CAGE Score Research Articles

Binge Drinking in Spain, 2008–2010

Most alcohol-related research has focused on northern and eastern Europe and the United States. Data on Mediterranean countries point to drinking patterns approaching the sporadic and excessive patterns found in northern and eastern Europe. This is the first study to estimate the prevalence of binge drinking (BD) and the joint distribution of BD, regular heavy alcohol consumption, and alcohol abuse or dependence (AAD) in a nationally representative sample of the adult population of Spain. Cross-sectional study conducted in 2008 to 2010 with 9,130 persons aged 18 to 64years. BD was defined as intake of ≥80g of alcohol in men (≥60g in women) during any drinking occasion in the previous month, with ≥3 BD episodes discriminating between frequent and sporadic BD. Regular alcohol consumption was measured with a validated diet history, and the threshold between moderate and heavy drinking was ≥40g of alcohol/d in men (≥24g in women). AAD was defined by a CAGE score ≥2. BD prevalence was 10% (95% confidence interval [CI]: 8.8 to 11.2) in men and 4.2% (95% CI: 3.5 to 4.8) in women, and proved highest among 18- to 24-year-olds (19.5% in men and 10.3% in women). During the latest BD episode, men consumed a mean of 114g of alcohol versus 85.3g in women; spirits accounted for 65.2 and 66.2% of total intake, respectively. The mean number of monthly BD episodes was 2.3 in men and 2 in women. Among binge drinkers, 61% were 18- to 34-year-olds, over 80% had regular moderate drinking, 25% reported frequent BD, and 22.8% reported AAD. In multivariate analyses, sporadic BD and frequent BD were associated with AAD independently of regular alcohol intake. Prevalence of BD in Spain is moderately high. Prevention interventions should consider that the majority of binge drinkers are young men with regular moderate consumption and no AAD traits.

Factors associated with alcohol problems among Asian American college students: gender, ethnicity, smoking and depressed mood

Objective: This study examined gender, ethnicity and psychological factors associated with alcohol problems among Asian American college students, using the CAGE questionnaire. Method: The study is a cross-sectional, school-based survey. College students who self-identified as Asian, participated. Results: The sample comprised 258 Asian American college students (132 men and 126 women). In all, 17.7% of males and 8.9% of females had alcohol problems based on CAGE score of 2 or more; yet, the difference was marginally significant (χ2 [1, N = 225] = 3.7, p = 0.08). Chinese and Vietnamese males tended to have more alcohol problems than females in their respective ethnic subgroups. Among Koreans, more females (33%) had the problems than males (11%). Male students did not differ in alcohol problems by ethnicity, whereas Korean females were more likely to have the problems (χ2 [4, N = 112] = 13.0, p = 0.01) than females in the other groups. After controlling for gender, Asian American college students who were older (≥25), smoking currently and reporting depressed mood were more likely to have alcohol problems. Conclusions: College health center workers should monitor more closely Asian students who have the risk factors for early detection of and treatment for alcohol problems.

Common perinatal mental disorders and alcohol dependence in men in northern Viet Nam

To establish the prevalence and correlates of the perinatal common mental disorders of depression and anxiety (PCMD) and alcohol dependence (AD) in men in northern Viet Nam. A cross-sectional study of men whose wives were >28weeks pregnant or mothers of newborns recruited from randomly-selected rural and urban communes. Data sources were Structured Clinical Interviews for DSM IV; CAGE assessment of alcohol use and study-specific questionnaires. Odds ratios and 95% CIs were calculated by multiple logistic regressions. Overall, 231/360 eligible men were recruited, of whom 17.7% [95% CI, 12.8-22.7] were diagnosed with a PCMD; 33.8% [95% CI, 27.9-40.1] with AD (CAGE score≥2) and 6.9% [95% CI, 4.3-11.0] with co-morbid PCMD and AD. PCMD were associated with experiences of coincidental life adversity, intimate partner violence, age>30; an unwelcome pregnancy and primiparity. AD was more common among men with low education, living in the poorest households and in unskilled work. Common mental disorders and AD are prevalent, but currently unrecognised among men in northern Viet Nam whose wives are pregnant or have recently given birth.

