Scholastic Ashaba1, Bernard Kakuhikire1, Charles Baguma1, Emily N Satinsky2,3, Jessica M Perkins4, Justin D Rasmussen5, Christine E Cooper-Vince6, Phionah Ahereza1, Patrick Gumisiriza1, Justus Kananura1, David R Bangsberg1,7, Alexander C Tsai1,2,8,9. 1. Mbarara University of Science and Technology, Mbarara, Uganda. 2. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA. 3. Department of Psychology, University of Southern California, Los Angeles, CA, USA. 4. Peabody College, Vanderbilt University, Nashville, TN, USA. 5. Duke University, Durham, NC, USA. 6. Départment de Psychiatrie, Universitié de Genève, Switzerland. 7. Oregon Health and Science University - Portland State University School of Public Health, Portland, OR, USA. 8. Harvard Medical School, Boston, MA, USA. 9. Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
Abstract
Background: Adverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as one of the highest levels of alcohol consumption in Africa. Few population-based studies from Africa have estimated associations between ACEs and adult alcohol use, or assessed the potential buffering effects of social participation. Methods: This cross-sectional, population-based study was conducted in a rural parish in southwestern Uganda between 2016 and 2018. We assessed self-reported ACEs using a modified version of the Adverse Childhood Experiences - International Questionnaire (ACE-IQ) scale. We measured heavy alcohol consumption using a 3-item scale previously validated in this population. We measured social participation using a 10-item scale eliciting participants' membership and participation in different community groups over the past two months. We fitted multivariable Poisson regression models to estimate the associations between ACEs and heavy alcohol consumption, and to assess for the potential buffering effects of social participation. Results: We estimated statistically significant associations between the total ACE score and heavy alcohol consumption (adjusted relative risk [ARR] per ACE=1.17; 95% CI, 1.09-1.25; P ≤0.001). Social participation had a statistically significant moderating effect on the association between total ACE score and heavy alcohol consumption (P=0.047 for interaction): the estimated association between total ACE score and heavy alcohol consumption among study participants who did not participate in a community group was larger, with a narrower confidence interval (ARR=1.21 per ACE; 95% CI, 1.11-1.33; P<0.001), while the estimated association among study participants who did participate in a community group was smaller and less precisely estimated (ARR=1.12 per ACE; 95% CI, 1.02-1.24; P=0.02). Conclusions: Our findings demonstrate an association between ACEs and heavy alcohol consumption behavior among adults in rural Uganda. The adverse effects of ACEs were buffered in part by social participation. To prevent or reduce harmful alcohol use behaviors among adults, it is important to address the chronic stress caused by ACEs.
Background: Adverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as one of the highest levels of alcohol consumption in Africa. Few population-based studies from Africa have estimated associations between ACEs and adult alcohol use, or assessed the potential buffering effects of social participation. Methods: This cross-sectional, population-based study was conducted in a rural parish in southwestern Uganda between 2016 and 2018. We assessed self-reported ACEs using a modified version of the Adverse Childhood Experiences - International Questionnaire (ACE-IQ) scale. We measured heavy alcohol consumption using a 3-item scale previously validated in this population. We measured social participation using a 10-item scale eliciting participants' membership and participation in different community groups over the past two months. We fitted multivariable Poisson regression models to estimate the associations between ACEs and heavy alcohol consumption, and to assess for the potential buffering effects of social participation. Results: We estimated statistically significant associations between the total ACE score and heavy alcohol consumption (adjusted relative risk [ARR] per ACE=1.17; 95% CI, 1.09-1.25; P ≤0.001). Social participation had a statistically significant moderating effect on the association between total ACE score and heavy alcohol consumption (P=0.047 for interaction): the estimated association between total ACE score and heavy alcohol consumption among study participants who did not participate in a community group was larger, with a narrower confidence interval (ARR=1.21 per ACE; 95% CI, 1.11-1.33; P<0.001), while the estimated association among study participants who did participate in a community group was smaller and less precisely estimated (ARR=1.12 per ACE; 95% CI, 1.02-1.24; P=0.02). Conclusions: Our findings demonstrate an association between ACEs and heavy alcohol consumption behavior among adults in rural Uganda. The adverse effects of ACEs were buffered in part by social participation. To prevent or reduce harmful alcohol use behaviors among adults, it is important to address the chronic stress caused by ACEs.
Entities:
Keywords:
Uganda; adverse childhood experiences; heavy alcohol consumption; social participation
Authors: Alexander C Tsai; David R Bangsberg; Edward A Frongillo; Peter W Hunt; Conrad Muzoora; Jeffrey N Martin; Sheri D Weiser Journal: Soc Sci Med Date: 2012-03-23 Impact factor: 4.634
Authors: Jolanda Jetten; Nyla R Branscombe; S Alexander Haslam; Catherine Haslam; Tegan Cruwys; Janelle M Jones; Lijuan Cui; Genevieve Dingle; James Liu; Sean C Murphy; Sean Murphy; Anh Thai; Zoe Walter; Airong Zhang Journal: PLoS One Date: 2015-05-27 Impact factor: 3.240
Authors: Steven Ndugwa Kabwama; Sheila Ndyanabangi; Gerald Mutungi; Ronald Wesonga; Silver K Bahendeka; David Guwatudde Journal: Glob Health Action Date: 2016-08-03 Impact factor: 2.640