Epidemiology of harmful use of alcohol in Nigeria: a systematic review and meta-analysis

<i>Background</i>: Nigeria, the most populous country in Africa, has reported relatively high levels of alcohol misuse, yet limited resources to guide effective population-wide response. There is a need to integrate existing empirical information in order to increase the power and precision of estimating epidemiological evidence necessary for informing policies and developing prevention programs. <i>Objectives</i>: We aimed to estimate nationwide and zonal prevalence of harmful use of alcohol in Nigeria to inform public health policy and planning. <i>Methods</i>: Epidemiologic reports on alcohol use in Nigeria from 1990 through 2018 were systematically searched and abstracted. We employed random-effects meta-analysis and meta-regression model to determine the number of harmful alcohol users. <i>Results:</i> 35 studies (n = 37,576 Nigerians) were identified. Pooled crude prevalence of harmful use of alcohol was 34.3% (95% CI: 28.6–40.1); twice as high among men (43.9%, 31.1–56.8) compared to women (23.9%, 16.4–31.4). Harmful alcohol use was higher in rural settings (40.1%, 24.2–56.1) compared to urban settings (31.2%, 22.9–39.6). The number of harmful alcohol users aged ≥15 years increased from 24 to 34 million from 1995 to 2015. However, actual age-adjusted prevalence of harmful use of alcohol in Nigeria decreased from 38.5% to 32.6% over the twenty-year period. <i>Conclusions</i>: While the prevalence of the total population that drinks harmfully appears to be dropping, absolute number of individuals that would be classified as harmful drinkers is increasing. This finding highlights the complexity of identifying and advocating for substance abuse policies in rapidly changing demographic settings common in Africa, Asia, and other developing countries.

背景：作为非洲人口最多的国家，尼日利亚的酒精滥用报告水平相对较高，但用于指导全人群有效应对的资源却较为有限。当前亟需整合现有实证研究信息，以提升用于制定政策、开发预防项目所需的流行病学证据的估计效力与精度。
研究目标：本研究旨在估算尼日利亚全国及各区域的有害酒精使用患病率，为公共卫生政策制定与规划提供依据。
研究方法：系统检索并摘录1990年至2018年间发表的关于尼日利亚酒精使用情况的流行病学报告。本研究采用随机效应荟萃分析（random-effects meta-analysis）与元回归模型（meta-regression model），以估算有害酒精使用者的规模。
研究结果：最终纳入35项研究，共涉及37576名尼日利亚受试者。有害酒精使用的合并粗患病率为34.3%（95%置信区间：28.6%~40.1%）；男性有害酒精使用患病率（43.9%，95%CI：31.1%~56.8%）约为女性（23.9%，95%CI：16.4%~31.4%）的2倍。农村地区有害酒精使用患病率（40.1%，95%CI：24.2%~56.1%）高于城市地区（31.2%，95%CI：22.9%~39.6%）。1995年至2015年间，15岁及以上有害酒精使用者的绝对数量从2400万增至3400万；但同期尼日利亚经年龄调整后的有害酒精使用患病率从38.5%下降至32.6%。
研究结论：尽管全人群有害酒精使用的患病率呈下降趋势，但被归类为有害饮酒者的绝对人数却在增加。这一发现凸显了在非洲、亚洲及其他发展中国家普遍存在的快速变化的人口结构背景下，识别并推动药物滥用政策的复杂性。