On the Relationship Between Inside and Outside: Conceptualising Acoustic Space in John Cage's Variations IV

This paper is an attempt to construct a spatial acoustic theory on the manner of operations within John Cage's 1963 musical composition titled Variations IV . In constructing such a theory I introduce Barry Blesser and Linda-Ruth Salter's notion of aural architecture , reflect on a number of details and references in Cage's score, and apply the visualisation methodology of semiotician A. J. Greimas. I also examine Cage's realisation directives as a system of emergence, primarily through the work's notation and its inherent spatial proclivities. In applying the semiotic square visualisation technique of Greimas I further derive the deep-level concepts of site , scale , landscape , and architecture , and discuss their relevance to the manner in which an emergent aural architecture is constructed by the work. A final diagram maps the listener experience of Variations IV as one predicated on the merging between interior and exterior acoustic spaces through the fluctuating interrelation between local and distant sound events and the architectural form.

Characteristics of Cancer Pain in an Outpatient Palliative Care Center According To the ECS-CP (776)

1.Learn about the characteristics of cancer pain among advanced cancer patients seen at an outpatient palliative care center.2.Identify the features that are associated with higher pain intensity. The Edmonton Classification System for Cancer Pain (ECS-CP) has demonstrated value in predicting pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. There is however limited literature on ECS-CP use in the outpatient setting. We examined the characteristics of patients with cancer pain at our outpatient palliative care center using ECS-CP. Records of patients seen at our outpatient palliative care center were reviewed. Baseline characteristics, morphine equivalent daily dose (MEDD), opiate rotation, Edmonton Symptom Assessment System (ESAS), Memorial Delirium Assessment Scale (MDAS) and CAGE scores were obtained at the initial visit. 91 consecutive patients with advanced cancer were included. The median age was 58 years, 55% were female, and 70% were white. The most common pain type was nociceptive pain (68%). 62% had incidental pain, 52% had psychological distress, and 2/91 (<1%) had cognitive impairment. The median MEDD was 45 and the CAGE score was positive in 7.8% of patients. There were no associations between pain intensity and age, gender, race or cancer type. ECS-CP psychosocial distress (r = 0.18, P = 0.07), addictive behavior (r = 0.09, P = 0.28), and cognitive function (r = 0.02, P = 0.8) were also not associated with pain intensity. There was however significant association between pain intensity and ECS-CP pain type (r = 0.29, P = 0.005), incidental pain(r = 0.21, P = 0.04), MEDD(R = 0.23, P = 0.02), and opioid rotation(r = 0.32, P = 0.002). Patients with higher pain intensity are more likely to have nociceptive pain, incidental pain, higher MEDD scores and are likely to have opioid rotation. Further studies are needed to optimize the use of ECS-CP for better symptom control.

End of Life Curriculum in an Internal Medicine Residency Program: Curriculum Reevaluation (777)

Result. 91 consecutive patients with advanced cancer were included. The median age was 58 years, 55% were female, and 70% were white. The most common pain type was nociceptive pain (68%). 62% had incidental pain, 52% had psychological distress, and 2/91 (<1%) had cognitive impairment. The median MEDD was 45 and the CAGE score was positive in 7.8% of patients. There were no associations between pain intensity and age, gender, race or cancer type. ECS-CP psychosocial distress (r 1⁄4 0.18, P 1⁄4 0.07), addictive behavior (r 1⁄4 0.09, P 1⁄4 0.28), and cognitive function (r 1⁄4 0.02, P 1⁄4 0.8) were also not associated with pain intensity. There was however significant association between pain intensity and ECS-CP pain type (r 1⁄4 0.29, P 1⁄4 0.005), incidental pain(r 1⁄4 0.21, P 1⁄4 0.04), MEDD(R 1⁄4 0.23, P 1⁄4 0.02), and opioid rotation(r 1⁄4 0.32, P 1⁄4 0.002).

