Psychosocial interventions for reducing alcohol consumption in sub-Saharan African settings: a systematic review and meta-analysis
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Background: Harmful alcohol use is a leading cause of morbidity and mortality in sub‐Saharan Africa (sSA); however, the effects of non‐pharmacological alcohol interventions in this region are unknown. Design: A systematic review and meta‐analysis of the available literature through 14 March 2019 was undertaken. Two authors extracted and reconciled relevant data and assessed risk of bias. Meta‐analyses were conducted. The review protocol is registered on International Prospective Register of Systematic Reviews (PROSPERO) (CRD42019094509). Setting: Studies conducted in sSA were eligible for inclusion. Participants: Individuals participating in interventions aimed at reducing alcohol use. Interventions: Randomized and non‐randomized controlled trials testing non‐pharmacological interventions (psychosocial and structural) on alcohol consumption in sSA. Measurements: Eligible outcomes included the Alcohol Use Disorders Identification Test (AUDIT) scores; alcohol abstinence; measures of drinking quantity and frequency; and biomarkers of alcohol consumption. Findings: Nineteen intervention trials (18 reports) testing psychosocial interventions (no structural interventions included), judged of moderate quality, were included in meta‐analyses. A beneficial effect was identified for psychosocial interventions on alcohol abstinence at 3–6 months [odds ratio (OR) = 2.05, 95% confidence interval (CI) = 1.20–3.48, k = 5, n = 2312, I 2 = 79%] and 12–60 months (OR = 1.91, 95% CI = 1.40–2.61, k = 6, n = 2737, I 2 = 63%) follow‐up. There were no statistically significant effects found for AUDIT score [2–3 months: mean differences (MD) = −1.13, 95% CI = −2.60 to 0.34, k = 6, n = 992, I 2 = 85%; 6 months: MD = −0.83, 95% CI = −1.92 to 0.26, k = 6, n = 1081, I 2 = 69%; 12 months: MD = −0.15, 95% CI = −1.66 to 1.36, k = 4; n = 677; I 2 = 75%], drinks per drinking day (3 months: MD = –0.22, 95% CI = −2.51 to 2.07, k = 2, n = 359, I 2 = 82%; 6–36 months: MD = −0.09, 95% CI = −0.49 to 0.30, k = 3, n = 1450, I 2 = 60%) or percentage of drinking days (3 months: MD = −4.60, 95% = −21.14 to 11.94; k = 2; n = 361; I 2 = 90%; 6–9 months: MD = 1.96, 95% CI = −6.54 to 10.46; k = 2; n = 818; I 2 = 88%). Conclusion: Psychosocial interventions show promise at increasing self‐reported alcohol abstinence in sSA, but clinical, methodological and statistical heterogeneity across meta‐analytical outcomes suggests that results should be interpreted with caution.
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Two additional reviews examined the effectiveness of psychosocial interventions more generally on hazardous and harmful alcohol use in Sub-Saharan Africa and LMICs, respectively.
“Two additional reviews examined the effectiveness of psychosocial interventions more generally on hazardous and harmful alcohol use in Sub‐Saharan Africa and LMICs, respectively (Preusse 2020; Sileo 2021).”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Sileo 2021
The Discussion (page unavailable) confirms that Sileo 2021 reviewed the effectiveness of psychosocial interventions on alcohol consumption. But the sentence’s “respectively” assigns the LMIC-wide review to Sileo, whereas its Discussion and Results limit the review to sub-Saharan African settings; the Results list studies from seven countries in that region. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA systematic review and meta-analysis conducted in Sub-Saharan Africa identified 19 intervention trials of moderate quality that showed some evidence of the efficacy of psychosocial interventions for promoting the odds of abstinence, but did not identify effects on hazardous or harmful alcohol use or consumption.
“The systematic review and meta‐analysis conducted in Sub‐Saharan Africa identified 19 intervention trials (including randomized and non‐randomized designs) of moderate quality that showed some evidence of the efficacy of psychosocial interventions for promoting the odds of abstinence, but did not identify effects on hazardous or harmful alcohol use or consumption.”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Sileo 2021
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- Authors
- Sileo, K. M., Miller, A. P., Wagman, J. A., & Kiene, S. M.
- Affiliations
- San Diego State University (US)
- University of California San Diego (US)
- University of California, Los Angeles (US)
- Corresponding author
- Sileo, Katelyn M.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2020-09-15
- Volume
- 116
- Issue
- 3
- Pages
- 457-473
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC8543382
- OpenAlex
- W3049077469
- Semantic Scholar
- 7c0818ed25aab149b4cecae0058bcc92be0e8016
- Cited by
- 47
- References
- 47
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 8 · 2023: 19 · 2022: 6 · 2021: 4 · 2020: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (5T32MH020031‐18)
- National Institute on Alcohol Abuse and Alcoholism (7K01AA024068‐05)
- National Institute on Drug Abuse (T32DA23356)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- psychosocial interventions, alcohol consumption, alcohol consumption reduction, alcohol abstinence, AUDIT score, hazardous drinking, sub-Saharan Africa, non-pharmacological treatment, alcohol screening, brief intervention, alcohol marketing regulation, alcohol pricing, alcohol taxation, alcohol advertising ban, alcohol availability
- MeSH terms
- Psychosocial Intervention, Alcohol Drinking, Alcoholism, Humans, Africa South of the Sahara, Alcohol Abstinence
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