The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study

Abstract Background Globally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death and disability. This project aimed t...

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Main Authors: Catherine A. Staton, Joao Ricardo Nickenig Vissoci, Nicole Toomey, Jihad Abdelgadir, Patricia Chou, Michael Haglund, Blandina T. Mmbaga, Mark Mvungi, Monica Swahn
Format: Article
Language:English
Published: BMC 2018-02-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-018-5144-z
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author Catherine A. Staton
Joao Ricardo Nickenig Vissoci
Nicole Toomey
Jihad Abdelgadir
Patricia Chou
Michael Haglund
Blandina T. Mmbaga
Mark Mvungi
Monica Swahn
author_facet Catherine A. Staton
Joao Ricardo Nickenig Vissoci
Nicole Toomey
Jihad Abdelgadir
Patricia Chou
Michael Haglund
Blandina T. Mmbaga
Mark Mvungi
Monica Swahn
author_sort Catherine A. Staton
collection DOAJ
description Abstract Background Globally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death and disability. This project aimed to determine the proportion of injuries related to alcohol and the increased risk of injury due to alcohol among injury patients seeking care at the emergency department (ED) of Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Methods A representative cross-sectional sample of adult patients presenting to the KCMC ED with acute injury were enrolled in this study with a nested case-crossover design. Patient demographics, injury characteristics, and severity as well as alcohol use behaviors were collected. Alcohol breathalyzers were administered to the enrolled patients. Data on activities and alcohol use were collected for the time period 6 h prior to injury and two control periods: 24–30 h prior to injury and 1 week prior to injury. Results During 47 weeks of data collection, 24,070 patients were screened, of which 2164 suffered injuries, and 516 met the inclusion and exclusion criteria, consented to participate, and had complete data. Of the study participants, 76% were male, and 30% tested positive for alcohol on arrival to the ED. Alcohol use was associated with being male and being employed. Alcohol use was associated with an increased risk of injury (OR 5.71; 95% CI 3.84–8.50), and specifically road traffic injuries were associated with the highest odds of injury with alcohol use (OR 6.53, 95% CI 3.98–10.71). For all injuries and road traffic injuries specifically, we found an increase in the odds of injury with an incremental increase in the dose of alcohol. Conclusions At KCMC in Moshi, Tanzania, 3 of 10 injury patients tested positive for alcohol on presentation for care. Similarly, alcohol use conveys an increased risk for injury in this setting. Evidence-based prevention strategies for alcohol-related injuries need to be implemented to reduce alcohol misuse and alcohol-related injuries.
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spelling doaj.art-10b49100585447f68d9451333bb870082022-12-21T19:09:03ZengBMCBMC Public Health1471-24582018-02-011811910.1186/s12889-018-5144-zThe impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover studyCatherine A. Staton0Joao Ricardo Nickenig Vissoci1Nicole Toomey2Jihad Abdelgadir3Patricia Chou4Michael Haglund5Blandina T. Mmbaga6Mark Mvungi7Monica Swahn8Division of Emergency Medicine, Duke University Medical CenterDivision of Emergency Medicine, Duke University Medical CenterDuke Global Health Institute, Duke UniversityDuke Global Health Institute, Duke UniversityNational Institute of Alcohol Abuse and AlcoholismDuke Global Health Institute, Duke UniversityKilimanjaro Christian Medical CenterKilimanjaro Christian Medical CenterDivision of Epidemiology and Biostatistics, School of Public Health, Georgia State UniversityAbstract Background Globally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death and disability. This project aimed to determine the proportion of injuries related to alcohol and the increased risk of injury due to alcohol among injury patients seeking care at the emergency department (ED) of Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Methods A representative cross-sectional sample of adult patients presenting to the KCMC ED with acute injury were enrolled in this study with a nested case-crossover design. Patient demographics, injury characteristics, and severity as well as alcohol use behaviors were collected. Alcohol breathalyzers were administered to the enrolled patients. Data on activities and alcohol use were collected for the time period 6 h prior to injury and two control periods: 24–30 h prior to injury and 1 week prior to injury. Results During 47 weeks of data collection, 24,070 patients were screened, of which 2164 suffered injuries, and 516 met the inclusion and exclusion criteria, consented to participate, and had complete data. Of the study participants, 76% were male, and 30% tested positive for alcohol on arrival to the ED. Alcohol use was associated with being male and being employed. Alcohol use was associated with an increased risk of injury (OR 5.71; 95% CI 3.84–8.50), and specifically road traffic injuries were associated with the highest odds of injury with alcohol use (OR 6.53, 95% CI 3.98–10.71). For all injuries and road traffic injuries specifically, we found an increase in the odds of injury with an incremental increase in the dose of alcohol. Conclusions At KCMC in Moshi, Tanzania, 3 of 10 injury patients tested positive for alcohol on presentation for care. Similarly, alcohol use conveys an increased risk for injury in this setting. Evidence-based prevention strategies for alcohol-related injuries need to be implemented to reduce alcohol misuse and alcohol-related injuries.http://link.springer.com/article/10.1186/s12889-018-5144-zAlcohol useInjuryTanzania
spellingShingle Catherine A. Staton
Joao Ricardo Nickenig Vissoci
Nicole Toomey
Jihad Abdelgadir
Patricia Chou
Michael Haglund
Blandina T. Mmbaga
Mark Mvungi
Monica Swahn
The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
BMC Public Health
Alcohol use
Injury
Tanzania
title The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
title_full The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
title_fullStr The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
title_full_unstemmed The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
title_short The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
title_sort impact of alcohol among injury patients in moshi tanzania a nested case crossover study
topic Alcohol use
Injury
Tanzania
url http://link.springer.com/article/10.1186/s12889-018-5144-z
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