Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.
OBJECTIVE
Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies.


METHODS
Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird).


RESULTS
We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%).


CONCLUSIONS
Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population.
London School of Hygiene and Tropical Medicine, London, UK; National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania.
Joel M
JM
Francis
Heiner
H
Grosskurth
John
J
Changalucha
Saidi H
SH
Kapiga
Helen A
HA
Weiss
D000293:Adolescent; D000351:Africa, Eastern / Q000453:epidemiology; D000428:Alcohol Drinking / Q000453:epidemiology*; D016206:Databases, Bibliographic; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D060386:Sex Workers / Q000706:statistics & numerical data; D013334:Students / Q000706:statistics & numerical data; D055815:Young Adult
AUDIT; CAGE; alcohol use; eastern Africa; meta-analysis; problem drinking; screening questionnaires; systematic review; young people