Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences.
Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences.
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DOI：
10.1186/1753-2000-4-17
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发表时间：
2010-06-22
影响因子：
5.6
通讯作者：
Ezeh AC
中科院分区：
文献类型：
--
作者：
Kabiru CW;Beguy D;Crichton J;Ezeh AC
饮酒与急性和慢性不良健康后果有关。很少有研究探讨撒哈拉以南非洲青少年饮酒的决定因素，尤其是研究不良童年经历对饮酒的影响。这篇论文采用了来自布基纳法索、加纳、马拉维和乌干达的9819名12-19岁青少年的具有全国代表性的数据。Logistic回归模型被用来确定自我报告的过去一年醉酒的相关因素。接触四种不利的童年经历构成了主要的独立变量：生活在食物不安全的家庭中，与酗酒者生活在一起，遭受过身体虐待，以及被强迫发生性行为。我们对年龄、宗教信仰、当前受教育程度、户主性别、居住安排、居住地、婚姻状况和调查国家进行了控制。所有分析都是分别针对男性和女性进行的。在双变量水平上，所有自变量(男性中被强迫的性别除外)都与结果变量相关。总体而言，9%的青少年报告称，他们在调查前12个月内喝过酒。总体而言，童年经历过不良事件的受访者更有可能报告自己喝醉了。在多变量分析中，只有两个童年时期的不良事件被认为是男性在过去一年中自我报告的醉酒的重要预测因素：在10岁之前与一个酗酒问题的人生活在一起，以及在10岁之前受到身体虐待。对于女性来说，暴露在家庭酗酒、身体虐待和被强迫的性行为中，增加了在过去12个月报告醉酒的可能性。不良事件和报告的醉酒之间的联系在女性中更为明显。对于男性和女性来说，经历的不良事件数量和报告醉酒的比例之间存在分级关系。我们发现，在撒哈拉以南的四个非洲国家，儿童时期不良事件的经历与青少年醉酒之间存在关联。童年不良经历对青年发展和行为的复杂影响，可能对旨在减少青年酒精依赖的干预措施的有效性有重要影响。
Consumption of alcohol is associated with acute and chronic adverse health outcomes. There is a paucity of studies that explore the determinants of alcohol use among adolescents in sub-Saharan Africa and, in particular, that examine the effects of adverse childhood experiences on alcohol use. The paper draws on nationally-representative data from 9,819 adolescents aged 12-19 years from Burkina Faso, Ghana, Malawi, and Uganda. Logistic regression models were employed to identify correlates of self-reported past-year drunkenness. Exposure to four adverse childhood experiences comprised the primary independent variables: living in a food-insecure household, living with a problem drinker, having been physically abused, and having been coerced into having sex. We controlled for age, religiosity, current schooling status, the household head's sex, living arrangements, place of residence, marital status, and country of survey. All analyses were conducted separately for males and females. At the bivariate level, all independent variables (except for coerced sex among males) were associated with the outcome variable. Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. In general, respondents who had experienced an adverse event during childhood were more likely to report drunkenness. In the multivariate analysis, only two adverse childhood events emerged as significant predictors of self-reported past-year drunkenness among males: living in a household with a problem drinker before age 10, and being physically abused before age 10. For females, exposure to family-alcoholism, experience of physical abuse, and coerced sex increased the likelihood of reporting drunkenness in the last 12 months. The association between adverse events and reported drunkenness was more pronounced for females. For both males and females there was a graded relationship between the number of adverse events experienced and the proportion reporting drunkenness. We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.