title: Hazardous alcohol use and associated factors in a rural Ethiopian district: a cross-sectional community survey.
abstract: BACKGROUND
  Alcohol related health and social problems are on the rise in sub-Saharan Africa. This survey reports the prevalence and associated factors for hazardous drinking in rural Sodo district, southern Ethiopia. The survey was part of a multi-center study, Programme for Improving Mental Health Care (PRIME), which is a consortium of research institutions and ministries of health of five low and middle income countries, namely Ethiopia, India, Nepal, South Africa and Uganda in partnership with UK institutions and World Health Organization (WHO).
  
  
  METHODS
  A cross-sectional community survey was conducted involving 1500 adults, age 18 and above, recruited using multi-stage random sampling. Data on alcohol use was collected using the Fast Alcohol Screening Test (FAST). Standardised instruments were used to measure potential associated factors, including a validated adaptation of the Kessler 10 (psychological distress), the List of Threatening Experiences (number of adverse life events). Exploratory multivariable logistic regression was conducted to examine factors associated with hazardous alcohol use.
  
  
  RESULTS
  The overall prevalence of hazardous alcohol use was found to be 21 %; 31 % in males and 10.4 % in females, P < 0.05. Factors independently associated with hazardous alcohol use were being male (adjusted OR = 4.0, 95 % CI = 2.44, 6.67), increasing age, having experienced one or more stressful life events (adjusted OR = 1.71, 95 % CI = 1.18, 2.48, and adjusted OR = 2.12, 95 % CI = 1.36, 3.32 for 1-2 and 3 or more adverse life events, respectively) and severe psychological distress (adjusted OR = 2.96, 95 % CI = 1.49, 5.89). High social support was found to be protective from hazardous alcohol use (adjusted OR = 0.41, 95 % CI = 0.23, 0.72).
  
  
  CONCLUSIONS
  High level of hazardous alcohol use was detected in this predominantly rural Ethiopian setting. The finding informed the need to integrate services for hazardous alcohol use such as brief intervention at different levels of primary care services in the district. Public health interventions to reduce hazardous alcohol use also need to be launched.
authors.affiliation: Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. soloteferra@yahoo.com.
authors.forename: Solomon
authors.initials: S
authors.lastname: Teferra
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Girmay
authors.initials: G
authors.lastname: Medhin
authors.affiliation: Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Medhin
authors.initials: M
authors.lastname: Selamu
authors.affiliation: Health Systems Research Unit, South African Medical Research Council, School of Applied Human Sciences, University of KwaZulu-Natal , Durban, South Africa.
authors.forename: Arvin
authors.initials: A
authors.lastname: Bhana
authors.affiliation: Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.|King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hanlon
authors.affiliation: Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.|King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK.
authors.forename: Abebaw
authors.initials: A
authors.lastname: Fekadu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult