Table 2. Studies reporting on the epidemiology of substance use or SUDs.
| Author, Year | Study design | Study population/study setting | Sample size | Age; gender distribution | Substance(s) assessed | Standardized tool/criteria used | Main findings (prevalence, risk factors, other key findings) |
|---|---|---|---|---|---|---|---|
| Dhadphale et al. 1982 [12] | Cross-sectional | Students (Secondary school) | 2870 | Age range: 14–20 years Male to female ratio 2:1 |
Alcohol, tobacco, cannabis | None | Prevalence of tobacco use 3 or more times a
week—16.1% Prevalence of alcohol use 3 or more times a week—10.3% Prevalence of cannabis use was 13.5% at a rate of 1 time per month |
| Omolo & Dhadphale 1987 [36] | Cross-sectional | General patients (Hospital) | 100 | Age distribution not reported Males 50% |
Khata | None | Lifetime prevalence khat use was
29%. Mild and moderate chewing significantly associated with age < 20 years (p<0.001) |
| Nielsen et al. 1989 [161] | Cross-sectional | Outpatients (Hospital) | 112 | 18–65 years Males 50% |
Alcohol | DSM-III | 30 patients met the criteria for both
alcohol abuse and alcohol dependence. 8 patients received a diagnosis of alcohol abuse only and 6 patients received a diagnosis of alcohol dependence only. 39% of the sample exceeded the cut off score for one or both DSM diagnoses |
| Kaplan et al. 1990 [106] | Cross-sectional | Adults (Community) | Not indicated | Age range: 20–40 years Gender distribution not reported |
Tobacco | None | Highest prevalence lifetime tobacco smoking
was by luo community: 63% males and 67%
females Reasons for smoking: positive feelings, to work harder |
| Hall et al. 1993 [93] | Cross-sectional | General patients (Hospital) | 105 | Mean age: 35.4 years Males 78.1% |
Alcohol | DSM-III-R/ ICD-I0. | Prevalence of weekly alcohol use was 48% |
| Saunders et al. 1993 [188] | Cross-sectional | General patients (Hospital) | Country specific sample size not reported | Country specific demographics not reported | Alcohol | None | Prevalence of alcohol use for Kenya ->40g per day was 43%, and >60g per day was 37% |
| Dhadphale 1997 [27] | Cross-sectional | Psychiatric patients (Hospital) | 220 | Age range: 18–55 years Males 50.9% |
Alcohol | MAST and ICD-9 criteria | Lifetime prevalence of alcohol use among patients with psychiatry morbidity was 12.7% (and 3.1% of those attending outpatient care) |
| Othieno et al. 2000 [168] | Cross-sectional | General patients (Hospital) | 150 | Modal age group: 20–39 years Males 50% |
Alcohol, tobacco, khat, cannabis, methaqualone | DSM IV Criteria | Lifetime prevalence: alcohol use (56.7%),
tobacco use (32%), khat use (10.7%), cannabis use
(5.3%), methaqualone use (0.7%) Alcohol use (p = 0.000), tobacco use (p = 0.000), khat use (p = 0.045), cannabis use (p = 0.004) associated with being male |
| Ayaya et al. 2001 [74] | Case-control | Children living in the streets | 191 | Mean age: 14.03 (SD2.4) Gender distribution not reported |
Alcohol, tobacco, cannabis, glue, cocaine | None | Prevalence for drug abuse was 545 per 1000
children. Specific substance prevalence: tobacco 37.6%; sniffing glue 31.2%; alcohol 18.3%; cannabis 8.3%; and sniffing cocaine 4.6% Reasons for substance use included peer pressure, to get drunk, to feel better and to feel warm |
| Kwamanga et al. 2001 [124] | Cross-sectional | Teachers (School) | 800 | Median age: 35 years, Males 74.5% |
Tobacco smoking | WHO standard self- administered questionnaire | 50% of males and 3% of females reported
tobacco smoking. Peer pressure (63%) and advertisements (21%) are major drivers of smoking |
| Christensen et al. 2009 [81] | Cross-sectional | Adults (Community) | 1179 | Mean age: 38.6 years Males 42% |
Alcohol, tobacco | None | Tobacco use was 6.6% in females and 16.2%
in males; Alcohol use was 5.4% in females and 20.9% in
males Daily alcohol use in males associated with glucose intolerance (p<0.01) |
| Kwamanga et al. 2003 [125] | Cross-sectional | Students (Secondary school) | 5311 | Mean age: 16.7 years, Males 68.1% |
Tobacco smoking | A WHO standard self- administered questionnaire | Prevalence of current smoking was 10.5%. A
total of 12.4% of male students and 6.4% of female
students were current smokers. Smoking associated with older age (p<0.001), being in a private school (p<0.001). Reduced odds of stopping smoking with increase in number of tobacco smoked (OR 0.22; 95% CI = 0.19, 0.26; p<0.001) |
| Maru et al. 2003 [30] | Cross-sectional | Children and youth (Juvenile court) | 90 | Age range: 8–18 years Males 71.1% |
Alcohol, khat, tobacco, volatile hydrocarbons, sedatives, cannabis | None | Overall prevalence of substance use 43.3%.
