic sampling to select the respondents. The study sample was (N= 237 ) among health care workers in selected facilities in 3 sub counties of Bungoma county .The study response rate was 96.3 %(237/247) . Self-reported data on substance use during their lifetime, use in the past 12 months and past 30 days was used as key parameters to determine patterns and correlates of substance Results: As compared with females, males were found to have a greater like hood of substance use, having family member with a history of substance use and a colleague who uses substances were key predictors for substance use. Substance use prevalence without generalization to the population of Health care workers (HCWs) in this study shows a high prevalence of lifetime substance use (35.02, 29.17- 41.36) concurs with findings in a study in Machakos and Nairobi (Mokaya et al 2018). Alcohol had the highest lifetime prevalence rate (33%) Conclusion; Alcohol use among HCW had the highest prevalence with socio-demographic factors on gender, family and peer influence associated with substance use among health workers. The study findings suggest preventive interventions against substance use are required at family level and among peers. Further research is needed on substance abuse, dependence, reasons for substance use and how it affects health workers performance Keywords: Substance Use, abuse, dependence, patterns, correlates, lifetime use

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The Association between Sociocultural Factors and Substance Use among Haramaya University Students

Substance Abuse Research and Treatment ◽

10.1177/11782218211004522 ◽

2021 ◽

Vol 15 ◽

pp. 117822182110045

Author(s):

Zelalem Tadese Feyisa

Keyword(s):

Substance Use ◽

Alcohol Use ◽

University Students ◽

Health Workers ◽

Sociocultural Factors ◽

University Management ◽

Negative Consequences ◽

Cross Sectional ◽

Negatively Associated ◽

Khat Use

All the associated risk factors were not equally responsible for influencing individuals either in alcohol use, khat use, tobacco, or cannabis use. This study attempted to examine sociocultural factors influencing university students in substance use by comparing one with another. A cross-sectional study was carried out. The study used a quantitative approach to collect data from 384 students. Compared with their involvement in khat use, female students were positively influenced in cigarette and hashish use (Adjusted Odds Ratio, AOR = 1.102, 95% CI: 1.056, 1.149) and alcohol use (AOR = 1.066, 95% CI: 1.021, 1.113). The involvement of students in alcohol use (AOR = 0.884, 95% CI: 0.838, 0.932) and cigarettes and hashish use (AOR = 0.909, 95% CI: 0.866, 0.953) were negatively associated with stress related to their academic activities. The involvement of students in alcohol use (AOR = 0.942, 95% CI: 0.906, 0.979) was negatively associated with parental influences; involved in alcohol use (AOR = 0.445, 95% CI: 0.210, 0.941) was negatively associated with the thoughts of considering substances as an energizer. The involvement of students in alcohol use (AOR = 4.980, 95% CI: 1.614, 15.368) was positively associated with peer influences. It was, thus, suggested that the management of Haramaya University should work on creating awareness of the negative consequences of substance use. Concerned professionals, including sociologists, psychologists, and health workers, should work on raising students’ awareness as it was possible to undertake their studies without substance use. Moreover, the university management is strongly recommended to expand recreational centers within the campus. Lastly, Haramaya woreda administration should restrict the availability and accessibility of these substances around the campus.

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Hotspots of unimproved sources of drinking water in Ethiopia: Mapping and Spatial analysis of Ethiopia Demographic and Health Survey Data 2016

10.21203/rs.2.18991/v1 ◽

2019 ◽

Author(s):

Getahun Gebre Bogale

Keyword(s):

