title: Validation of the MINI (DSM IV) Tool for the Assessment of Alcohol Dependence among Young People in Northern Tanzania Using the Alcohol Biomarker Phosphatidylethanol (PEth).
abstract: The alcohol dependence section of the Mini International Neuropsychiatric Interview questionnaire (MINI) has not been evaluated in young Africans. We applied the MINI in a cross-sectional study of 202 alcohol users from northern-Tanzania, aged 18-24 years (103 male casual workers and 99 students), and validated it against phophatidylethanol (PEth) at a cut-off suggesting heavy chronic alcohol use (≥0.30 µmol/L). Blood was assayed for PEth (16:0/18:1-subform) by liquid chromatography-tandem mass spectrometry. The MINI dependence criteria (≥3 positive responses) were met by 39% participants although their PEth levels were low. Contrary, many young people with high PEth levels were not classified as dependent. The sensitivity of the MINI ranged from 0% to 69% (female students and male workers, respectively) and specificity from 52% to 85% (workers and female students, respectively). The highest AUROC (0.68) occurred with a cut-off of ≥4 positive responses. A modified MINI with three affirmative responses to five questions increased specificity to 92%-97%; however, sensitivity remained low. The performance of the MINI in detecting dependence among young people from northern-Tanzania is unsatisfactory. Specificity was improved using a modified version but sensitivity remained low. An accurate tool for the diagnosis of alcohol dependence is needed for epidemiological and clinical purposes.
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. joelmfrancis@gmail.com.|National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania. joelmfrancis@gmail.com.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Francis
authors.affiliation: Department of Laboratory Medicine, Karolinska Institutet, Stockholm SE-141 86, Sweden. anders.helander@ki.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Helander
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Saidi.Kapiga@lshtm.ac.uk.|National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania. Saidi.Kapiga@lshtm.ac.uk.|Mwanza Intervention Trials Unit (MITU), Mwanza, Tanzania. Saidi.Kapiga@lshtm.ac.uk.
authors.forename: Saidi H
authors.initials: SH
authors.lastname: Kapiga
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Helen.Weiss@lshtm.ac.uk.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Heiner.Grosskurth@lshtm.ac.uk.|National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania. Heiner.Grosskurth@lshtm.ac.uk.|Mwanza Intervention Trials Unit (MITU), Mwanza, Tanzania. Heiner.Grosskurth@lshtm.ac.uk.
authors.forename: Heiner
authors.initials: H
authors.lastname: Grosskurth
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000097:blood*; D000437:Alcoholism / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D020404:Glycerophospholipids / Q000097:blood*; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D013636:Tanzania; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020404:Glycerophospholipids; C051521:phosphatidylethanol
keywords: AUDIT; DSM IV; MINI; PEth; Tanzania; alcohol dependence; young people