Alcohol Use Among Adolescents in Eight Sub-Saharan African Countries: Evidence from The Global School-Based Student Health Survey (2012-2017).

Abstract

Introduction: Alcohol use is a major and a global public health issue due to associated negative physical, mental and social health outcomes among adolescents. Alcohol use is a major risk factor for adolescents’ increased morbidity and mortality. However, there is dearth of literature on the burden of alcohol use in adolescents in sub-Saharan Africa (SSA) to inform evidence-based cost-effective public health interventions targeted at identified vulnerability and resilience factors. Aims: This study examined the current alcohol use, drunkenness and alcohol problems among 16,331 adolescents from eight selected SSA countries. The study further assessed the vulnerability and resilience factors of alcohol use behaviours among the adolescents. Methods: A secondary analysis of the Global School-based student Health Survey (GSHS) datasets from 8 cross-sectional surveys was conducted. The Stata statistical software package (Version 17) was used for the data analysis. Descriptive statistics, Pearson’s Chi-square and multivariate logistic regression analyses were conducted with statistical significance set at pvalue <0.05. Results: Findings showed that overall prevalence of current alcohol use, drunkenness and alcohol problems were 12.56% (95%CI = 12.05%-13.08%), 8.32% (95%CI = 7.90% - 8.76%) and 4.74% (95%CI = 4.42% - 5.08%) respectively in the selected countries in SSA. For current alcohol use, adolescents in Seychelles reported the highest prevalence of 47.21% (95%CI = 44.86% - 49.61%) and adolescents in Tanzania reported the lowest prevalence of 2.89% (95%CI = 2.28% - 3.58%). For lifetime drunkenness, adolescents in Seychelles reported the highest prevalence of 42.17% (95%CI = 39.82% - 44.52%) and adolescents in Tanzania reported the lowest prevalence of 1.41% (95%CI = 1.00% - 1.92%). For lifetime alcohol problem, adolescents in Namibia reported the highest prevalence of 13.76% (95%CI = 12.56% - 15.05%) and adolescents in Tanzania reported the lowest prevalence of 1.89% (95%CI = x 1.41% - 2.47%). Being male, older age, truancy, bullying, fighting, having no close friends, smoking cigarette, smoking marijuana and anxiety are significant risk factors for current alcohol use among adolescents who are in school in SSA. Parental supervision and parental bonding are significant protective factors for current alcohol use among adolescents who are in school in SSA. For lifetime drunkenness, being male, older age, truancy, bullying, fighting, hunger, smoking cigarette, smoking marijuana, anxiety, loneliness, and suicidal plan are the significant risk factors whereas parental supervision and parental bonding are significant protective factors. For lifetime alcohol trouble, older age, truancy, bullying, fighting, physical attack, smoking cigarette, smoking marijuana, anxiety and suicidal attempt are significant risk factors. Conclusion: There is a relatively high alcohol use behaviours among adolescents who are in school in the eight selected countries SSA with country-level variations. Multilevel vulnerability and resilience factors consistent with the socio-ecological model were identified and should be incorporated in school-based public health interventions to reduce the risk and burden of alcohol use among adolescents in SSA.