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Prevalence and correlates of alcohol use in a central Nepal district: secondary analysis of a population-based cross-sectional study.

ABSTRACT: Background:As reported from studies conducted in Nepal, between 15% and 57% of adults had ever consumed alcohol and between 1.5% and 25% of adults have alcohol use disorders (AUD). Few studies in Nepal have identified the correlates of consumption or described the help-seeking patterns and stigma among those affected with AUD. Methods:Interviewers administered the Alcohol Use Disorders Identification Test (AUDIT) as part of population-based surveys of adults in Chitwan District between 2013 and 2017. We conducted a secondary analysis to identify sociodemographic and health-related correlates of recent alcohol consumption using the ?2 test, to identify correlates of total AUDIT scores among men who drink using negative binomial regression, and to describe the treatment-seeking and stigma beliefs of men with AUD. Results:Over half (53.7%, 95% CI 50.4-57.0) of men (n = 1130) recently consumed alcohol, and there were associations between being a drinker with age, religion, caste, education, occupation and tobacco use. Nearly one in four (23.8%, 95% CI 20.2-27.8%) male drinkers screened positive for AUD, and AUDIT scores were associated with age, caste, marital status, occupation, tobacco use, depression, functional status and suicidal ideation. Few (13.3%, 95% CI 11.7-15.0) women (n = 2352) recently consumed alcohol, and 5.3% (95% CI 3.0-9.1) of female drinkers screened positive for AUD. Among AUDIT-positive men, 38% spoke to another person about their problems and 80% had internalized stigma. Conclusions:This study revealed that nearly one in four men who drink likely have AUD. Higher AUDIT scores were associated with depression, suicidality, dysfunctionality and internalized stigma.

SUBMITTER: Rathod SD

PROVIDER: S-EPMC6315279 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Prevalence and correlates of alcohol use in a central Nepal district: secondary analysis of a population-based cross-sectional study.

Rathod S D SD Luitel N P NP Jordans M J D MJD

Global mental health (Cambridge, England) 20181113

<h4>Background</h4>As reported from studies conducted in Nepal, between 15% and 57% of adults had ever consumed alcohol and between 1.5% and 25% of adults have alcohol use disorders (AUD). Few studies in Nepal have identified the correlates of consumption or described the help-seeking patterns and stigma among those affected with AUD.<h4>Methods</h4>Interviewers administered the Alcohol Use Disorders Identification Test (AUDIT) as part of population-based surveys of adults in Chitwan District be ...[more]

PMID: 30637110

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Project description:BACKGROUND:Alcohol and illicit drug use has been recognized as a growing problem among adolescents in Botswana. Little is known about factors affecting alcohol and drug use among Botswana's secondary school students. To aid the design and implementation of effective public health interventions, we sought to determine the prevalence of alcohol and drug use in secondary school students in urban and peri-urban areas of Botswana, and to evaluate risk and protective factors for substance use. METHODS:We performed a 72-item cross-sectional survey of students in 17 public secondary schools in Gaborone, Lobatse, Molepolole and Mochudi, Botswana. The World Health Organization's (WHO) Alcohol Use Disorder Identification Test (AUDIT) was used to define hazardous drinking behavior. Using Jessor's Problem Behavior Theory (PBT) as our conceptual framework, we culturally-adapted items from previously validated tools to measure risk and protective factors for alcohol and drug use. Between-group differences of risk and protective factors were compared using univariate binomial and multinomial-ordinal logit analysis. Relative risks of alcohol and drug use by demographic, high risks and low protections were calculated. Multivariate ordinal-multinomial cumulative logit analysis, multivariate nominal-multinomial logit analysis, and binominal logit analysis were used to build models illustrating the relationship between risk and protective factors and student alcohol and illicit drug use. Clustered data was adjusted for in all analyses using Generalized Estimating Equations (GEE) methods. RESULTS:Of the 1936 students surveyed, 816 (42.1%) reported alcohol use, and 434 (22.4%) met criteria for hazardous alcohol use. Illicit drug use was reported by 324 students (16.7%), with motokwane (marijuana) being the most commonly used drug. Risk factors more strongly associated with alcohol and drug use were reported alcohol availability, individual and social vulnerability factors, and poor peer modeling. Individual and social controls protections appear to mitigate risk of student alcohol and drug use. CONCLUSIONS:Alcohol and illicit drug use is prevalent among secondary school students in Botswana. Our data suggest that interventions that reduce the availability of alcohol and drugs and that build greater support networks for adolescents may be most helpful in decreasing alcohol and drug use among secondary school students in Botswana.

