Abstract

IntroductionAlcohol use disorder (AUD) is among the leading cause of morbidity and mortality in sub-Saharan Africa. Despite this, AUD is often not detected in health care settings, which contributes to a wide treatment gap. Integrating services for mental, neurological, and substance use disorders in general health care settings is among the recommended strategies to narrow this treatment gap. This scoping review aimed to map the available evidence on integration of AUD interventions in general health care settings in sub–Saharan Africa.MethodsWe searched four databases (PubMed, PsycINFO, CINAHL, and Africa Wide Information) for publications up to December 2020. The search strategy focused on terms for alcohol use, alcohol interventions, and sub-Saharan African countries. Studies that reported AUD interventions in general health care settings in sub–Saharan Africa were eligible for inclusion. Over 3,817 potentially eligible articles were identified. After the removal of duplicates and screening of abstracts, 56 articles were included for full article review. Of these, 24 papers reporting on 22 studies were eligible and included in a narrative review.ResultsOf the 24 eligible articles, 19 (80%) described AUD interventions that were being delivered in general health care settings, 3 (12%) described plans or programs for integrating AUD interventions at different levels of care, including in health facilities, and 2 (8%) studies reported on AUD interventions integrated into general health care settings.ConclusionsThis review shows that there is limited evidence on the integration of AUD interventions in health care settings in sub-Saharan Africa. There is an urgent need for studies that report systematically on the development, adaptation, implementation, and evaluation of integrated AUD interventions in health care settings in sub-Saharan Africa.

Highlights

  • Alcohol use disorder (AUD) is among the leading cause of morbidity and mortality in sub-Saharan Africa

  • We excluded 32 articles that did not report on Alcohol Use Disorder (AUD) interventions or reported on AUD interventions from settings other than general health care

  • We present the review findings as follows: (i) the underlying study design, (ii) targeted population and type of health care service, (iii) region of sub-Saharan Africa where the study took place, (iv) publication year, (v) primary outcome, and (vi) AUD intervention

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Summary

Introduction

Alcohol use disorder (AUD) is among the leading cause of morbidity and mortality in sub-Saharan Africa. Integrating services for mental, neurological, and substance use disorders in general health care settings is among the recommended strategies to narrow this treatment gap. This scoping review aimed to map the available evidence on integration of AUD interventions in general health care settings in sub–Saharan Africa. Even though the magnitude and factors associated with AUD are substantial, AUD appears to be rarely detected by health care providers [11] leading to a wide treatment gap [9, 11–13]. This gap is marked in low-income and lower-middle-income countries [9, 11, 12]

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