The prevalence of alcohol and illicit drug use among injured patients presenting to the emergency department of a national hospital in Tanzania: A prospective cohort study

• Type of Material: Article
• Authors: Muller M. Mundenga, Muhimbili University of Health and Allied Sciences; Hendry R. Sawe, Muhimbili University of Health and Allied Sciences; Michael S. Runyon, Carolinas Medical Center; Victor G. Mwafongo, Muhimbili University of Health and Allied Sciences; Juma A. Mfinanga, Muhimbili National Hospital; Brittany Murray, Emory University
• Language: English
• Date: 2019-01-24
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12873-019-0222-9
• Title of Journal or Parent Work: BMC Emergency Medicine
• ISSN: 1471-227X
• Volume: 19
• Issue: 1
• Start Page: 15
• End Page: 15
• Grant/Funding Information: This research was not funded.; The principal investigator used his personal time and funds to facilitate data collection.; Test kits for alcohol and illicit drugs were donated to the project by the Emergency Medicine Association of Tanzania, Dr. Brittany Murray and Dr. Margaret Salmon, none of whom have any relationship to the makers of the testing devices/supplies.; Other authors donated their time towards the project, without any funding.
• Keywords: Road traffic injury; Illicit drugs; Alcohol; Injured patients; Emergency medicine
• Research Categories: Health Sciences, Public Health

Abstract

Background: Alcohol and illicit drugs have been found to be major contributing factors leading to severe injuries in a variety of settings. In Tanzania, the use of these substances among injured patients has not been studied. We investigated the prevalence of positive tests for alcohol and illicit drug use among injured patients presenting to the emergency medicine department (ED) of Muhimbili National Hospital (MNH). Methods: This was a prospective cohort study of a consecutive sample of patients > 18 years of age presenting to the ED-MNH with injury related complaints in October and November 2015. A structured data sheet was used to record demographic information, mechanism of injury, clinical presentation, alcohol and illicit drug test results, and ED disposition. Alcohol levels and illicit drug use were tested by breathalyser device or swab stick alcohol test and multidrug urine panel, respectively. Patients were followed up for 24 h and 30 days using medical chart reviews and phone calls. Descriptive statistics and relative risk were used to describe the results. Results: We screened 1011 patients and we enrolled all 143 (14.1%) patients who met inclusion criteria. 123 (86.0%) were male, the median age was 30 years (IQR: 23-36 years). The most frequent mechanism of injury was road traffic accidents (84.6%). 67/143 (46.9%) patients tested positive for alcohol and 44/122 (36.1%) patients tested positive for drugs. 29 (26.1%) tested positive for alcohol and drugs. The most frequently detected illicit drug was marijuana in 30/122 (24.5%) injured patients. 23/53 (43.4%) patients with positive alcohol testing self-reported alcohol use. 3/25 patients with positive illicit drug tests who were able to provide self-reports, self-reported drug use. At 30-day followup, 43 (64.2%) injured patients who tested positive for alcohol had undergone major surgery, 6 (9.0%) had died, and 36 (53.7%) had not yet returned to their baseline. Conclusions: The prevalence of alcohol and illicit drugs is very high in patients presenting to the ED-MNH with injury. Further studies are needed to generalise the results in Tanzania. Public health initiatives to decrease drinking and/or illicit drug use and driving should be implemented.