Drinking Water ◽

Statistical Tests ◽

National Level ◽

Population Based ◽

Cross Sectional Study ◽

Moran’S I ◽

Systematic Sampling ◽

Cluster Sampling ◽

Cross Sectional ◽

Moran's I

Abstract Background: More than 35% of Ethiopian population is using drinking water from unimproved sources. As per the United Nations’ Sustainable Development Goals, Ethiopia is aspiring to achieve universal and equitable access to safe and affordable drinking water for all by 2030. For these goals to be accomplished, it is important to map the country’s hotspot areas of unimproved source of drinking-water so that resource allocation and disease control can be optimized there. Methods: A population based cross-sectional study was conducted in Ethiopia from January 18 to June 27, 2016. Data were collected from 10,064 households using a pretested and structured questionnaire. A stratified two-stage cluster sampling was employed where the enumeration areas were primary sampling units and households were secondary sampling units. Systematic sampling with probability proportional to size was employed to select samples. Data were cleaned in spreadsheet and entered in to SaTScan and ArcGIS soft-wares for mapping and analysis. The Global Moran’s I and spatial scan statistical tests (Bernoulli model) were done to explore the presence of clustering in the study area and local spatial clusters (hotspots) of unimproved sources of drinking water using ArcGIS version 10.3 and Kuldorff’s SaTScan version 9.4 soft-wares, respectively. Moran’s I value closer to +1 declared presence of clustering at national level and Log-Likelihood ratio (LLR) greater than the critical value with p<0.05 declared statistical significant hotspots across the regions. Results: In this study, unimproved sources of drinking water were spatially clustered at the study area (Moran’s I: 0.35, p<0.05). A total of 143 significant clusters were identified. Of which, eight were most likely (primary) clusters and the rest 135 were secondary clusters. The first spatial window which contains primary clusters was located in Amhara and Afar regions (LLR: 78.89, at p<0.001). The rest 33 spatial windows which contain secondary clusters were found in all regions, except Gambela region and Addis Abeba city administration (with a range of LLR: 10.09-78.89, p<0.001). Conclusions: This study identified non-random clusters and hot spots of unimproved sources of drinking water. Therefore, the result helps decision makers for their geographical interventions to combat problems related to hotspots.

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S238. PATIENT ENGAGEMENT TO EARLY INTERVENTION IN PSYCHOSIS SERVICES: RETROSPECTIVE ANALYSIS OF ENGAGEMENT PATTERNS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.304 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S129-S130

Author(s):

Candice Crocker ◽

Michael Teehan ◽

Zenovia Ursuliak ◽

Jason Morrison ◽

Nancy Robertson ◽

...

Keyword(s):

Substance Use ◽

Early Intervention ◽

Alcohol Use ◽

Health Services ◽

Well Being ◽

Time Frame ◽

Individual Risk ◽

Cross Sectional ◽

Data Set ◽

Early Intervention In Psychosis

Abstract Background Within outpatient mental health services there exists an important awareness of the difficulties in engaging and maintaining contact with patients, as well as the understanding of the negative effects of disengagement, including worse patient outcomes and increased healthcare burden. Despite the importance of engagement on service delivery and recovery outcomes, few studies have examined rates and predictors of engagement in the early phase psychosis population. Although better than community care, it has been reported that an average of 30% of patients disengage from specialized early intervention services for psychosis (EIS). We examined rates of disengagement to a 5 year EIS for psychosis, including potential individual risk factors for disengagement at entry to service. Methods This cross-sectional cohort study examined engagement to services to a single EIS site from November 2006 to November 2016. Disengagement was determined retrospectively on review of medical records, defined as not attending to clinic services despite repeated attempts by clinicians/clinic for a three month time frame. Gender, age at clinic entry, ethnicity, Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory (DAI-30), General Assessment of Function (GAF), Social and Occupational Functioning Assessment Scale (SOFAS), WHO-ASSIST version 3.0, and the Psychological General Well Being (PGWB)scale at entry to service were examined between groups. . Descriptive statistical and survival analyses for time to disengagement were conducted on the patient data set. Results 331 patient records were complete (with above scales) from entry to service to discharge or loss to follow-up. Patients were found to fall into 3 categories with regard to patterns of engagement. The first category we named “engagers” as they remained committed to their care throughout the program and comprised 50% of the sample. The second group were labeled the disengagers (20% of the group) and these were individuals who disengaged at some point in the program and did not return, in contrast to “intermittent engagers“ who comprised 30% of the sample. Intermittent engagers were patients who at some point during their care would meet criteria for disengagement but would re-engage later (still within the 5 years from entry to EIS) and complete the program. Absolute disengagement by the disengager group was predominantly prior to 12 months of treatment (78% of the group) with a survival analysis showing a median time to absolute disengagement of 8 months. The 3 groups though defined based on their engagement status, did not significantly differ in age, gender and ethnicity. Additionally, the clinician reported scores GAF and SOFAS did not differ between the groups. Patterns of substance use differed between the groups. There was a trend toward higher tobacco use in the two groups showing disengagement. Cannabis use did not differ significantly between groups but the pattern of use was highest in the disengagers followed by the engagers and then intermittent engagers. Alcohol use was significantly different between the groups with 81% of the disengagers having problem levels of alcohol use (WHO ASSIST v. 3.0 score above 4), however, there was no correlation between alcohol score and time to disengagement. Discussion Our retrospective study found a surprisingly large portion of the patient population will wax and wane in their commitment to health services but ultimately maintain attendance to complete the program, suggesting that patients should not be discharged early from EIS for psychosis. Substance use patterns and functional measures may identify patients who are at risk of early disengagement from EIS.

