title: Screening Caregivers of Children for Risky Drinking in KwaZulu-Natal, South Africa.
abstract: Background and Objectives Alcohol abuse, a significant health problem in South Africa, affects the ability of adults to care for children. Little is known regarding risky alcohol use among child caregivers there. A large population-based study examined the prevalence of, and factors associated with, risky drinking among caregivers of young children in KwaZulu-Natal, South Africa comparing the use of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT-C screens for hazardous or harmful drinking (referred to here as risky drinking). Methods 83 % of child caregivers from five tribal areas were interviewed using the 10-question AUDIT to screen for risky drinking. The AUDIT-C screen, a subset of AUDIT questions, targets alcohol consumption and binge drinking. Factors associated with risky drinking were investigated using logistic regression. Results 1434 caregivers participated, 98 % female. Sixteen percent reported ever drinking alcohol. Based on AUDIT criteria for risky drinking, 13 % of the sample scored as moderate drinkers, 2 % as hazardous users, and 1 % as harmful or dependent users (identifying 3 % as risky drinkers). Using AUDIT-C criteria to identify risky drinking significantly increased the proportion of caregivers identified as risky drinkers to 9 %. In multivariate analyses, factors associated with risky drinking were similar in both screens: partner violence, smoking, HIV-infection, caring for a child with disabilities. Conclusions for Practice Since the AUDIT-C identified risky alcohol use not otherwise detected with the full AUDIT, and since resources for screening in health care settings is limited, the AUDIT-C may be a more appropriate screen in populations where binge drinking is common.
authors.affiliation: University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Myra
authors.initials: M
authors.lastname: Taylor
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, 10032, NY, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Knox
authors.affiliation: University of KwaZulu-Natal, Durban, South Africa.|School of Public Health, Private Bag X17, Bellville, 7535, Republic of South Africa.
authors.forename: Meera K
authors.initials: MK
authors.lastname: Chhagan
authors.affiliation: University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Shuaib
authors.initials: S
authors.lastname: Kauchali
authors.affiliation: University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Jane
authors.initials: J
authors.lastname: Kvalsvig
authors.affiliation: HIV Center for Clinical and Behavioral Studies, 722 W 168 St, New York, 10032, NY, USA.
authors.forename: Claude Ann
authors.initials: CA
authors.lastname: Mellins
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, 10032, NY, USA.|Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 630 W 168 St, New York, 10032, NY, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Arpadi
authors.affiliation: University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Murray H
authors.initials: MH
authors.lastname: Craib
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, 10032, NY, USA. lld1@columbia.edu.|Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 630 W 168 St, New York, 10032, NY, USA. lld1@columbia.edu.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Davidson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D063425:Binge Drinking / Q000453:epidemiology*; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: AUDIT; AUDIT-C; Alcohol Use; Binge drinking; Child caregivers; Population-based; South Africa