scholarly journals The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3145
Author(s):  
Ivneet Sohi ◽  
Ari Franklin ◽  
Bethany Chrystoja ◽  
Ashley Wettlaufer ◽  
Jürgen Rehm ◽  
...  

This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the Global Information System on Alcohol and Health with corresponding relative risk estimates from meta-analyses. The mortality and health data were obtained from the Global Health Observatory. Among people 69 years of age and younger in 2016, 2.0 million deaths and 117.2 million Disability Adjusted Life Years (DALYs) lost were attributable to alcohol consumption, representing 7.1% and 5.5% of all deaths and DALYs lost in that year, respectively. The leading causes of the burden of alcohol-attributable deaths were cirrhosis of the liver (457,000 deaths), road injuries (338,000 deaths), and tuberculosis (190,000 deaths). The numbers of premature deaths per 100,000 people were highest in Eastern Europe (155.8 deaths per 100,000), Central Europe (52.3 deaths per 100,000 people), and Western sub-Saharan Africa (48.7 deaths per 100,000). A large portion of the burden of disease caused by alcohol among people 69 years of age and younger is preventable through the implementation of cost-effective alcohol policies such as increases in taxation.


Author(s):  
Alemu Earsido Addila ◽  
Telake Azale Bisetegn ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal Mengistu ◽  
Getnet Mihretie Beyene

Abstract Background Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries. Methods The results of the review were reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline and, it was registered in the Prospero database, number CRD42019127103. The available primary studies were collated from different databases: PubMed, CINAHL, Cochrane Library, PsycINFO, Google Scholar, African Journals Online and Centre for Addiction and Mental Health Library. The main search terms were [((alcohol consumption) OR (alcohol drinking) OR (alcohol use) OR (ethanol use) OR (alcohol exposure)) AND ((pregnant women) OR (pregnant mother) OR (during pregnancy)) AND (Sub-Saharan Africa)]. We used the Joanna Briggs Institute (JBI) for critical appraisal of studies. The random-effects model was computed to estimate the pooled prevalence. Heterogeneity between studies was checked using the I2 statistic and the Cochrane Q test. Results The review resulted in 963 original studies after searching various databases, and finally 37 studies in qualitative synthesis and 30 articles in the systematic review and meta-analysis were included. The overall summary estimate of the prevalence of alcohol consumption during pregnancy was found to be 20.83% (95% CI: 18.21, 23.46). The pooled estimate of meta-analysis showed that depression (OR: 1.572; 95% CI: 1.34, 1.845), partners’ alcohol use (OR: 1.32, 95% CI: 1.11, 1.57), knowledge on harmful effect of alcohol consumption (OR: 0.36, 95% CI: 0.29, 0.45) and, unplanned pregnancy (OR: 2.33, 95% CI: 1.17, 4.63) were statistically significant factors with alcohol consumption during pregnancy. Conclusions The result showed that there was high alcohol consumption during pregnancy in Sub- Saharan Africa. Alcohol consumption during pregnancy was associated with depression, partners’ alcohol use, unplanned pregnancy and knowledge of the harmful effects of alcohol consumption. Therefore, this will be a basis for public policy and resource allocation for prevention initiatives.



2021 ◽  
Author(s):  
Bezawit Mulat ◽  
Wallelign Alemnew ◽  
Kegnie Shitu

Abstract BackgroundAlcohol drinking during pregnancy is towering in spite of the well-established prove on its unfavorable pregnancy results and destitute child improvement. Despite such enormous consequences, there are limited data that explore about the extent of alcohol drinking and its associated factors among mothers during pregnancy in sub-Saharan Africa. ObjectiveThis study aimed to assess the prevalence and associated factors of alcohol consumption during pregnancy among pregnant mothers in sub-Saharan Africa. MethodA community based crossectional demographic and health survey was conducted from 2013 to 2017 among four Sub-Sahara African countries: Burundi, Ethiopia, Liberia and Zimbabwe. A two-stage stratified sampling technique was employed to select the participants. Multivariable Logistic regression analysis was used to identify factors associated with alcohol consumption during pregnancy. A p-value less than 0.05 and 95% confidence interval were used to declare statistical significance.ResultA total of 3,953 weighed sample of pregnant mothers were included in the study. The mean age of the participants was 27.3 (± 6.8) years with an age range of 15-49 years. The overall prevalence of alcohol use during pregnancy was 22.8% with (95% CI (21.5, 24)) and it was significantly associated with increased age (AOR=1.02, 95% CI (1.01, 1.04)), Muslim religion follower ( AOR=0.07, 95% (0.05,0.11), husband/partner’s educational status of primary (AOR=0.7 ,95% CI (0.55,0.84), secondary (AOR=0.53, 95% CI ( 0.41,0.7)) and higher (AOR=0.49 , 95% CI(0.31,0.8), being currently working (AOR=1.5,95% CI ( 1.09,1.55) , having ANC visit ( AOR=0.82, 95% C I(0.68,0.98) and increased gravidity ( AOR=0.93,95% CI( 0.86,0.99).Conclusion Alcohol drinking during pregnancy was high among pregnants in sub-Saharan African countries. Maternal age, religion, husband educational status, current working status of the mother, presence of ANC visit and gravidity of the mother were factors which have significant association with alcohol drinking during pregnancy. This calls a tailored behavior change intervention to reduce alcohol use during pregnancy. More emphasis should also be given for pregnant women with no ANC visit, lower gravidity, and an illiterate husband, currently working and Christianity followers.



2019 ◽  
Vol 69 (4) ◽  
pp. 588-595 ◽  
Author(s):  
Tao Chen ◽  
Lawrence Mwenge ◽  
Shabir Lakhi ◽  
Duncan Chanda ◽  
Peter Mwaba ◽  
...  

Abstract Background Mortality from cryptoccocal meningitis remains high. The ACTA trial demonstrated that, compared with 2 weeks of amphotericin B (AmB) plus flucystosine (5FC), 1 week of AmB and 5FC was associated with lower mortality and 2 weeks of oral flucanozole (FLU) plus 5FC was non-inferior. Here, we assess the cost-effectiveness of these different treatment courses. Methods Participants were randomized in a ratio of 2:1:1:1:1 to 2 weeks of oral 5FC and FLU, 1 week of AmB and FLU, 1 week of AmB and 5FC, 2 weeks of AmB and FLU, or 2 weeks of AmB and 5FC in Malawi, Zambia, Cameroon, and Tanzania. Data on individual resource use and health outcomes were collected. Cost-effectiveness was measured as incremental costs per life-year saved, and non-parametric bootstrapping was done. Results Total costs per patient were US $1442 for 2 weeks of oral FLU and 5FC, $1763 for 1 week of AmB and FLU, $1861 for 1 week of AmB and 5FC, $2125 for 2 weeks of AmB and FLU, and $2285 for 2 weeks of AmB and 5FC. Compared to 2 weeks of AmB and 5FC, 1 week of AmB and 5FC was less costly and more effective and 2 weeks of oral FLU and 5FC was less costly and as effective. The incremental cost-effectiveness ratio for 1 week of AmB and 5FC versus oral FLU and 5FC was US $208 (95% confidence interval $91–1210) per life-year saved. Clinical Trials Registration ISRCTN45035509. Conclusions Both 1 week of AmB and 5FC and 2 weeks of Oral FLU and 5FC are cost-effective treatments.



2021 ◽  
Author(s):  
Louisa Manby ◽  
Catherine Aicken ◽  
Marine Delgrange ◽  
Julia V. Bailey

AbstractHIV is still the leading cause of death in Sub-Saharan Africa (SSA), despite medical advances. eHealth interventions are effective for HIV prevention and management, but it is unclear whether this can be generalised to resource-poor settings. This systematic review aimed to establish the effectiveness of eHealth interventions in SSA. Six electronic databases were screened to identify randomised controlled trials (RCTs) published between 2000 and 2020. Meta-analyses were performed, following Cochrane methodology, to assess the impact of eHealth interventions on HIV-related behaviours and biological outcomes. 25 RCTs were included in the review. Meta-analyses show that eHealth interventions significantly improved HIV management behaviours (OR 1.21; 95% CI 1.05–1.40; Z = 2.67; p = 0.008), but not HIV prevention behaviours (OR 1.02; 95% CI 0.78–1.34; Z = 0.17; p = 0.86) or biological outcomes (OR 1.17; 95% CI 0.89–1.54; Z = 1.10; p = 0.27) compared with minimal intervention control groups. It is a hugely important finding that eHealth interventions can improve HIV management behaviours as this is a low-cost way of improving HIV outcomes and reducing the spread of HIV in SSA. PROSPERO registration number: CRD42020186025.