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Prevalance of Using Cigarette,Alcohol,Substance Among High School Students and Factors Affected Them

European Journal of Public Health ◽

10.1093/eurpub/ckz186.129 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Y Levent ◽

A Ozer ◽

A Gokce

Keyword(s):

High School ◽

Substance Use ◽

High School Students ◽

Alcohol Use ◽

Cross Sectional Study ◽

School Students ◽

Chi Square ◽

Cross Sectional ◽

Cigarette Smokers ◽

Alcohol Users

Abstract Background Usage rate of cigarette, alcohol, and substance is increasing day by day.Protectiv efactors have primary importance for prevention of substance use.The aim of this study is to investigate the prevalance of using cigarette, alcohol and substance and research relationship between risk factories and substance using, among high school students. Methods Ä°n Malatya city there are 17866 Anatolian, 14381 Vocational,10362 Religious high school students.Totally all of this 42629 students form the universe of this cross-sectional study. When the prevalance of using cigarette accepted as 25 % in high school students; sample size in Anatolian high school,Occupatioanal high school and Religious high school was found 283, 283 and 280 respectively.This survey was conducted in 9 different high schools which choosed by stratified sampling method, and 975 high school students have been reached in this survey.Ä°n the statistical analysing of data,Chi square test, logistic regression test were used. Results The prevalance of cigarette, alcohol and substance using found 34%, 14.3% and 4.2% respectivey among students participating in the survey.Cigarette using; in male students is 2.2 times higher (Cl 95%,1.661-3.073), in alcohol users is 7.6 times higher(Cl 95%,4.919-11.834)(p < 0.05).Alcohol using is 9.6 times higher(Cl 95%, 5.712-16.250) in cigarette smokers(p < 0.05).And alcohol using in students with alcohol use in their families is 26.8 times higher(Cl 95%,12.489-57.711)(p < 0.05).Substance using; found 12.2 times higher(Cl 95%,4.900-30.566) in alcohol users,2.4 times higher(Cl 95%,5.712-16.250) in cigarette smokers and 5.6 times higher(Cl 95%,1.366-23.068)in students with substance use in their families (p < 0.05). Conclusions Cigarette using is more common in males and alcohol users.Alcohol use increses in smokers and students with alcohol use in their families.Substance use among students increases when student uses cigarette or alcohol and if there are substanceuse in their families. Key messages Alcohol use increses in smokers, smoking increses in alcohol users. Substance use increses in smokers, alcohol users and in the students with substance use in their families.

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Spirituality and substance use in a sample of Russian adolescents

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh.2012.022 ◽

2012 ◽

Vol 24 (2) ◽

Cited By ~ 2

Author(s):

Pallav Pokhrel ◽

Steve Sussman ◽

Shekhar Regmi ◽

Jeffrey S. Hallam ◽

Vadim Kniazev ◽

...

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Protective Effects ◽

Cross Sectional ◽

Perceived Risks ◽

Religious Background ◽

The Relationship

Abstract Aim: The aim was to examine the effects of spirituality on recent cigarette and alcohol use, intentions to use cigarette and alcohol, and perceived risks of cigarette/alcohol use in a sample of Russian adolescents. Methods: Cross-sectional data were obtained from 362 10th graders from Ufa, Russia. Results: Adolescents scoring higher on spirituality were significantly more likely to report lower levels of intentions to use cigarettes or alcohol. However, spirituality was not associated with recent cigarette/alcohol use or perceived risks. Analyzed separately for ethnic Russians and non-Russians, the relationship between spirituality and intentions were significant only among ethnic non-Russians. Conclusions: Our data suggests that the protective effects of spirituality on substance use may not be universal and may depend on subjects’ national, ethnic, or religious background.

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Evaluation of Integrated Health System Technology Acceptance among the users of Health Centers of Zahedan University of Medical Sciences: Iran

Evidence Based Health Policy Management and Economics ◽

10.18502/jebhpme.v3i3.1503 ◽

2019 ◽

Author(s):

Mohammad Khammarnia ◽

Fatemeh Setoodehzadeh ◽

Mostafa Peyvand ◽

Amir Hossein Setayesh ◽

Kosar Rezaei ◽

...

Keyword(s):

Health System ◽

Technology Acceptance ◽

Acceptance Rate ◽

Health Centers ◽

Cluster Sampling ◽

Medical Sciences ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Integrated Health ◽

System Acceptance

Background: The integrated health system (IHS) entitled “SIB” was launched in 2016 aimed to electronic health record (EHR) in the field of health. Given that, in addition to deploying the system, its acceptance criteria by users has a significant effect on its effectiveness and benefits: therefore, the present study was carried out aimed to determine the acceptance rate of IHS technology in health centers. Methods: This study as a cross-sectional survey and applied research was conducted in Zahedan University of Medical Sciences (ZAUMS) in 2017. The population in the present study consisted of all users of SIB system affiliated ZAUMS. Of these, 285 users were selected (physician, health care provider, Behvarz) in five counties affiliated with ZAUMS using multistage cluster sampling. In this study, standard technology acceptance questionnaire was used for data collection. The data were analyzed by SPSS-v22 software and analyzed using descriptive statistics, one-way Anova, T test and other related tests. Results: About 77.9 % of users used the system for several times a day. The SIB system acceptance rate by 49.5 % of users was moderate and 38.9% of the users had excellent acceptance of this system. There was a significant relationship between the acceptance rate of SIB system among the users with age, gender, city, level of education, type of employment, place of work and organizational position (P < 0.05). Conclusion: The results of this study show that, most users have accepted and confirmed the SIB system. Modification of the system with regional approach with the opinion and participation of specialists in comprehensive health service centers is suggested.

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Prevalence of substance use in Bangladesh

Bangladesh Journal of Psychiatry ◽

10.3329/bjpsy.v32i1.53043 ◽

2020 ◽

Vol 32 (1) ◽

pp. 1-8

Author(s):

Md Faruq Alam ◽

Mekhala Sarkar ◽

Mohammad Tariqul Alam ◽

Helal Uddin Ahmed ◽

Avra Das Bhowmik ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Low Income ◽

Sampling Technique ◽

Income Group ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Statistical Parameters ◽

Cross Sectional ◽

Middle Income

The prevalence of substance use is on rising trend in the country. This two-stage nationwide multicentric community based cross sectional study was conducted by National Institute of Mental Health (NIMH), Dhaka during the period of September 2017 to July 2018 to determine the prevalence of substance use as well as to identify the proportion of users used different substances and to find out socio-demographic correlates of substance use in Bangladesh. The sample were collected by cluster sampling technique. In the first stage data were collected from 19692 respondents aged between 7 years and above in 140 clusters through face-to-face interview using semi-structured questionnaires to collect information by trained data collector. Diagnoses of substance use were made in the second stage of interview by research psychiatrists following DSM-5 diagnostic criteria of mental disorders. Descriptive and inferential statistics of the collected data was done using standard statistical parameters. SPSS programme (Version 23) was used to summarize and to analyze the data. The results showed that, the prevalence of substance use was found as 3.3% among the population 18 years and above. Prevalence of substance use was 4.8% in male and 0.6% in female. Most frequently used substances include cannabis in (42.7%), alcohol in 27.5%, amphetamine (yaba) in 15.2%, opioid in 5.3% and sleeping pills in 3.4% users. Among professions of substance users 6.7% were labors, 5.7% unemployed, 4.3% business men, 3.8% farmers and 3.5% service holders. Extremes of social classes were found as increased users of substances such as people with low income 3.2% and people with high income 3.8% using as against 2.6% in middle income group. The data of this community survey will be used for planning of mental health services in Bangladesh. Bang J Psychiatry June 2018; 32(1): 1-8

