Prevalence of hazardous alcohol consumption and effectiveness of early intervention among psychiatric patients at Muhimbili National Hospital in Dar-es-Salaam

Abstract

BACKGROUND: The results of treating the established and heavily dependent drinker have usually been poor. The hazardous level, which is a pre-harmful stage, is a stage where evidence shows that intervention is most likely to be effective. OBJECTIVES: The study seeks to determine the proportion of psychiatric patients attending Muhimbili National Hospital in Dar-es-Salaam, involved in hazardous alcohol consumption using the AUDIT (Alcohol Use Disorder Identification Test) as the screening instrument and the effectiveness of the World Health Organization's (WHO) simple intervention technique. DESIGN: A hospital based cross-sectional survey using multiple case studies I SETTING: The study was carried out at psychiatric unit of Muhimbili National Hospital. It is a major referral and teaching hospital and is based in Dar-es- Salaam, which is a major port in Tanzania. PARTICIPANTS: The study population includes both inpatients and outpatients. The outpatients consisted of individuals attending the new case clinics and follow-up outpatient clinics of all three Districts in Dar es Salaam (T emeke, lIala, and Kinondoni). Care was taken so that those individuals who were recruited during their inpatient period were not included in the outpatient category as well. The patients selected were those who were assessed as competent to give informed consent. INSTRUMENTS: Patients recruited for the study were administered the demographic, life style, AUDIT, and BPRS questionnaire. They were then assigned to two different intervention groups, the WHO simple intervention and

viii a standard treatment intervention by a process of simple randomization using the lottery method. Half of patient population were allocated to "simple intervention" group and the other half" to the standard treatment". Patients were requested to come back after three months, after which they were re- administered, the AUDIT and the BPRS. For those who did not return, the research assistant made a follow-up using the tracing card. A comparison was then made between the results obtained at the initial stage of the study and those obtained during follow-up to see if there have been any changes in their drinking patterns and psychopathology. RESULTS: A total of 174 males and 25 females were recruited for the study. Of these, 63% (90% male and 10% female) were found to be drinking at a hazardous level. The response rate was low (44%). A larger proportion of patients (76%) drinking at a hazardous level came for the follow up on schedule compared to non- hazardous drinkers (24%). The results showed a significant reduction in both the frequency and number of drinks, irrespective of the type of intervention. CONCLUSION: The above findings suggest that integrating a routine program of both screening and intervention at all levels of health care as part of prevention could make a significant contribution in the health delivery services in Tanzania.