Project description:OBJECTIVES:To explore the prevalence, perpetrator characteristics and the correlates of child abuse in Kathmandu, Nepal. METHODS:For this cross-sectional study, we translated the internationally validated questionnaire developed by the International Society for Prevention of Child Abuse and Neglect, Child Abuse Screening Tool-Child Home into Nepali. We added questions on descriptive information about students and their family to the questionnaire. We recruited students from 20 schools selected randomly-2 from each of the 10 electoral constituencies of Kathmandu district. In each school, we administered the questionnaires to the students in a classroom selected randomly. To assess the correlates, we ran multilevel multivariable logistic regression models, stratified by schools. RESULTS:Among the 962 students, 88.88% had experience of at least one form of abuse throughout their lifetime. Psychological abuse was the most prevalent form of abuse (previous year: 75.19%; lifetime: 76.15%) followed by physical abuse, exposure to violence, neglect and sexual abuse. Adults were the most common perpetrators of child abuse (37.55%). The correlates identified in this study mostly aligned with the global literature on correlates of abuse. Female students were more likely to report neglect (previous year: adjusted OR (AOR) 1.50, 95%?CI 1.10 to 2.04; lifetime: AOR 1.49, 95%?CI 1.10 to 2.02), but no gender difference was observed with other forms of abuse. Students living with a single parent had a greater likelihood of exposure to violence (previous year: AOR 2.55, 95%?CI 1.31 to 4.94; lifetime: AOR 2.77, 95%?CI 1.39 to 5.53), neglect (previous year: AOR 2.01, 95%?CI 1.10 to 3.69; lifetime: AOR 2.08, 95%?CI 1.14 to 3.81) and sexual abuse (previous year: AOR 3.03, 95%?CI 1.45 to 6.37; lifetime: AOR 2.49, 95%?CI 1.21 to 5.14). CONCLUSIONS:Over 88% of students reported experiencing child abuse in the home in one or more forms throughout their lifetime. Delineating the reasons for the high burden and its implications are important topics for future research.

Project description:BackgroundAlcohol use and risky drinking are significant public health problem globally. Young people, including university students, are among the most affected populations. We conducted the study to determine the prevalence and correlates of alcohol use and risky drinking among undergraduate students in the Faculty of Health Sciences at the University of the Witwatersrand, South Africa.MethodsWe conducted a cross-sectional study using an anonymous, self-administered online survey in REDCap. The survey questionnaire consisted of socio demographic, and alcohol use questions using the risky drinking identification screening tool (AUDIT-C). We performed descriptive statistics, bivariate and multivariable logistic regression to determine factors associated with alcohol use and risky drinking. The p-value of < 0.05 was considered statistically significant.ResultsThe response rate was 15.7%. Most participants were female (69.6%) and majority of the participants were White (38.1%). The prevalence of lifetime use of alcohol was 79.1%, and among the lifetime users; 70.2% reported alcohol use in the last 12-months, 37.1% reported alcohol use in the last 30 days. The prevalence of risky drinking was 54.8% among lifetime drinkers. Factors significantly associated with current alcohol use were siblings alcohol use (aOR = 1.79, 95% CI: 1.02-3.15) and parents alcohol use (aOR = 2.58, 95% CI: 1.39-4.80), white race (aOR = 5.70, 95% CI: 3.12-10.41), and always or daily exposure to alcohol marketing in the media (aOR = 3.31, 95% CI: 1.07-10.24). Factors associated with risky drinking were: Indian/Asian race (aOR = 2.82, 95% CI: 1.09-7.31), White race (aOR = 2.15, 95% CI: 1.14-4.04), and exposure to alcohol marketing in the media as follows, most of the time (aOR = 3.42, 95% CI: 1.29-9.04) and Always/daily exposure (aOR = 3.31, 95% CI: 1.07-10.24).ConclusionThe reported alcohol use and risky drinking were common amongst undergraduate students at Wits university. There is an urgent need to design, pilot and adapt targeted interventions for this population group.

Project description:ObjectiveTo examine the prevalence, correlates and sociodemographic inequalities of undiagnosed hypertension in Nepal.DesignThis study used cross-sectional 2016 Nepal Demographic and Health Survey (NDHS) data. Undiagnosed patients with hypertension were defined as an NDHS respondent who was diagnosed as hypertensive (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) during the survey, but never took any prescribed anti-hypertensive medicine to lower/control blood pressure and was never identified as having hypertension by a health professional prior the survey. Multiple binary logistic regression analysis was performed, and Concentration Index was measured.SettingNepal.ParticipantsAdult patients with hypertension.ResultsAmong 3334 patients with hypertension, 50.4% remained undiagnosed during the survey in Nepal. Adjusted model reveals that patients who were male, belonged to households other than the highest wealth quintile, and lived in province 4 and province 5 were at higher risk of remaining undiagnosed for hypertension. Patients who were ≥65 years of age and were overweight/obese were at lower risk of remaining undiagnosed for hypertension. The poor-rich gap was 24.6 percentage points (Q1=64.1% vs Q5=39.6%) and poor:rich ratio was 1.6 (Q1/Q5=1.6) in the prevalence of undiagnosed hypertension. Undiagnosed hypertension was disproportionately higher among lower socioeconomic status groups (Concentration Index, C=-0.18). Inequalities in the prevalence of undiagnosed hypertension further varied across other geographic locations, including place of residence, ecological zones and administrative provinces.ConclusionsUndiagnosed hypertension was highly prevalent in Nepal and there were substantial inequalities by sociodemographics and subnational levels. Increasing awareness, strengthening routine screening to diagnose hypertension at primary health service facilities and enactment of social health insurance policy may help Nepal to prevent and control this burden.

Project description:BackgroundThe WHO seeks to control trachoma as a public health problem in endemic areas. Achham District in western Nepal was found to have TF (trachoma follicular) above 20% in a 2006 government survey, triggering 3 annual mass drug administrations finishing in 2010. Here we assess the level of control that has been achieved using surveillance for clinical disease, ocular chlamydia trachomatis infection, and serology for antibodies against chlamydia trachomatis protein antigens.MethodsWe conducted a cross-sectional survey of children aged 1-9 years in communities in Achham District in early 2014 including clinical examination validated with photographs, conjunctival samples for Chlamydia trachomatis (Amplicor PCR), and serological testing for antibodies against chlamydia trachomatis protein antigens pgp3 and CT694 using the Luminex platform.FindingsIn 24 randomly selected communities, the prevalence of trachoma (TF and/or TI) in 1-9 year olds was 3/1124 (0.3%, 95% CI 0.1 to 0.8%), and the prevalence of ocular chlamydia trachomatis infection was 0/1124 (0%, 95% CI 0 to 0.3%). In 18 communities selected because they had the highest prevalence of trachoma in a previous survey, the prevalence of TF and/or TI was 7/716 (1.0%, 95% CI 0.4 to 2.0%) and the prevalence of ocular chlamydia trachomatis infection was 0/716 (0%, 95% CI 0 to 0.5%). In 3 communities selected for serological testing, the prevalence of trachoma was 0/68 (0%, 95% CI 0 to 5.3%), the prevalence of ocular chlamydia trachomatis infection was 0/68 (0%, 95% CI 0 to 0.5%), the prevalence of antibodies against chlamydia trachomatis protein antigen pgp3 was 1/68 (1.5%, 95% CI 0.04% to 7.9%), and the prevalence of antibodies against chlamydia trachomatis protein antigen CT694 was 0/68 (0%, 95% CI 0 to 5.3%).Conclusion/significanceThis previously highly endemic district in Nepal has little evidence of recent clinical disease, chlamydia trachomatis infection, or serological evidence of trachoma, suggesting that epidemiological control has been achieved.

Project description:BackgroundBy revealing historical and present plant use, ethnobotany contributes to drug discovery and socioeconomic development. Nepal is a natural storehouse of medicinal plants. Although several ethnobotanical studies were conducted in the country, many areas remain unexplored. Furthermore, few studies have compared indigenous plant use with reported phytochemical and pharmacological properties.MethodsEthnopharmacological data was collected in the Rasuwa district of Central Nepal by conducting interviews and focus group discussions with local people. The informant consensus factor (FIC) was calculated in order to estimate use variability of medicinal plants. Bio-efficacy was assessed by comparing indigenous plant use with phytochemical and pharmacological properties determined from a review of the available literature. Criteria were used to identify high priority medicinal plant species.ResultsA total of 60 medicinal formulations from 56 plant species were documented. Medicinal plants were used to treat various diseases and disorders, with the highest number of species being used for gastro-intestinal problems, followed by fever and headache. Herbs were the primary source of medicinal plants (57% of the species), followed by trees (23%). The average FIC value for all ailment categories was 0.82, indicating a high level of informant agreement compared to similar studies conducted elsewhere. High FIC values were obtained for ophthalmological problems, tooth ache, kidney problems, and menstrual disorders, indicating that the species traditionally used to treat these ailments are worth searching for bioactive compounds: Astilbe rivularis, Berberis asiatica, Hippophae salicifolia, Juniperus recurva, and Swertia multicaulis. A 90% correspondence was found between local plant use and reported plant chemical composition and pharmacological properties for the 30 species for which information was available. Sixteen medicinal plants were ranked as priority species, 13 of which having also been prioritized in a country-wide governmental classification.ConclusionsThe Tamang people possess rich ethnopharmacological knowledge. This study allowed to identify many high value and high priority medicinal plant species, indicating high potential for economic development through sustainable collection and trade.

Dataset Information

Prevalence and correlates of alcohol use in a central Nepal district: secondary analysis of a population-based cross-sectional study.

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Prevalence and correlates of alcohol use in a central Nepal district: secondary analysis of a population-based cross-sectional study.

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