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“Students in public and private schools—which are at higher risk of drug use?”: A survey from Iran

10.21203/rs.3.rs-57494/v1 ◽

2020 ◽

Author(s):

Ali Bahramnejad ◽

Abedin Iranpour ◽

Nouzar Nakhaee

Keyword(s):

Substance Use ◽

Public Schools ◽

Drug Use ◽

Private Schools ◽

Private School ◽

Cross Sectional Study ◽

Cluster Sampling ◽

School Students ◽

Cross Sectional ◽

Public And Private

Abstract Background Recent evidence from Western countries suggests that private school students are more prone to drug use. Such an evidence is lacking in Muslim countries. The aim of this study was to examine whether the risk of drug use is higher in private schools than public schools.Methods This cross sectional study was conducted on 650 tenth grade students of Kerman city, the center of largest province of Iran using cluster sampling. Well-validated questionnaires regarding current, lifetime substance use, and perceived use by classmates were utilized. Substances included in the questionnaire were waterpipe, cigarette, alcohol, marijuana, opium, methamphetamine, and Naas. Drug Use Tendency Scale was used to measure the attitudes of students towards drug use.Results The response rate was 93.7%. More than 82% of sample were public school students (n = 504). Current use of cigarette and marijuana was higher in private schools (12.2% and 3.0%, respectively) than public schools (4.4% and 0.5%, respectively) (P < 0.05). Perceived prevalence of cigarette smoking by classmates was higher among private school students.Conclusion Despite the popular belief that private schools are better than public schools regarding the risk of substance use, students who attend private schools may be at a higher risk of turning to some drugs comparing to public schools in Iran.

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Association of bullying behaviour with smoking, alcohol use and drug use among school students in Erbil City, Iraq

Eastern Mediterranean Health Journal ◽

10.26719/2021.27.5.483 ◽

2021 ◽

Vol 27 (5) ◽

pp. 483-490

Author(s):

Beena Shawki ◽

Tariq Al-Hadithi ◽

Nazar Shabila

Keyword(s):

Substance Use ◽

Public Schools ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Future Research ◽

Cluster Sampling ◽

School Students ◽

Cross Sectional ◽

Effective School ◽

Wide Range

Background: Substance use and bullying are prevalent among adolescents and have a wide range of adverse outcomes. The association of bullying with substance use has not been examined in Kurdistan and Iraq, which have suffered from the effects of long-term conflict and economic hardship. Aims: To examine the association between each form of bullying among adolescents and substance use. Methods: This cross-sectional study was conducted in a sample of public schools in Erbil City, Iraq in 2017. The study involved 1070 adolescents selected from 35 schools using a multistage cluster sampling method. A self-reported close-ended questionnaire was used for data collection. Male and female students attending grades 7–12 and aged 13–18 years were included. Results: The overall prevalence of bullying behaviour was 60.0%; 30.8% were victims, 26.2% were bully-victims, and 3.0% were bullies. There was a significant association between different forms and categories of bullying and substance use. The strongest association was with the students involved in sexual bullying, followed by racial and cyber bullying. The strongest association between bullying and substance use was found in the bully-victim category, followed by victims and bullies. Conclusions: Substance use and bullying behaviour seem to be widespread problems among adolescents in Erbil schools. Substance use is significantly associated with different categories of bullying behaviour. There is a need for effective school-based preventive interventions to tackle these problems. Future research needs to examine the likely direction of the association between bullying and substance use.

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