Concurrent validity of the CAGE questionnaire. The Nord-Trøndelag Health Study

The aim of this study was to examine the psychometric properties of the CAGE questionnaire, and the questionnaire's concurrent validity with current and previous alcohol consumption. This study employed data from the Nord-Trøndelag Health Survey wave 1 (HUNT-1 in 1984–86: N = 24,900) and wave 2 (HUNT-2 in 1995–97: N = 36,350). The concurrent validity of the CAGE questionnaire was examined both as a dichotomous variable with the recommended cut-off (≥2 affirmative answers) for alcohol problems, and as a categorical scale. The categorical scale was constructed by counting responses from 0 to 4, and a separate category for current abstainers in HUNT-2. Current self-reported consumption above the gender specific 80th percentile was defined as “current excessive consumption”. “Previous excessive consumers” were defined by meeting at least one of the two following criteria at the time of HUNT-1: reporting drinking too much alcohol in any period of their life, or reporting a high level of alcohol consumption. The internal reliability of CAGE was adequate, and in relation to alcohol consumption, there was a linear relationship between the CAGE score and both the current and previous excessive consumption. In conclusion, this study indicates good concurrent validity and adequate psychometric properties of the CAGE questionnaire. The dose–response pattern seen between the CAGE score and alcohol consumption, suggests that it can be used as an ordinal measure, rather than with a cut-off of two or more. The concurrent validity of the CAGE is better in women than in men.

Harmful alcohol consumption and patterns of substance use in HIV-infected patients receiving antiretrovirals (ANRS-EN12-VESPA Study): relevance for clinical management and intervention

Alcohol abuse affects secondary prevention and disease progression in HIV-infected patients, and adherence and response to treatment in those chronically treated. The objective of this study was to estimate the prevalence of harmful alcohol consumption (HAC) using various indicators and identify which groups of patients may require specific targeted interventions for HAC risk reduction. A cross-sectional survey, based on a random sample representative of people living with HIV/AIDS (PLWHA) was carried out in 102 French hospital departments delivering HIV care. As alcohol abuse is particularly detrimental to patients receiving highly active antiretroviral therapy (HAART), we focused only on those individuals receiving HAART with complete alcohol assessment (CAGE, AUDIT-C, regular binge drinking, N=2340). Collected information included medical and socio-demographic data, HIV risk behaviors, adherence to treatment and substance and alcohol use, together with depression, anxiety, and experience of attempted suicide or sex work. HAC prevalence was evaluated as follows: 12% (CAGE score ≥2), 27% (AUDIT-C), and 9% (regular binge drinking). Three groups were at higher risk of HAC: men who have sex with men using stimulants, polydrug users, and to a lesser degree, ex-drug users. Innovative intervention strategies to reduce HAC and improve HIV prevention and HAART adherence in various PLWHA populations need urgent testing and implementation. Such interventions for alcohol risk reduction remain central to promoting improved HIV prevention and assuring HAART effectiveness in these populations.

Problematic alcohol use and HIV risk among Black men who have sex with men in Massachusetts

This analysis was designed to explore the frequency of problem drinking and its role in potentiating HIV risk among a community-recruited sample of Black men who have sex with men (MSM) in Massachusetts. Black MSM (n=197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered survey, including HIV sexual behavior, the Center for Epidemiologic Studies Depression Scale (CES-D), and the CAGE alcohol screener. Bivariate and multivariable logistic regression procedures examined the association of behavioral HIV-risk factors and other psychosocial variables with problematic alcohol use (CAGE score 3 or 4). Overall, 29% of the sample was found to abuse alcohol. In a multivariable model adjusting for demographic and behavioral variables, factors associated with increased odds of problem drinking were: (1) depressive symptoms (CES-D 16+ ); (2) one or more episodes of serodiscordant unprotected anal sex during last sexual encounter with a casual male partner; and (3) one or more episodes of unprotected anal or vaginal sex with a female partner in the past 12 months. Black MSM who engaged in HIV risk behaviors may be more likely to have concurrent problematic alcohol use. HIV prevention interventions with Black MSM may benefit from incorporating screening and/or treatment for alcohol problems, as well as screening for co-morbid depressive symptoms.

Trace Elements Profile among Alcohol Abusers in a Nigerian Community

Alcohol abuse has been associated with Trace elements deficiencies which have been known to cause Neuro Psychiatric Disorders. The focus of this study being on locally brewed alcohol is to establish the pattern if any of trace elements derangements. The trace element profile among alcohol abusers in a Nigerian Community was analysed using the 4 – item CAGE instrument to separate alcohol abusers, social drinkers, and total abstainers. The Royal College of Physicians’ criteria 1987 for Alcohol abuse was also used to validate the CAGE score. Using the CAGE score, the following results were obtained, 50 Alcohol abusers (AOA), 47 Social Drinkers (SOD) and 45 Total Abstainers (TOA) emerged out of 162 subjects. Mean values obtained for Manganese (Mn), Zinc (Zn), Iron (Fe) and Copper (Cu) were 0.17 nmol/L, 9.03 umol/L, 27.46 umol/L and 25.44umol/L respectively. This showed that Mn, Fe and Cu were significantly increased while Zn was reduced significantly in alcohol abusers when compared with the control group of total abstainers. Excessive consumptionof burukutu seems to significantly alter the trace elements status in abusers. Duration of intake and excessive use of burukutu can be associated with both deficiency and toxicity of essential and heavy metals. Abstinence therefore should continue to be the main stay of counseling.

Prevalence of tobacco smoking in teachers following anti-smoking policies: results from two French surveys (1999 and 2005)

French public health policies aimed at reducing smoking were reinforced in France between 1999 and 2004 to decrease tobacco consumption. The consequences of these policies are of particular interest to teachers who play a role model for young people. Depression and alcohol problems were particularly studied as they may influence smoking behaviour. Two large cross-sectional health surveys conducted in 1999 (N = 2931) and 2005 (N = 3702) included teachers, aged 20-59 years. Smoking status, socio-demographic characteristics, history of depressive episode in the previous year and problems with alcohol were collected using self-administered postal questionnaires. From 1999 to 2005, the prevalence of smoking decreased significantly from 25.7 to 18.2% for men (P < 0.001), from 20.0 to 16.5% (P < 0.001) for women; and the proportion of never-smokers increased. In smokers, the number of cigarettes consumed per day decreased significantly. Multivariate analysis revealed a significant decrease of the risk of being a smoker in 2005 compared with 1999 [odds ratio (OR) = 0.68 for men; OR = 0.78 for women]. Risk factors of smoking were: men aged 20-34 years (OR = 1.81), CAGE score > or =2, (OR = 1.95 for men, 2.12 for women) history of a major depressive episode in the previous 12 months (OR = 1.46 for men, 1.44 for women). Anti-smoking policies resulted in a decrease of teachers' tobacco consumption between 1999 and 2005. However, people with more difficulties in quitting smoking, in particular people with depressive episodes or problems with alcohol, might benefit from comprehensive programmes, including training of health professionals.

