Magnitude and Burden of Substance Use Disorders Among Adolescents in Eastern Sub-Saharan Africa: Regional Analysis From Global Burden of Diseases 1990 to 2023
Sebsibe Tadesse, Miesa Gelchu, Wolyu Korma, Abdulbasit Sherfa, Yohannes Addisu Wondimagegne, Anteneh Berhane, Hagos Tesfay Medhin, Abadi Hailay Atsbaha, Embay Amare Alemseged, Yonas Angaw, Angefa Ayele, Gemechis Tuke, Hailu Lemma, Lechisa Asefa, Abinet Zewudie, Geleta Nenko Dube, Debela Tsegaye, Gedeno Karbana, Anteneh Fikrie Tekola, Gelgelo WodessaBackground
Substance use disorders are chronic conditions characterized by compulsive substance use despite adverse health consequences. However, low-resource settings have limited epidemiological data to inform policies. This study estimated the extent and impact of substance use disorders among adolescents in the Eastern Sub-Saharan African region from 1990 to 2023.
Methods
The Global Burden of Diseases 2023 estimates, computational techniques, and tools were applied. Disease modelling with a Bayesian meta-regression (DisMod-MR 2.1) was used to estimate non-fatal health outcomes, while the cause of death ensemble model (CODEm) was employed to estimate the fatal health outcomes. Estimates were smoothed by applying the spatiotemporal Gaussian process regression (ST-GPR).
Results
In 2023, there were an estimated 1135 prevalent cases per 100,000 adolescents (95% UI: 821-1510), 514 incident cases per 100,000 adolescents (95% UI: 360-697), 100 years lived with disability per 100,000 adolescents (95% UI: 62-147), 4 years of life lost per 100,000 adolescents (95% UI: 3-5), and 104 disability-adjusted life years per 100,000 adolescents (95% UI: 66-150). Males had higher rates than females in most countries. Except for an increase in disability-adjusted life years, the other rates remained stable between 1990 and 2023. Most rates increased in Eritrea and Ethiopia.
Conclusion
This study indicated that substance use disorders caused substantial morbidity and disability among adolescents in the Eastern Sub-Saharan African region over the past three decades. Moreover, males consistently experienced a greater health burden than females. Thus, gender-responsive interventions, integration of early detection, treatment, and rehabilitation services into primary healthcare, coordination of region-wide surveillance systems, and cross-border substance control can be recommended.