Screening Caregivers of Children for Risky Drinking in KwaZulu-Natal, South Africa
Background and Objectives Alcohol abuse, a significant health problem in South Africa, affects the ability of adults to care for children. Little is known regarding risky alcohol use among child caregivers there. A large population-based study examined the prevalence of, and factors associated with, risky drinking among caregivers of young children in KwaZulu-Natal, South Africa comparing the use of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT-C screens for hazardous or harmful drinking (referred to here as risky drinking). Methods 83 % of child caregivers from five tribal areas were interviewed using the 10-question AUDIT to screen for risky drinking. The AUDIT-C screen, a subset of AUDIT questions, targets alcohol consumption and binge drinking. Factors associated with risky drinking were investigated using logistic regression. Results 1434 caregivers participated, 98 % female. Sixteen percent reported ever drinking alcohol. Based on AUDIT criteria for risky drinking, 13 % of the sample scored as moderate drinkers, 2 % as hazardous users, and 1 % as harmful or dependent users (identifying 3 % as risky drinkers). Using AUDIT-C criteria to identify risky drinking significantly increased the proportion of caregivers identified as risky drinkers to 9 %. In multivariate analyses, factors associated with risky drinking were similar in both screens: partner violence, smoking, HIV-infection, caring for a child with disabilities. Conclusions for Practice Since the AUDIT-C identified risky alcohol use not otherwise detected with the full AUDIT, and since resources for screening in health care settings is limited, the AUDIT-C may be a more appropriate screen in populations where binge drinking is common.
KeywordsAlcohol Use Binge drinking AUDIT AUDIT-C Child caregivers Population-based South Africa
We wish to thank the children and their families who shared their lives and their time with us and the study team, the field workers and psychological assessors who made it all possible. We also thank Andrew Pangilinan for assestance with the analyses. The ASENZE study was funded by the National Institute of Drug Abuse 5 R01 DA023697 in conjunction with the Fogarty Brain Disorders in Developing Countries Program. The opinions represented here are the sole responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
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