Prevalence of alcohol use among road traffic crash victims presenting to a Malawian Central Hospital: A cross-sectional study

Abstract

Background: Alcohol consumption is a well-known risk factor for sustaining road traffic injuries worldwide. Malawi is a low-income country with a large and increasing burden of road traffic injuries. It has generally been viewed as a country with relatively little alcohol consumption. This study investigates the role of alcohol in road traffic injuries in and around the capital Lilongwe. Methods: All patients presenting to the emergency department of Kamuzu Central Hospital after being injured in road traffic crashes were asked to participate in the study. Alcohol testing was done with a breathalyzer or a saliva test. Participants were asked about alcohol use before the injury as well as hazardous drinking using the AUDIT-C questionnaire. Results: Of 1347 patients age 18 years or older who were asked to participate, 1259 gave informed consent, and data on alcohol use (alcohol test results and/or self-reported intake) were available for 1251 participants. Of those, 251 (20.1%) tested positive for alcohol, whereas 221 (17.7%) reported alcohol use before the crash; in total 311 (24.9%, 95% CI 22.5-27.3) either tested positive, reported use, or both. Females had a low prevalence of alcohol use (2.5%), while 30.6% of males had consumed alcohol before the injuries. Pedestrians had the highest prevalence at 41.8% (95% CI 35.5-48.4), while car drivers had 23.8% (95% CI 18.2-30.5). Among male pedestrians, 49.5% had used alcohol before the injury. Alcohol-associated injuries had a peak in the evening and at night, especially in the weekends. Of the patients, 63.1% reported that they had not consumed alcohol during the last year, while 21.4% had an AUDIT-C score suggesting hazardous drinking, and 66.2% of those had used alcohol before the injury. Conclusions: A large percentage of road traffic injured patients had been drinking alcohol before their injury, especially male pedestrians. A large proportion of the patients were abstaining from alcohol, but those not abstaining had a high prevalence both of alcohol use when injured and hazardous drinking identified by AUDIT-C. This has important implications for prevention.

Estimating the health burden of road traffic injuries in Malawi using an individual based model

“…The several age-related parameters were also calibrated to the GBD estimated age distribution of those with RTIs. Another risk factor for RTIs is alcohol consumption, for example, roughly 25% of the road tra c injury patients treated at Kamuzu Central Hospital either tested positive for alcohol or reported using alcohol before their injuries (Sundet et al 2020). We used the relative risk of alcohol consumption in a Tanzanian study to parameterise 'rr_injrti_excessalcohol' (Staton et al 2018).…”

“…shows the model's resulting percentage of RTIs that involve alcohol consumption compared to output from Kamuzu Central Hospital(Sundet et al 2020), Figure2eshows the calibration of the overall incidence of on-scene mortality RTIs in the population to the estimate from Malawi police data(Schlottmann et al 2017), Figure2fshows the calibration number of injuries of those in the health system, to an estimate from Kamuzu Central Hospital(Sundet et al 2018), Figure2gshows the calibration of the overall percentage of HSB, compared to the bounds reported in other SSA countries(Zafar et al 2018), and Figure2hshows the calibration percentage of overall in-hospital mortality to the Tanzanian national average in-hospital mortality for RTIs(Sawe et al 2021). Based on the range of parameters which produced HSB that t within the ranges reported by Zafar et al (2018) (Figure2g), we recalibrated several model parameters to produce the above calibration targets for each value of rt_emergency_care_ISS_score_cut_off to ensure full calibration in each model run (TableA 4).…”

Prevalence and correlates of depression and substance use disorders in emergency department populations: A cross-sectional study at East Africa's largest public hospital

“…Mental disorders are associated with increase in mortality and poorer health outcomes, especially in LMICs [8] . High rate of unhealthy substance use, particularly alcohol use, has been well documented among adults presenting with injuries in African countries like Ghana [ 9 , 10 ], Malawi [11] and Mozambique [12] and South Africa [13] . The interface between mental illness, substance use disorders and other NCDs, is well-established in studies from High-Income Country settings [14] , [15] , [16] .…”

Substâncias psicoativas no sangue: métodos de análises toxicológicas e prevalência do uso em pacientes com lesões traumáticas

“…Em outros países, o consumo de álcool por pedestres lesionados foi ainda maior do que o encontrado no presente estudo 150,174 . Por outro lado, o consumo de drogas ilícitas, principalmente cocaína foi mais prevalente neste estudo.…”

“…Na Tailândia, motociclistas corresponderam à grande maioria (89%) dos acidentados atendidos em um departamento de emergência173 . Em Malawi, na África, 12% dos pacientes admitidos em um hospital eram motociclistas, sendo que 24% destes estavam sob efeito de álcool174 .A alta proporção de motociclistas lesionados reflete uma crescente tendência no Brasil e na cidade de São Paulo. Nos últimos dois anos o número de motociclistas fatalmente lesionados tem crescido constantemente na capital paulista, sendo que em 2018, foram elevados ao grupo com maior mortalidade no trânsito, ultrapassando os pedestres175 .…”