A systematic review and meta-analysis of factors associated with adolescent substance use in Africa, 2000 to 2020

IF 5.3 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2025-02-27 DOI:10.1111/add.70023

Sandra Jumbe, Tony Mwenda Kamninga, Ukwuori-Gisela Kalu, Joel Nyali, Lara Saleh, Chris Newby, Joel Msafiri Francis

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Abstract

Background and aims

Adolescent substance use is a growing public health concern in Africa, yet little is known about the contextual factors of substance use among young African populations. This systematic review identified factors associated with substance use among adolescents (aged 10–19 years) in Africa.

Methods

This review was conducted in line with PRISMA guidelines. We searched six databases (from January 2000 to December 2020): PubMed, Cochrane Library, African Journals Online (AJOL), Google Scholar, ScienceDirect and World Health Organization (WHO) African Index Medicus. We included population-based observational studies reporting on factors associated with adolescent substance use across Africa. Study screening was conducted by at least four independent reviewers who resolved discrepancies through discussion and consensus. All included studies were analysed in a narrative synthesis. Studies providing sufficient statistics, i.e. three or more reporting the same outcome and exposure/predictor, were included in meta-analyses.

Results

Sixty-three peer reviewed studies that were full text accessible were included. The majority were cross-sectional surveys. Factors associated with adolescent substance use identified were linked to individual, family, socioenvironmental and non-familial social networks determinants. Results from both the narrative synthesis and meta-analysis revealed that being male and an older adolescent were significantly associated with adolescent substance use. Combined odds ratio (OR) of males who currently smoke compared with females was 1.81 [95% confidence interval (CI) = 1.37–2.39; 6 studies, 13 443 participants, I² = 59.67%]. Additional meta-analysis outcomes found that having a friend who smokes was associated with tobacco smoking. Combined OR of ‘ever-smokers’ with a friend who smoked was 4.83 (CI = 2.56–9.10; 3 studies, 18 858 participants, I² = 79.21%). Having a family member who smokes was associated with smoking initiation (OR = 2.99; CI = 2.67–3.35; 3 studies, 18 858 participants, I² = 0%) and current smoking (OR = 2.33; CI = 2.23–2.45; 4 studies, 13 282 participants, I² = 0%).

Conclusion

Multiple factors that operate on individual, family and societal levels influence adolescent substance use in Africa. Key factors of adolescent substance use in Africa appear to include being male, being an older adolescent and being exposed to peer substance use.

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2000年至2020年非洲青少年药物使用相关因素的系统回顾和荟萃分析。

背景和目的：青少年药物使用是非洲日益严重的公共卫生问题，但对非洲年轻人药物使用的背景因素知之甚少。本系统综述确定了与非洲青少年（10-19岁）药物使用相关的因素。方法：本综述按照PRISMA指南进行。我们检索了6个数据库（2000年1月至2020年12月）：PubMed、Cochrane图书馆、非洲在线期刊（AJOL）、b谷歌Scholar、ScienceDirect和世界卫生组织（WHO）非洲索引Medicus。我们纳入了以人口为基础的观察性研究，报告了非洲各地青少年药物使用相关因素。研究筛选由至少四名独立审稿人进行，他们通过讨论和共识来解决差异。所有纳入的研究都以叙事综合的方式进行分析。提供充分统计数据的研究，即三个或更多报告相同结果和暴露/预测因子的研究，被纳入荟萃分析。结果：纳入了63项同行评议的研究，这些研究均可获得全文。大多数是横断面调查。已确定的与青少年药物使用相关的因素与个人、家庭、社会环境和非家庭社会网络决定因素有关。叙事综合和荟萃分析的结果显示，男性和年龄较大的青少年与青少年药物使用显著相关。目前吸烟的男性与女性的综合优势比（OR）为1.81[95%可信区间(CI) = 1.37-2.39；6项研究，13 443名受试者，[2 = 59.67%]。另外的荟萃分析结果发现，有一个吸烟的朋友与吸烟有关。“曾经吸烟者”与吸烟的朋友的综合OR为4.83 (CI = 2.56-9.10；3项研究，18 858名受试者，I2 = 79.21%)。家庭成员吸烟与开始吸烟有关(OR = 2.99；Ci = 2.67-3.35；3项研究，18858名参与者，I2 = 0%)和当前吸烟(OR = 2.33；Ci = 2.23-2.45；4项研究，13282名受试者，I2 = 0%)。结论：影响非洲青少年药物使用的多重因素在个人、家庭和社会层面发挥作用。非洲青少年药物使用的关键因素似乎包括男性、年龄较大的青少年和接触同龄人药物使用。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.

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