Prevalence and factors associated with substance abuse among people aged 10-24 in Malaba Town, Tororo District, Eastern Uganda

Abstract

Background: Research has demonstrated that substance abuse among young people has increased considerably in the recent years and Uganda is no exception. Besides the economic burden, some communities in Uganda face a rapidly growing population of drug users among young people in households, and those with no decent homes. Many young people have become innovative focusing on the most readily available and easily accessible harmful substances as a way of getting intoxicated. Objectives: This study aimed at determining the prevalence and factors associated with substance abuse. In addition, the study also explored motivating factors and lived experiences of young people who abused substances in Malaba town, Tororo district. Method: This was a household cross-sectional study conducted from February 29 to April 20, 2020 among people aged 10-24 years in Malaba town council, Tororo district Eastern Uganda. Participants were selected by multi-stage sampling using a modified WHO structured questionnaire on substance abuse among out-of-school children. Bivariate and multiple regression analyses were performed using the modified Poisson to identify factors associated with substance abuse. Thematic analysis was used to analyze qualitative data on motivating factors and lived experience of Inhalant users. Results: A total of 662 young people participated in the study with a response rate of 96%. Current prevalence of substance abuse among young people was 43.2%. The lifetime prevalence and last month prevalence were; 24.5%, 82.1% for solvent inhalants, 28.1%, 90% for khat and 17.7%, 93.2% for marijuana respectively. History of child abuse (APR=0.84; 95%CI: 0.7001-0.989), father’s level of education: Primary level (APR=0.74; 95%CI: 0.616-0.895); secondary or higher (APR=0.81; 95%CI: 0.664-0.982), Belong to peer (APR=1.51; 95%CI: 1.257-1.8095), friends who use drugs (APR=1.75;95%CI:1.401-2.191) and, easy access to drug (APR=2.0;95%CI:1.521-2.633) were factors associated with substance abuse. Motivating factors to inhalant use were; easy access and low cost, peer influence, coping with stressful life events, being out of school, idleness and curiosity. Lived experiences included: community discrimination and social stigma, poor academic performance and ill-health. Conclusion: The proportion of young people who use substances is high in Malaba town council for the three substances demonstrated. Khat is the most abused substance followed by solvent inhalants. Individual, family and social factors are important in determining substance abuse among young people. In addition, inhalant users are motivated by easy access to inhalants, peer influence, stressful life events, idleness, curiosity and being out of school. Early interventions addressing this public health burden should aim at changing the child’s life trajectory away from risk factors but towards positive behavior. The prevention programs should in addition address all forms of substance abuse, alone or in combination including use of illegal substances (khat and marijuana) among under-age and strict control of inappropriate use of legally obtained substances such as, glue, petrol, aviation fuel. In order to effectively achieve the UN’s sustainable development goal 3.5 that is, to prevent and treat substance abuse, a combination of key informant and in-depth interview guide a long quantitative methods is likely to establish a better understanding on community motivating factors and individual beliefs about solvent inhalants. This would further result in establishment of community interventions that specifically target young people who abuse other substances.