The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study
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BACKGROUND: Globally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death and disability. This project aimed to determine the proportion of injuries related to alcohol and the increased risk of injury due to alcohol among injury patients seeking care at the emergency department (ED) of Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. METHODS: A representative cross-sectional sample of adult patients presenting to the KCMC ED with acute injury were enrolled in this study with a nested case-crossover design. Patient demographics, injury characteristics, and severity as well as alcohol use behaviors were collected. Alcohol breathalyzers were administered to the enrolled patients. Data on activities and alcohol use were collected for the time period 6 h prior to injury and two control periods: 24-30 h prior to injury and 1 week prior to injury. RESULTS: During 47 weeks of data collection, 24,070 patients were screened, of which 2164 suffered injuries, and 516 met the inclusion and exclusion criteria, consented to participate, and had complete data. Of the study participants, 76% were male, and 30% tested positive for alcohol on arrival to the ED. Alcohol use was associated with being male and being employed. Alcohol use was associated with an increased risk of injury (OR 5.71; 95% CI 3.84-8.50), and specifically road traffic injuries were associated with the highest odds of injury with alcohol use (OR 6.53, 95% CI 3.98-10.71). For all injuries and road traffic injuries specifically, we found an increase in the odds of injury with an incremental increase in the dose of alcohol. CONCLUSIONS: At KCMC in Moshi, Tanzania, 3 of 10 injury patients tested positive for alcohol on presentation for care. Similarly, alcohol use conveys an increased risk for injury in this setting. Evidence-based prevention strategies for alcohol-related injuries need to be implemented to reduce alcohol misuse and alcohol-related injuries.
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In the authors' prior data, binge drinking carries an increased risk of injury requiring healthcare services.
“In our prior data, binge drinking carries an increased risk of injury requiring healthcare services [5].”
Preliminary data showed that 30% of patients seeking care for an injury consumed alcohol prior to injury or had an alcohol-related injury.
“While AUD is not routinely assessed or screened for individuals attending healthcare facilities in Tanzania, our preliminary data demonstrated that 30% of patients seeking care for an injury consumed alcohol prior to injury or had an alcohol related injury [5].”
Alcohol use is associated with a 6-times increased risk of road traffic injury.
“The KCMC ED reports a higher proportion of injury patients testing positive for alcohol compared to neighboring Mozambique (17%) [41], with alcohol use being associated with a 6-times increased risk of road traffic injury [42].”
The study demographic is expected based on prior studies.
“The study demographic is expected based on prior studies [40,42].”
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“In our prior data, binge drinking carries an increased risk of injury requiring healthcare services [5].”
Self-citation
- Authors
- Staton, C. A., Vissoci, J. R. N., Toomey, N., Abdelgadir, J., Chou, P., Haglund, M., Mmbaga, B. T., Mvungi, M., & Swahn, M.
- Affiliations
- Duke University (US)
- National Institute on Alcohol Abuse and Alcoholism (US)
- Kilimanjaro Christian Medical Centre (TZ)
- Georgia State University (US)
- Corresponding author
- Staton, Catherine A.
- ORCID
- Venue
- BMC Public Health
- Published
- 2018-02-21
- Volume
- 18
- Issue
- 1
- Pages
- 275-275
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC5822650
- OpenAlex
- W2794296384
- Cited by
- 63
- References
- 23
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 13 · 2023: 10 · 2022: 13 · 2021: 6 · 2020: 7 · 2019: 2 · 2018: 3
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DigitalCommons - Kennesaw State University (Kennesaw State University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Fogarty International Center (Staton, K01 TW010000-01A1)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- alcohol consumption, alcohol-related injuries, road traffic injuries, injury risk, emergency department patients, alcohol dose, injury prevention, Moshi, Tanzania
- MeSH terms
- Adult, Alcohol Drinking, Breath Tests, Cross-Sectional Studies, Emergency Service, Hospital, Female, Humans, Male, Middle Aged, Tanzania, Wounds and Injuries, Case-Control Studies, Risk Assessment, Cross-Over Studies, Young Adult
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