title: Coverage of alcohol consumption by national surveys in South Africa.
abstract: Evidence suggests that adult per-capita alcohol consumption, as estimated from self-reports of nationally representative surveys, underestimates 'true' consumption, as measured as the sum of recorded and unrecorded consumption. The proportion of total adult alcohol per capita reported in representative surveys is usually labelled 'coverage'. The aim of the present paper was to estimate coverage for South Africa under different scenarios of alcohol use assessment and 'true' consumption.
  
  
  
  Five nationally representative surveys from South Africa were used to estimate the prevalence of drinking and the grams per day among current drinkers. All surveys used a complex multi-stage sampling frame that was accounted for by using survey weights. The total (recorded and unrecorded), the recorded and the adjusted total adult per-capita alcohol consumption in South Africa served as different estimates of the 'true' consumption.
  
  
  
  South Africa.
  
  
  
  Alcohol use information was assessed on a total of 8115, 16 398 and 13 181 adults (15 years or older) in surveys from the years 2003, 2005 and 2008, respectively. Two surveys in 2012 included 27 070 and 18 688 adults.
  
  
  
  Coverage of the alcohol use reported in the surveys was calculated, compared with the 'true' adult per-capita alcohol.
  
  
  
  The survey data covered between 11.8% [2005; 95% uncertainty interval (UI) = 9.3-16.2%)] and 19.4% (2003; 95% UI = 14.9-24.2%) of the total alcohol used per capita. The highest coverage of 27.9% (95% UI = 22.4-36.8%) was observed when looking only at recorded alcohol in 2003.
  
  
  
  Evidence from five nationally representative surveys assessing alcohol use suggests that less than 20% of the total adult per-capita alcohol consumption in South Africa is reported in surveys.
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.|Institute for Clinical Psychology and Psychotherapy, Dresden, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Probst
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Shuper
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.|Institute for Clinical Psychology and Psychotherapy, Dresden, Germany.|Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada.|Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D013019:South Africa; D055815:Young Adult
keywords: Adult per-capita alcohol consumption; South Africa; alcohol use; coverage; survey; under-reporting