title: Comparison of self-reported alcohol use with the alcohol biomarker phosphatidylethanol among young people in northern Tanzania.
abstract: BACKGROUND
  The one-month Time Line Follow Back calendar (TLFB) and the Alcohol Use Disorders Identification Test (AUDIT) are used to collect self-reported alcohol intake data. We compared these instruments with the alcohol biomarker phosphatidylethanol (PEth) among young-people in northern Tanzania.
  
  
  METHODS
  AUDIT and TLFB were applied in a cross-sectional study of 202 young people (18-24 years), who reported using alcohol during the past year (103 male casual labourers; 99 college students). We assayed whole blood for PEth 16:0/18:1, using liquid chromatography-tandem mass spectrometry.
  
  
  RESULTS
  For both self-report methods, alcohol consumption was high, particularly among men (e.g. a median of 54 drinks per month in labourers), and about half of male students (48%) reported hazardous or harmful levels of drinking (AUDIT ≥8). Almost half (49%) of participants were PEth-positive (median concentration 0.03μmol/L). There were significant positive correlations between reported total alcohol intake and PEth concentration in males (Spearman's correlation rs=0.65 in college students and rs=0.57 in casual labourers; p<0.001). Self-reported use in the past month was a sensitive marker of having a positive PEth result (≥0.01μmol/L) with 89% of those with a PEth positive result reporting alcohol use, and this was similar in all groups. The proportion of those with AUDIT scores ≥8 and AUDIT-C scores ≥6 among those with a high cut-off positive PEth result (≥0.30μmol/L) ranged between 94 and 100%.
  
  
  CONCLUSIONS
  TLFB and AUDIT are sensitive measures to detect heavy alcohol use among young-people in northern Tanzania. They can be used to identify young people who may benefit from alcohol-focused interventions.
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Mwanza Centre, National Institute for Medical Research, Mwanza, Tanzania. Electronic address: joelmfrancis@gmail.com.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Francis
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.affiliation: Karolinska Institutet, Karolinska University Laboratory, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Helander
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Mwanza Centre, National Institute for Medical Research, Mwanza, Tanzania; Mwanza Intervention Trials Unit (MITU), Mwanza, Tanzania.
authors.forename: Saidi H
authors.initials: SH
authors.lastname: Kapiga
authors.affiliation: Mwanza Centre, National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Mwanza Centre, National Institute for Medical Research, Mwanza, Tanzania; Mwanza Intervention Trials Unit (MITU), Mwanza, Tanzania.
authors.forename: Heiner
authors.initials: H
authors.lastname: Grosskurth
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000097:blood* / Q000523:psychology; D000437:Alcoholism / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D020404:Glycerophospholipids / Q000097:blood*; D006306:Health Surveys; D006801:Humans; D008297:Male; D057566:Self Report; D013636:Tanzania; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020404:Glycerophospholipids; C051521:phosphatidylethanol
keywords: AUDIT; AUDIT-C; PEth; TLFB; Young people Tanzania