Tobacco 32.2%; volatile hydrocarbons 21.1%; cannabis
8.9%; alcohol 6.7%; khat 5.6%; sedatives
3.3% Substance use associated with being male (p = 0.0134) |
| Ogwell et al. 2003 [163] | Cross-sectional | Pupils (Primary school) | 1130 | Mean age: 14.1 (SD 0.9) years Males 52% |
Tobacco | None | Lifetime tobacco use was 31%, lifetime use
of smokeless tobacco was 9%, 55% had friends who
smoked Rates of lifetime smoking higher in urban than in suburban students (p<0.005) |
| Astrom et al. 2004 [71] | Cross-sectional | Pupils (Primary school) | 1130 | Mean age: 14.1 (SD 0.9) years Males 52% |
Tobacco | None | Tobacco smoking; 31% reported ever smoking
tobacco Sources of anti-tobacco messages: broadcast media (47%), Newspapers and magazines (45%), schoolteachers (32%), health workers (29%) |
| Kamotho et al. 2004 [105] | Cross-sectional | Patients undergoing coronary angiography (Hospital) | 144 | Coronary artery disease (CAD): Mean age: 54.4 years, male to female ratio -5.5:1; No CAD: Mean age: 49.8 years, male to female ratio 2.3:1 |
Alcohol, tobacco smoking, | None | CAD: Smoking prevalence 15.4%, alcohol
32.7; No CAD: smoking prevalence 13.0%, alcohol
36.9% There was no difference in prevalence of smoking (p = 0.227) and alcohol use (p = 0.67) between those with CAD and those without |
| Shaffers et al. 2004 [191] | Cross-sectional | General patients (Hospital) | 299 | Mean age: 38 (SD 8) years Males 55% |
alcohol | AUDIT | Prevalence of hazardous drinking 53.5%,
(males 76. %, female 25%), Being male associated with hazardous drinking (p = 0.01) |
| Aden et al. 2006 [23] | Cross-sectional | Adults (Community) | 50 | Age range: 15–34 years Males 80% |
Khat | None | Prevalence of khat use was 88% |
| Beckerleg et al. 2006 [76] | Cross- sectional | Adults (Community) | 496 | Age data not given Males 95% |
Heroin | None | Prevalence of lifetime heroin injection was
15%; current injection was 7% Average number of years of heroin use was 11.1 years |
| Macigo et al. 2006 [32] | Case-control | Adults and adolescents (Community) | 226 | Age: 15 years and above Males 100% |
Tobacco | None | Smoking tobacco was associated with development of oral leukoplakia among those who brushed (RR 4.6 95%CI 2.9–5.1 p<0.001) and those who did not brush teeth (RR 7.3 95%CI 3.6–16.3 p<0.001) |
| Cleland et al. 2007 [82] | Cross-sectional | PWID use (Community) | 106 | Mean age (SD): Males 29 [7];
Female 28 [8] Males 87% |
Injection drugs (not specified) | None | Receptive sharing 26% Distributive sharing 41% |
| Kanyanya et al. 2007 [31] | Cross-sectional | Inmates (Prison) | 76 | Mean age: 33.5 years Males 100% |
alcohol | DSM-IV Criteria | 71.1% had lifetime abuse or dependence of alcohol |
| Rudatsikira et al. 2007 [186] | Cross-sectional study | Pupils (Primary school) | 242 | Age: 54.3% aged >15 years Gender distribution: males 55.7% |
Alcohol, tobacco smoking, other drugs (not specified) | None | Lifetime use: alcohol 10.7%, smoking 10.3%,
other drugs 8.4% Past month use: alcohol 9.1%, smoking 6.0% The risk factors for having sex among males were: ever smoked (OR = 2.05, 95%CI 1.92, 2.19), currently drinking alcohol (OR = 1.13, 95%CI 1.06, 1.20), ever used drugs (OR = 2.36, 95%CI 2.24, 2.49) and among females ever used drugs (OR = 2.85, 95%CI 2.57, 3.15). |
| Sanders et al. 2007 [187] | Cross-sectional study | Men who have Sex with Men Exclusively
(MSME) and Men who have Sex with both Men and Women
(MSMW) (Community) |
285 | Median age (IQR): MSME 27 [23–29]; MSMW 28[23–35] all males |
Injection drugs (not specified) | None | Prevalence of IV drug use among MSME was 0.9% and among MSMW was 1.8% |
| Ndetei et al. 2008 [28] | Cross-sectional | Psychiatric Patients (Hospital) | 691 | 78% aged between 21–45 years Males: 63% |
Alcohol, opioid, sedatives, khat | SCID-I for DSM IV | Prevalence substance abuse disorder—34.4%.
