Consumption of illegal home-made alcohol in Malawi: A neglected public health threat

Namondwe, Thokozani; Ching'anda, Connel; Gama, Aggrey Pemba; Matumba, Limbikani

doi:10.1016/j.alcohol.2018.08.003

Cited by 6 publications

(6 citation statements)

References 24 publications

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“… 23 Much stronger (20–50% ABV) home distillations are also consumed, called chang'aa in Kenya, 21 gongo in Tanzania, 22 and kachasu in Malawi. 24 Additionally, there are medium-strength (5–8% ABV) fermentations of locally sourced produce such as banana, palm, and coconut. 25 …”

Section: Introductionmentioning

confidence: 99%

Alcohol consumption and oesophageal squamous cell cancer risk in east Africa: findings from the large multicentre ESCCAPE case-control study in Kenya, Tanzania, and Malawi

Middleton

Mmbaga

Menya

et al. 2022

The Lancet Global Health

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Background The contribution of alcohol to the large burden of oesophageal squamous cell carcinoma (ESCC) in east Africa remains uncertain and difficult to assess owing to complex consumption patterns of traditional and commercial drinks. We aimed to assess whether alcohol drinking, overall and at specific intake levels, contributes to ESCC risk in east Africa. MethodsWe did a hospital-based case-control study in Kenya, Tanzania, and Malawi, which included comprehensive assessment of a variety of locally consumed alcohol that we used to classify drinkers as exclusively low alcohol-byvolume (ABV; <30% ABV) drinkers or drinkers of some high-ABV drinks, as well as the number of drinks consumed, average weekly ethanol intake, and the contribution of each drink type to overall ethanol consumption. Cases were patients aged 18 years and older with incident primary ESCC, confirmed histologically for the majority of cases, and a clinical diagnosis for the remainder. Controls were frequency-matched on age and sex in a 1:1 ratio with cases. The controls were recruited from the same hospitals as cases and included outpatients, inpatients, and hospital visitors who did not have cancer or any other digestive disease. Consenting participants took part in face-to-face interviews in which they were asked whether they had ever consumed alcohol (the primary exposure variable); those who had were asked follow-up questions about their consumption habits for different alcoholic drinks. Findings 1279 cases and 1346 controls were recruited between Aug 5, 2013, and May 24, 2020, including 430 cases and 440 controls from Kenya, 310 cases and 313 controls from Tanzania, and 539 cases and 593 controls from Malawi. 65 (4•8%) of 1344 cases were excluded. Consistent positive associations with ESCC risk were found for ever having consumed alcohol in Kenyan men and Tanzanian men, and for daily number of drinks and estimated ethanol intake in Kenya, Tanzania (both sexes) and Malawian women. Corresponding population-attributable fractions of ESCC for those reporting ever drinking alcohol (vs never drinking) were 65% (95% CI 52-78) in Kenyan men and 23% (<1-45) in Kenyan women, and 56% (95% CI 36-76) in Tanzanian men and 5% (0-42) in Tanzanian women. Increased risk and population-attributable fractions were almost entirely due to risks in high-ABV drinkers.Interpretation Alcohol appears to be a substantial contributor to ESCC risk in east Africa, particularly among men, and a large fraction of ESCC could be prevented by cessation or reduction of alcohol consumption. Future studies should consider independent ascertainment of alcohol intake to assess the potential of under-reporting in Malawi.

