Alcohol use and alcohol use disorders in Sub-Saharan Africa: A systematic review and meta-analysis

Background

Population-level alcohol use data is available from high-income countries, but only limited research has been conducted in Sub-Saharan Africa. This systematic review and meta-analysis aimed to summarize population-level alcohol use in Sub-Saharan Africa. 

Method

Databases searched included PubMed, EMBASE, PsycINFO, and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'Substance-Related Disorders' & 'Prevalence' & 'Sub-Saharan Africa'. We included general population studies on alcohol use (including any use, high-risk alcohol use, and alcohol use disorders) from 2018. Prevalence data for alcohol use among Sub-Saharan African adolescents (10–17) and adults (18+) were extracted. Analyses included lifetime, past 12-and 6-month alcohol use. No data were available for the past 12-month prevalence adolescent alcohol use in western, eastern, and central Sub-Saharan Africa. Past 12- and 6-month prevalence are reported.

Results 

We included 141 papers. Among adolescents, the lifetime prevalence of alcohol use was 23.3% (95% confidence interval [CI] 11.3-37.1%), 36.2% (CI 18.4-56.1%) in the past year, and 11.3% (CI 4.5-20.4%) in the past 6-month. Among adolescents, 12-month prevalence of alcohol use disorder, and alcohol dependence were 7.7% (CI 0.0-27.8%), and 4.1% (CI 1.4-7.9%), respectively. Among adults, lifetime prevalence of alcohol use was 34.9% (CI 17.7-54.1%), 27.1% (CI 5.0-56.4%) in the past year, and 32.2% (CI 19.8-46.0%) in the past 6-month. Among adults, the 12-month prevalence of alcohol use disorder, and alcohol dependence were 9.5% (CI 0.0-30.4%), and 4.3% (CI 0.8-9.8%), respectively. Country-level differences were observed. The highest weighted lifetime prevalence of alcohol use, 86.4% was reported in Tanzania among adults. The highest weighted past 6-month prevalence of alcohol use, 80.6% was found in Zambia among adolescents.

Conclusion 

Alcohol is commonly consumed among adolescent and adult populations in some Sub-Saharan Africa countries, which requires monitoring and prevention in this region. There is a huge amount of heterogeneity across countries.