The Prevalence of Substance Use and the Association with Injury Severity among Emergency Department Patients in Moshi, Tanzania

Background: Alcohol and substance use are significant risk
factors for injury. To guide harm-reduction strategies, this study
describes alcohol and substance use patterns and analyzes
their association with injury severity among injury patients
presenting to Kilimanjaro Christian Medical Centre (KCMC).
Methods: Self-reported sociodemographic, alcohol, and
substance use data were collected from a prospective trauma
registry of adult patients admitted to KCMC for acute injury.
The Alcohol Use Disorder Identification Test (AUDIT) was also
administered. Injury severity data were determined by the
Kampala Trauma Score. Descriptive statistics and multivariable
logistic regressions assessed the association of
sociodemographic and substance use data with injury severity.
Results: of all participants (n=716), 57% self-reported alcohol
use within the last year. Of those participants, 20% were
determined to have an alcohol use disorder (AUDIT Score> 8).
26% of all participants reported alcohol use before the injury,
while 18% of participants reported current using tobacco. 20%
of participants reported use of any psychoactive substance,
including 3% reporting current marijuana use, and 1% reporting
current khat/mirungi use. Alcohol use in the past year was
associated with an increased likelihood of also using tobacco
(OR 5.2, 95% CI 3.0-9.9), while current other drug use was
associated with an increased likelihood of alcohol use (OR 5.9,
95% CI 1.8-38.6). Although alcohol use alone was not
associated with injury severity, other drug use was linked with a
3 times increased risk of a severe injury (OR 3.1, 95% CI
1.0-8.9).
Conclusion: Alcohol use is common among KCMC injury
patients. While illicit drug use is less common, it is associated
with an increased likelihood of severe injury occurrence.
Further research delineating the association of alcohol and
drug use on the severity of injury in similar injury populations is
suggested.