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Section: Introductionmentioning

confidence: 99%

Alcohol consumption and oesophageal squamous cell cancer risk in east Africa: findings from the large multicentre ESCCAPE case-control study in Kenya, Tanzania, and Malawi

Middleton

Mmbaga

Menya

et al. 2022

The Lancet Global Health

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“…In their research from 1992 to 2001 in Turkey, Yayci et al [ 33 ] note a gender influence with methanol poisoning, with men having the predominant fatalities (89.1%) compared to females (10.9%). In Africa, methanol poisoning from illicit alcohol production and sale is a particular health concern [ 23 , 38 , 39 , 40 ]. In 1963 in Spain, methanol was used to adulterate mixed alcohol liqueurs, and this incident led to 51 deaths [ 41 ].…”

Section: Illicit Alcohol Productionmentioning

confidence: 99%

Illicit Alcohol: Public Health Risk of Methanol Poisoning and Policy Mitigation Strategies

Manning

Kowalska

2021

Foods

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Illicit (unrecorded) alcohol is a critical global public health issue because it is produced without regulatory and market oversight with increased risk of safety, quality and adulteration issues. Undertaking iterative research to draw together academic, contemporary and historic evidence, this paper reviews one specific toxicological issue, methanol, in order to identify the policy mitigation strategies of interest. A typology of illicit alcohol products, including legal products, illegal products and surrogate products, is created. A policy landscape matrix is produced that synthesizes the drivers of illicit alcohol production, distribution, sale and consumption, policy measures and activity related signals in order to inform policy development. The matrix illustrates the interaction between capabilities, motivations and opportunities and factors such as access, culture, community norms and behavior, economic drivers and knowledge and information and gives insight into mitigation strategies against illicit alcohol sale and consumption, which may prove of value for policymakers in various parts of the world.

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“…Previous scholarly endeavors investigating drug abuse in Malawi have predominantly centered on specific cohorts, notably adolescents [ 1 , 2 ] and vulnerable adult populations [ 3 – 5 ] like commercial sex workers, farmers [ 6 , 7 ], HIV/AIDS patients [ 8 ] and casual laborers [ 4 ]. However, the current study represents a notable departure from this established trend, meticulously focusing on an often marginalized and underrepresented segment within the societal framework.…”

Section: Introductionmentioning

confidence: 99%

Unraveling substance abuse among Malawian street children: A qualitative exploration

Banda,

Banda

et al. 2024

PLoS ONE

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This qualitative study adopts a phenomenological and symbolic interactionist approach to comprehensively explore substance abuse among street children in Lilongwe, Malawi. The research aims to uncover the complex sociocultural, economic, and environmental determinants influencing substance abuse within this marginalized cohort. Through in-depth semi-structured interviews, the study engages with street children to understand their subjective experiences, perceptions, and interpretations of substance abuse within their community context. Employing convenience, purposive, and snowball sampling strategies, the research collected data from street children, acknowledging their transient nature and societal challenges. Thematic analysis was conducted on interview transcripts to derive comprehensive insights. Results revealed five key thematic areas: familial absence and emotional void, societal normalization and peer pressure, economic hardships, coping mechanisms, environmental accessibility, and peer influence and belongingness. These themes highlighted the intricate interplay between personal experiences, socio-environmental factors, and peer dynamics, shaping the prevalence and persistence of substance abuse among street children. This study’s implications for practice underscore the need for tailored interventions and support mechanisms addressing substance abuse within this demographic. It emphasizes the urgency for context-specific strategies and policy formulations aimed at ameliorating the challenges faced by street children dealing with substance abuse in Malawi. Ultimately, this research contributes to a deeper understanding of substance abuse among marginalized street children, advocating for compassionate and contextually sensitive interventions within this overlooked drug abusers’ population subset.

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Consumption of illegal home-made alcohol in Malawi: A neglected public health threat

Cited by 6 publications

References 24 publications

Alcohol consumption and oesophageal squamous cell cancer risk in east Africa: findings from the large multicentre ESCCAPE case-control study in Kenya, Tanzania, and Malawi

Alcohol consumption and oesophageal squamous cell cancer risk in east Africa: findings from the large multicentre ESCCAPE case-control study in Kenya, Tanzania, and Malawi

Illicit Alcohol: Public Health Risk of Methanol Poisoning and Policy Mitigation Strategies

Unraveling substance abuse among Malawian street children: A qualitative exploration

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