Alcohol use disorder (52%), opiate use disorder (55.5%),
sedative use disorder (71.4%), khat use disorder
(58.8%) Leisure, stress and peer pressure were the most common reasons given for abusing substances |
| Ndetei et al. 2008 [152] | Cross-sectional | Adults (Community) | 1420 | Mean age: 29.2 years Gender distribution not reported |
Alcohol, tobacco, khat, cocaine, heroin, sedatives, opioids, inhalants, phencyclidine, prescription pills, amphetamines | None | Alcohol use prevalence was 36.3% and
cocaine 2.2% (most and least abused substances
nationally). Prevalence of other substances not
stated. Reasons for substance use: leisure, stress and peer pressure |
| Thuo et al. 2008 [26] | Cross-sectional | Psychiatric Patients (Hospital) | 148 | Mean age: 31 years Males nearly two-thirds |
Alcohol | SCID for DSM IV | More males (n = 39) than
females (n = 6) were abusing substances
(p<0.001); Significant associations between PDs and substance abuse dependence (p<0.001) |
| Komu et al. 2009 [116] | Cross-sectional | Students (University) | 281 | Age data not given Males 60.4% |
Tobacco smoking | None | Prevalence of current tobacco smoking was 12.1% and lifetime prevalence was 38% |
| Ndetei et al. 2009 [153] | Cross-sectional | Students (Secondary school) | 1252 | Mean age: 17 years males 62.5% |
Alcohol, tobacco, amphetamines, sedatives, cannabis, hallucinogens, cocaine, methaqualone, ecstasy, heroin, inhalants. | School Toolkit by UNODC | Lifetime smoking reported by 25,3%, daily
smoking reported by 3.9% Lifetime use: alcohol 19.6%; heroin 4.0%, amphetamines 18.3%, sedatives 7.0%, cannabis 7.1%, hallucinogen 4.1%, cocaine 4.2%, mandrax 4.0%, ecstasy 4.0%, inhalants 6.6% Age at first use as low as below 11 years |
| Ndetei et al. 2009 [154] | Cross-sectional | Students (Secondary school) | 1328 | Mean age: 16 years Males 58.9% |
Not specified | DUSI-R | Prevalence of substance abuse was 33.9% but
substances not specified Substance use associated with psychiatric morbidity, school performance, social competence, peer relations, involvement in recreation, behavior problems (p<0.001 in each case). |
| Nguchu et al. 2009 [159] | Cross-sectional | Patients with diabetes (Hospital) | 400 | Mean age: 63.3 years Males 60% |
Tobacco smoking | None | Prevalence of tobacco smoking was 8.4% |
| Peltzer et al. 2009 [180] | Cross-sectional | Students (School) | 2758c | 13–15 years Country specific gender distribution not reported |
Alcohol, tobacco, illicit drugs (not specified) | Global School-Based Health Survey questionnaire | Prevalence tobacco use 17.5%, illicit drug use 9.5%, risky drinking 4.7% |
| Ndetei et al. 2010 [34] | Cross-sectional | Students (Secondary school) | 343 | Mean age: 16.8 years Males 64.1% |
Alcohol, tobacco, cannabis, khat, cocaine, heroin | None | Alcohol, tobacco, khat and cannabis were
the most commonly reported substance of use, with user
prevalence rates of 5.2%, 3.8%, 3.2%, and 1.7%, respectively. |
| Tegang et al. 2010 [195] | Cross-sectional | FSWs (Community) | 297 | Median age 25 (IQR 21–29) All female |
Tobacco smoking, khat, alcohol, heroin | None | Lifetime prevalence:91% for alcohol, 71%
for khat, 34% for cannabis, and 6% for
heroin, cocaine, glue or petrol. Lifetime prevalence of at least one substance was 96%, at least two substances 80% Lifetime use khat associated with age at first paid sex of <20 years (p<0.01); lifetime use tobacco associated with engagement in sex work of >5years (p<0.05); lifetime use heroin/cocaine/ glue/petrol associated with sex with 2 or more partners (p<0.005). |
