Abstract
BackgroundAlcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse.MethodsThis cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females.ResultsA total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females.ConclusionThe AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal.
Highlights
Alcohol problems are a major health issue in Nepal and remain under diagnosed
According to DSM-IV, drinkers were classified as absence of alcohol problem (n=562; 59.5%), alcohol abuse (n=78; 8.3%) alcohol dependence (n=304; 32.2%) and alcohol abuse/ dependence (n=382; 40.5%)
This study shows that the use of Nepali version of Alcohol Use Disorder Identification Test (AUDIT) is feasible and can be used reliably in the busy out-patient setting for screening of hazardous drinking and alcohol dependence
Summary
Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. Alcohol use disorders (AUDs), which includes alcohol abuse and alcohol dependence are regarded as one of the most important public health problems [1,2]. Increase in alcohol consumption in this country is due to many factors which include advertising, affordability and availability. Types of traditional and local alcoholic beverages include country liquors (low quality alcohol made from molasses and produced in small distilleries), homemade liquors, Jand (made of rice), Chang (made of rice by a different method) and Raksi (home-brewed alcohol made out of rice, millet or barley). Produced alcoholic beverages tend to be cheap, which promotes accessibility and consumption
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