2013 ◽  
Vol 2 (1) ◽  
pp. 99-110 ◽  
Author(s):  
Sarah E Woolf-King ◽  
Craig M Steinmaus ◽  
Arthur L Reingold ◽  
Judith A Hahn

Woolf-King, S., Steinmaus, C. M., Reingold, A. L. & Hahn, J. A. (2013). An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions. International Journal of Alcohol and Drug Research, 2(1), 99-110.  doi: 10.7895/ijadr.v2i1.45 (http://dx.doi.org/10.7895/ijadr.v2i1.45)Aims: Sub-Saharan Africa is disproportionately affected by HIV/AIDS, and growing evidence suggests that alcohol consumption is a co-occurring problem in the region.  We conducted a meta-analysis on studies of alcohol use and HIV infection in sub-Saharan Africa in order to assess associations, evaluate heterogeneity in the literature, identify susceptible subgroups, and suggest avenues for future research.Design: We performed a systematic review, including published review articles and electronic database searches, and identified 35 studies on alcohol use and HIV.Setting and participants: All of the studies included in the meta-analysis occurred with adults in sub-Saharan Africa.Measurements: Pooled odds ratio (OR) estimates were calculated using both the fixed inverse variance weighting method and the random effects method when evidence of heterogeneity was present.Findings: The pooled OR estimate for all studies was 1.61 (95% CI: 1.44–1.80).  The association between alcohol use and prevalence or incident HIV infection was particularly large among samples who reported problem drinking (OR = 2.17, 95% CI: 1.64–2.87) and drinking in sexual contexts (OR = 1.79, 95% CI: 1.55–2.06).  Some evidence of publication bias was present; however, the OR remained statistically significant in small and large studies and with population-based and high-risk samples.Conclusions: These results suggest that alcohol consumption, particularly at high levels and in sexual contexts, is associated with an increased risk of HIV infection.  An increased focus on methods that allow for more sensitive tests of the event-level association between alcohol consumption and risk of HIV infection may provide a better understanding of the causal mechanisms underlying this relationship.



2018 ◽  
Vol 29 (5) ◽  
pp. 465-472 ◽  
Author(s):  
Rachel Lang-Baldé ◽  
Roxanne Amerson

Introduction: Almost 830 women die daily in childbirth with 550 of those deaths occurring in sub-Saharan Africa. This region has the highest maternal mortality rates in the world with 546 deaths per 100,000 live births. Research must focus on understanding cultural beliefs and practices to improve maternal health outcomes. The purpose of this review is to provide evidence of relevant cultural beliefs and the impact on birth outcomes for women in sub-Saharan Africa. Method: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the literature focused on 25 articles that defined, directly or indirectly, associations of cultural values, beliefs, and lifeways to pregnancy and birth from the perspective of women of childbearing age. Results: Three relevant categories emerged from the literature: birth outcomes, maternal care-seeking, and maternal culture care. Discussion: Women’s voices and an understanding of cultural constructs of care are required to encourage the use of biomedical health system along with the use of indigenous practices.



F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 253
Author(s):  
Rashidah T. Uthman ◽  
Olalekan A. Uthman

Background: The most challenging issue physicians are facing is the appropriate timing of introducing antiretroviral therapy (ART) along with ongoing tuberculosis (TB) therapy in HIV and TB co-infected patients. This study examined the cost-effectiveness of early versus delayed ART initiation in TB patients, infected with HIV (co-infected patients) in a sub-Saharan Africa setting. Methods: A decision analytic model based on previously published and real-world evidence was applied to evaluate clinical and economic outcomes associated with early versus delayed ART in TB and HIV co-infection. Incremental cost-effectiveness ratio (ICER) was calculated with both costs and quality-adjusted life years (QALYs). Different assumptions of treatment benefits and costs were taken to address uncertainties and were tested with sensitivity analyses. Results: In base case analysis, the expected cost of giving early ART to TB patients infected with HIV was $1372, with a QALY gain of 0.68, while the cost of delayed ART was $955, with a QALY gain of 0.62. The ICER shows $6775 per QALYs, which suggests that it is not as cost-effective, since it is greater than 3 x GDP per capita ($5,086) for sub-Saharan Africa willingness to pay (WTP) threshold. At $10,000 WTP, the probability that early ART is cost effective compared to delayed ART is 0.9933. At cost-effectiveness threshold of $5086, the population expected value of perfect information becomes substantial (≈US$5 million), and is likely to exceed the cost of additional investigation. This suggests that further research will be potentially cost-effective. Conclusions: From the perspective of the health-care payer in sub-Saharan Africa, early initiation of ART in HIV and TB co-infection cannot be regarded as cost-effective based on current information. The analysis shows that further research will be worthwhile and potentially cost-effective in resolving uncertainty about whether or not to start ART early in HIV and TB co-infection.



2020 ◽  
Vol 2020 (10-3) ◽  
pp. 238-246
Author(s):  
Olga Dzhenchakova

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.



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