Attached to the web — harmful use of the Internet and its correlates

Background and aims The aim of this study was to test the validity of the Finnish version of the Internet Addiction Test and the correlates of harmful use of the Internet. Methods One thousand eight hundred and twenty-five students (45.5% men and 54.5% women, mean age 24.7 years, S.D. = 5.7) filled in a web-based questionnaire including IAT, reasons for use of the Internet, distress, social support, and substance use. Results Men had a statistically significantly higher mean score on the IAT than women. Subjects with self-reported use of cannabis had higher mean score on the IAT compared to non-users (39.5 [11.3] vs 35.8 [10.8]). The total IAT score was associated with “adult entertainment” (OR = 1.07, 95%CI: 1.06–1.08, P < 0.001), “playing games” (OR = 1.05, 95%CI: 1.04–1.06, P < 0.001), “chatting” (OR = 1.07, 95%CI: 1.06–1.08, P < 0.001) and “discussion” (OR = 1.08, 95%CI: 1.07–1.09, P < 0.001) as reasons for Internet use. The IAT score had a significant negative correlation with social support ( r = −0.24, P < 0.001) and a significant positive correlation with the CAGE score ( r = 0.18, P < 0.001). Using factor analysis, we found a single factor solution with a Cronbach's α of 0.92. Conclusions The IAT seems to provide a valid measurement of harmful use of the Internet, as the score was significantly associated with variables tapping psychopathology.

α-Synuclein, alcohol use disorders, and Parkinson disease: A case–control study

Collaborative pooled analyses demonstrated that allele length variability of the dinucleotide repeat sequence within the α-synuclein gene promoter ( SNCA REP1) is associated with Parkinson disease (PD) worldwide. Other studies demonstrated that variability in the SNCA promoter is also associated with alcohol use disorders, but not consistently. Yet other studies demonstrated that alcohol use disorders are inversely associated with PD, but not consistently. The aim of this study was to clarify the patterns of association between REP1 genotype, alcohol use disorders, and PD. Cases were recruited from the Department of Neurology of the Mayo Clinic in Rochester, MN. The controls included unaffected siblings and unrelated controls. We assessed alcohol use via a structured telephone interview and screened for alcohol use disorders using the CAGE questionnaire. REP1 genotyping was performed using an ABI 3730XL platform. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using conditional logistic regression models. We recruited 893 case–control pairs. There was an increasing risk of PD with increasing SNCA REP1 allele length (OR 1.18 for each REP1 genotype score unit, 95% CI 1.02–1.35; p = 0.02). There was a decreasing risk of PD with increasing CAGE score ( p = 0.01). The association of REP1 score with PD remained significant after adjusting for CAGE score, and the association of CAGE score with PD remained significant after adjusting for REP1 score. There were no pairwise interactions. Our findings suggest that SNCA REP1 genotype and alcohol use disorders are independently associated with PD.

Alcohol consumption and attitudes towards banning alcohol sales on campus among European university students

The European Commission's new health strategy for improving health at the European Union (EU) level includes tackling alcohol consumption. This study aimed to assess the prevalence of alcohol consumption and problem drinking, as well as students' attitudes towards banning the sale of alcohol on campus. In total, 5826 students from universities in seven European countries (Denmark, Germany, Spain, Lithuania, Poland, Bulgaria and Turkey) took part in this cross-sectional study. A self-administered questionnaire assessed sociodemographic information, frequency of alcohol consumption, problem drinking and attitudes towards banning the sale of alcohol on campus. The highest prevalence of drinking alcohol more than once per week was reported in Bulgarian (males 46%, females 64%) and Spanish students (males 59%, females 64%). Among those students who drank alcohol (n=3170), problem drinking (CAGE score >1) was found in 24% of males and 13% of females. Male gender, depressive moods and a low importance of good grades at university were risk factors for drinking alcohol more than once per week as well as for problem drinking. There were substantial country differences in the proportion of students who would support a ban of alcohol sales on campus (23% in Denmark, 88% in Poland). Support for a ban was higher among female students and among students who drank alcohol once or less per week. Problem drinking is a concern among students in many European countries, especially among males. Students' support for banning the sale of alcohol on campus varies between countries and should be considered in developing EU policy.

Who is Ready to Change Illicit Drug Use Behavior: An Emergency Department Study

To identify emergency department patients who are ready to change their illicit drug use behavior. A cross-sectional study of 198 Emergency Department patients at least 18 years old, seeking emergency department services, using at least one illicit drug, and scoring positive for alcohol problem based on CAGE score ≥ 1. Of the patients, 46% were "not ready" to change their drug behavior, 21% and 33% were "unsure" and "ready", respectively. Our results identified that "Readiness to change alcohol behavior" [t (197) = 3.37, p ≤ 0.001], health insurance [t (197) = -3.011, p ≤ 0.003], number of drug use [t (197) = 2.88, p ≤ 0.004], and drug-related injury [t (197) = 1.98, p ≤ 0.049] were related to readiness to change illicit drug behavior. Our results re-iterate the need for intervention programs that focus on screening and treatment for both drugs and alcohol.

The Association Between Alcohol Consumption and Risk of COPD Exacerbation in a Veteran Population

Alcohol has been associated with COPD-related mortality but has not yet been demonstrated to be an independent risk factor for COPD exacerbation. Our objective was to evaluate the association between alcohol consumption and the subsequent risk of COPD exacerbation. A prospective cohort study of general medicine outpatients seen at one of seven Veterans Affairs (VA) medical centers who returned health screening questionnaires. Three screening questionnaires, AUDIT-C (0 to 12 points), CAGE (0 to 4 points), and a single item about the frequency of drinking six or more drinks on an occasion (binge drinking), were used to classify alcohol consumption. The main outcome, COPD exacerbation, was based on primary VA discharge diagnosis (International Classification of Diseases, Ninth Revision) or outpatient diagnosis of COPD accompanied by prescriptions for either antibiotics or prednisone within 2 days. Among the 30,503 patients followed up for a median of 3.35 years, those patients with AUDIT-C scores > or = 6, CAGE scores > or = 2, or who reported binge drinking at least weekly were at an increased risk of COPD exacerbation in age-adjusted analysis. Adjusted hazard ratios were 1.4 (95% confidence interval [CI], 1.1 to 1.7) for AUDIT-C score > or = 6, 1.4 (95% CI, 1.3 to 1.5) for CAGE score > or = 2, and 1.6 (95% CI, 1.2 to 2.2) for those who reported binge drinking daily or almost daily. However, with adjustment for measures of tobacco use, the association between alcohol consumption and increased risk of COPD exacerbation was no longer evident. Alcohol consumption, whether quantified by AUDIT-C, CAGE score, or binge drinking, was not associated with an increased risk of COPD exacerbation independent of tobacco use.

A Health Survey of a Colonia Located on the West Texas, US/Mexico Border

Little is known about how health disparities affect the health status and general health perceptions of Hispanics living in Texas colonias. The purpose of this study was to conduct a health survey of residents (n = 216) of a colonia community on the border between El Paso, Texas and Juarez, Mexico. Instruments used in this study included a researcher developed demographic questionnaire, the Short Acculturation Scale for Hispanics (SASH), Cutting down, Annoyance by criticism, Guilty feeling and Eye-openers (CAGE) for alcohol consumption, and the Short Form version 2 (SF36v2) health survey. Study findings show the average participant was approximately 42 years old, attained an average of 9.6 years of education, earned an average annual household income of $17,575 and had an average SASH score of 25.4. SASH scores range from 12 to 60, with higher scores suggesting higher levels of American acculturation. Findings from this health survey suggest the average resident of the colonia may have health disadvantages when compared to residents from other parts of El Paso and Texas. Binge drinking was self-reported by 13.4% of all participants; with 5.6% having a CAGE score greater than 2 (indicating an increased propensity towards problems with alcohol). The self-report rates of diabetes, depression and anxiety were 15.3%, 20.4% and 16.7% respectively. The SF36v2 composite functional health status scores mirrored the national norms.

The feasibility and effectiveness of a web-based personalised feedback and social norms alcohol intervention in UK university students: A randomised control trial

Objective Alcohol misuse amongst University students is a serious concern, and research has started to investigate the feasibility of using e-health interventions. This study aimed to establish the effectiveness of an electronic web-based personalised feedback intervention through the use of a randomised control trial (RCT). Methods 506 participants were stratified by gender, age group, year of study, self-reported weekly consumption of alcohol and randomly assigned to either a control or intervention condition. Intervention participants received electronic personalised feedback and social norms information on their drinking behaviour which they could access by logging onto the website at any time during the 12-week period. CAGE score, average number of alcoholic drinks consumed per drinking occasion, and alcohol consumption over the last week were collected from participants at pre- and post-survey. Results A significant difference in pre- to post-survey mean difference of alcohol consumed per occasion was found, with those in the intervention condition displaying a larger mean decrease when compared to controls. No intervention effect was found for units of alcohol consumed per week or for CAGE scores. Sixty-three percent of intervention participants agreed that the feedback provided was useful. Those intervention participants who were above the CAGE cut off were more likely to report that the website would make them think more about the amount they drank. Conclusions Delivering an electronic personalised feedback intervention to students via the World Wide Web is a feasible and potentially effective method of reducing student alcohol intake. Further research is needed to replicate this outcome, evaluate maintenance of any changes, and investigate the process of interaction with web-based interventions.

PREVALENCE OF AND RISK FACTORS ASSOCIATED WITH ALCOHOL ABUSE IN MOSHI, NORTHERN TANZANIA

This study aimed to assess the prevalence of and risk factors associated with alcohol abuse among women and men in Moshi in northern Tanzania. Alcohol abuse was measured by a CAGE score of 2-4, versus 0-1 for no alcohol abuse (Ewing, 1984). Crude and adjusted logistic regression models determined odds ratios (OR) and 95% confidence intervals (95% CI) of alcohol abuse by characteristics of, respectively, women with partners (n=1200), women without partners (n=614) and men (n=788) (women's partners). Prevalence of alcohol abuse was 7.0% (95% CI: 5.6-8.4) among women with partners, 9.3% (95% CI: 7.0-11.6) among women without partners, and more than double among men at 22.8% (95% CI: 19.9-25.8). In general, Christians had higher alcohol abuse than Muslims or other religions, as did Chagga men compared with men of other ethnic groups. Other socio-demographic characteristics, such as education or income, were not significant. Sexual behaviours were significant predictors of alcohol abuse. For example, women without partners who reported more than two partners in the last year had higher alcohol abuse compared with women reporting no partners (OR=8.75; 95% CI: 2.37-32.31), as did men reporting it is 'OK to hit a partner' for any reason (OR=1.79; 95% CI: 1.16-2.77) compared with men who did not. HIV-1 infection was not significantly associated with alcohol abuse by women or men. The Christian Church in Moshi should consider raising awareness about the harmful effects of high alcohol use among its adherents. Comprehensive programmes focusing on reducing number of partners and alcohol use, particularly by men, are needed in this community.

Positive CAGE Screen Correlates with Cirrhosis in Veterans with Chronic Hepatitis C

The current study examines the relationship between problem alcohol use and severity of liver disease by self-administered questionnaires using both the CAGE questionnaire and beverage-specific quantity-frequency questions. The cohort consisted of 38 patients with cirrhosis (10 with decompensated liver disease) and 62 with mild fibrosis (stage 0-1), of comparable mean age and estimated duration of infection. Although mean alcohol consumption was similar in both groups, a positive CAGE screen (defined as two or more affirmative answers) was significantly more common among cirrhotics (OR = 5.24; 95% CI, 1.78-15.39) and tended to be associated with decompensated liver disease (OR = 13.3; 95% CI, 0.67-256) among cirrhotics. In multivariate analysis, only inflammatory grade on liver biopsy (OR = 67.7; 95% CI, 10.6-431) and positive CAGE score (OR = 8.09; 95% CI, 1.15-57.1) were independent predictors of cirrhosis. These findings suggest that the CAGE questionnaire predicts advanced liver disease better than daily or lifetime drinking measures.