ArticleBMC public health2025
Prevalence and factors associated with alcohol and substance use among secondary school adolescents in central and Eastern Uganda: a cross-sectional study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlcohol and substance use is a major public health concern in Uganda, with limited evidence focused on school-going adolescents. This study determined the prevalence and factors associated with alcohol and substance use among adolescents in secondary schools in Central and Eastern Uganda.
methodsThis cross-sectional study surveyed 1,833 adolescents aged 10-18 years from eight randomly selected secondary schools in Iganga (Eastern) and Mukono (Central) districts. Schools were stratified by ownership (private or public), and geographic setting (eastern or central). We used the Child and Adolescent Symptom Inventory-5 (CASI-5) to assess the primary outcomes: significant use of alcohol, tobacco, marijuana, and impairment from any substance use. Logistic regression models determined the factors independently associated with significant use of alcohol, tobacco, marijuana and impairment from any substance use. Adjusted odds ratios (AOR) and corresponding 95% confidence intervals (95%CI) were reported.
resultsAmong 1,833 school-going adolescents, the mean age was 15.1 years (SD ± 1.6), 60% were female, and 50.7% attended urban schools. The prevalence of significant use was 1.7% (n = 30) for tobacco, 3.0% (n = 54) for alcohol, 2.6% (n = 46) for marijuana, and 6.2% (n = 105) reported significant impairment from any substance use. In adjusted analyses, male adolescents had higher odds of marijuana use than females (AOR 2.21, 95%CI 1.17-4.19, p = 0.015). A history of mental illness was associated with higher odds of marijuana use (AOR 2.87, 95%CI 1.45-5.67, p = 0.002), alcohol use (AOR 2.69, 95%CI 1.42-5.09, p = 0.002), and SUD impairment (AOR 1.91, 95%CI 1.14-3.18, p = 0.014) compared to those with no such history. Urban school attendees had higher odds of SUD impairment than rural attendees (AOR 2.37, 95%CI 1.47-3.81, p < 0.001), and adolescents living in huts had higher odds of tobacco use than those in permanent housing (AOR 5.46, 95%CI 1.12-26.59, p = 0.036).
conclusionsTargeted school-based interventions addressing sex-specific risks, and urban-rural disparities in mental health may help reduce use of alcohol, substances and SUD impairment among adolescent students in central and eastern Uganda.
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