PUBLICATION: Child Adolescent Psychiatry Mental Health
Kabiru, C.W., Beguy, D., Crichton, J., Ezeh, A.C.
Background: Consumption of alcohol is associated with acute and chronic adverse health outcomes. There is a
paucity of studies that explore the determinants of alcohol use among adolescents in sub-Saharan Africa and, in
particular, that examine the effects of adverse childhood experiences on alcohol use.
Methods: The paper draws on nationally-representative data from 9,819 adolescents aged 12-19 years from Burkina
Faso, Ghana, Malawi, and Uganda. Logistic regression models were employed to identify correlates of self-reported
past-year drunkenness. Exposure to four adverse childhood experiences comprised the primary independent variables:
living in a food-insecure household, living with a problem drinker, having been physically abused, and having been
coerced into having sex. We controlled for age, religiosity, current schooling status, the household head’s sex, living
arrangements, place of residence, marital status, and country of survey. All analyses were conducted separately for
males and females.
Results: At the bivariate level, all independent variables (except for coerced sex among males) were associated with
the outcome variable. Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the
survey. In general, respondents who had experienced an adverse event during childhood were more likely to report
drunkenness. In the multivariate analysis, only two adverse childhood events emerged as significant predictors of selfreported past-year drunkenness among males: living in a household with a problem drinker before age 10, and being
physically abused before age 10. For females, exposure to family-alcoholism, experience of physical abuse, and coerced
sex increased the likelihood of reporting drunkenness in the last 12 months. The association between adverse events
and reported drunkenness was more pronounced for females. For both males and females there was a graded
relationship between the number of adverse events experienced and the proportion reporting drunkenness.
Conclusions: We find an association between experience of adverse childhood events and drunkenness among
adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young
people’s development and behavior may have an important bearing on the effectiveness of interventions geared at
reducing alcohol dependence among the youth.
Alex joined APHRC in 1998 (then a program of the Population Council in Nairobi) as a Senior Research Fellow. In 2000, he was appointed APHRC’s Interim Director and charged with the responsibility of leading its...