Prevalence of substance use disorders in an urban and a rural area in Suriname

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Abstract

Background

Alcohol use disorders (AUD) have the worst impact in low-middle-income countries (LMICs), where the disease burden per liter of alcohol consumed is higher than in wealthy populations. Furthermore, the median treatment gap for AUDs in LMICs is 78.1%. The highest prevalence of AUDs worldwide in 2004 was found in the western Pacific region, Southeast Asia, and the Americas. The main aim of this study was to estimate and compare the prevalence of risky alcohol use and the extent of the treatment gap in a rural (Nickerie) and in an urban (Paramaribo) area in Suriname, a LMICs country with a wide variety of ethnic groups.

Methods

The respondents were randomly recruited using a specific sampling method of the National Census Bureau. The final samples were 1837 households for Paramaribo and 1026 for Nickerie, reflecting the populations in both regions. The Alcohol Use Disorder Identification Test (AUDIT) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess the likelihood of the presence of alcohol use disorder. A score of > 7 for the AUDIT implies risky alcohol use.

Results

The results indicated that 2% of the women and 15% of the men in the rural area scored 8 or higher on the AUDIT. In the urban area, these numbers were 3% and 17%, respectively. In both samples, the men had the highest addiction risk at about 16% compared with 2% for females. Married persons are significantly less likely to become alcoholic than singles and other groups in Paramaribo. In both areas, higher education was associated with a lower probability of alcohol abuse and dependence, while handymen showed a higher odd. A treatment gap of 50% was found for alcohol use disorders in the rural area. The corresponding gap in the urban area was 64%.

Conclusions

Surinamese men show a high prevalence of the likelihood of AUD. In addition, the treatment gap for these possible patients is large. It is therefore of paramount importance to develop therapeutic strategies with the aim of tackling this physically and mentally disabling disorder. Tailored E-health programs may be of benefit.

Related collections

Most cited references 33

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Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Maheswar Satpathy, Mika Kivimaki, Shafiu Mohammed … (2019)

Summary Background Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week. Interpretation Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. Funding Bill & Melinda Gates Foundation.

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Alcohol use disorders

André F. Carvalho, Markus Heilig, Augusto Pérez … (2019)

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'Mobile' health needs and opportunities in developing countries.

S. J. Kahn, James G. Kahn, J Yang (2010)

Developing countries face steady growth in the prevalence of chronic diseases, along with a continued burden from communicable diseases. "Mobile" health, or m-health-the use of mobile technologies such as cellular phones to support public health and clinical care-offers promise in responding to both types of disease burdens. Mobile technologies are widely available and can play an important role in health care at the regional, community, and individual levels. We examine various m-health applications and define the risks and benefits of each. We find positive examples but little solid evaluation of clinical or economic performance, which highlights the need for such evaluation.

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Author and article information

Contributors

Raj Jadnanansing:

ORCID: http://orcid.org/0000-0002-2137-3653

raj.jadnanansing@pcs.sr , rajad5@yahoo.com

Journal

Journal ID (nlm-ta): Trop Med Health

Journal ID (iso-abbrev): Trop Med Health

Title: Tropical Medicine and Health

Publisher: BioMed Central (London )

ISSN (Print): 1348-8945

ISSN (Electronic): 1349-4147

Publication date (Electronic): 2 February 2021

Publication date PMC-release: 2 February 2021

Publication date Collection: 2021

Volume: 49

Electronic Location Identifier: 12

Affiliations

[1 ]GRID grid.440841.d, ISNI 0000 0001 0700 1506, Center for Psychiatry in Suriname and Department of Psychology Anton de Kom University of Suriname, ; Paramaribo, Suriname

[2 ]Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands

[3 ]GRID grid.440841.d, ISNI 0000 0001 0700 1506, Center for Psychiatry in Suriname and Faculty of Medical Science, , Anton de Kom University of Suriname, ; Paramaribo, Suriname

[4 ]GRID grid.12380.38, ISNI 0000 0004 1754 9227, Research Department, Arkin Mental Health Institute Amsterdam and Department of Clinical Psychology, , VU University, ; Amsterdam, The Netherlands

[5 ]GRID grid.440841.d, ISNI 0000 0001 0700 1506, Department of Physiology, Faculty of Medical Science, , Anton de Kom University of Suriname, ; Paramaribo, Suriname

Author information

Raj Jadnanansing http://orcid.org/0000-0002-2137-3653

Article

Publisher ID: 301

DOI: 10.1186/s41182-021-00301-7

PMC ID: 7852200

PubMed ID: 33526098

SO-VID: adf6523a-6442-4ac7-a013-a9ce7d9c2e69

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 8 July 2020

Date accepted : 21 January 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100007729, Ministerie van Buitenlandse Zaken;

Award ID: “Dwarkasing R, De Jonge M. Onderzoek naar alcoholgebruik, angst en depressieve klachten in Suriname, en aanbieden van zorg op maat en geïndiceerde e-mental health. Paramaribo, Amsterdam; 2014”

Award Recipient : Rudi Dwarkasing

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: alcohol use disorder,audit,treatment gap,suriname,population-based study

Data availability: