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.