| Atwoli et al. 2011 [72] | Cross-sectional | Students (University) | 500 | Mean age: 22.9 (SD2.5) Males 52.2% |
Alcohol, tobacco | WHO Model Core Questionnaire | Alcohol use: lifetime prevalence was 51.9%;
Current prevalence was 50.7%; Among those using alcohol,
50.4% used 5 or more drinks per day, on 1 or 2 days and
9.2% used for3 or more days. Lifetime tobacco smoking was 42.8%; cannabis (2%), cocaine (0.6%). Tobacco use higher among males compared to females (p < 0.05). 75.1% introduced to substances by a friend Reasons for use: to relax (62.2%) or relieve stress (60.8%). |
| Kinoti et al. 2011 [114] | Cross-sectional | Adults (Community) | 217 | Mean age: 34.2 years males 70.5% |
Alcohol, khat | None | Prevalence of use for bottled beer: 64.8%;
local brew– 41.6%; khat chewing– 41.6%; cannabis
-13.7% Males significantly more likely to use bottled beer (p<0.01) and local brew (p<0.01) and khat (p<0.01) Unemployment associated with use of bottled beer (p<0.05) and local brew (p<0.01) and khat (p<0.01) |
| Luchters et al. 2011 [129] | Cross-sectional | MSW (Community) | 442 | Mean age: 24.6 (SD 5.2) All males |
Alcohol and others (Khat, rohypnol, heroin or cocaine) | AUDIT | Alcohol: overall prevalence of use 70%; 35%
of participants who drink had hazardous drinking, 15%
harmful drinking and 21% alcohol
dependence. Binge drinking prevalence of 38.9% Prevalence of other substances (khat 75.5%, cocaine/heroin 7.7%, rohypnol 14.9%) Alcohol dependence was associated with inconsistent condom use (AOR = 2.5, 95%CI = 1.3–4.6), penile or anal discharge (AOR = 1.9, 95% CI = 1.0–3.8), and two-fold higher odds of sexual violence (AOR = 2.0, 95%CI = 0.9–4.9). |
| Muture et al. 2011 [148] | Case-control | Cases were patients on treatment for tuberculosis (Hospital) | 1978 cases and 945 controls | Mean age/age range: mean 31.2 years for
cases and 29.5 years for controls Males 59.4% in cases and 53% of controls |
Alcohol | None | Alcohol abuse was found to be a predictive factor for defaulting from TB treatment (OR 4.97; CI 1.56–15.9). |
| Ndugwa et al. 2011 [156] | Cross-sectional | Adolescents living in an informal settlement (community) | 1722 | Mean age: 12–19 years Males 47.2% |
Alcohol, tobacco, miraa, glue illicit drugs (not specified) | MPBI | Lifetime prevalence of alcohol use was 6.0%; tobacco smoking was 2.6%; other illicit drugs (not specified) 6.8% |
| Peltzer et al. 2011 [181] | Cross-sectional | Pupils (Primary school) | Mean age/range: 13–15 years Gender distribution: 47.7% |
Tobacco smoking | GSHS core questionnaire | Lifetime smoking prior to age 14 years
reported by 15.5% (20.1% boys and 10.9%
girls) early smoking initiation was among boys associated with ever drunk from alcohol use (OR = 4.73, p = 0.001), ever used drugs (OR = 2.36, p = 0.04) and ever had sex (OR = 1.63, p = 0.04). Among girls, it was associated with higher education (OR = 5.77, p = 0.001), ever drunk from alcohol use (OR = 4.76, p = 0.002), parental or guardian tobacco use (OR = 2.83, p = 0.001) and suicide ideation (OR = 2.05, p = 0.02) |
|
| Embleton et al. 2012 [85] | Cross-sectional | Children living in the streets | 146 | Age range: 10–19 Males 78% |
Alcohol, glue, tobacco, cannabis, khat, prescription medication, petrol | None | Lifetime substance use was 74%, current
substance use was 62% Lifetime and current prevalence for specific substances respectively was: glue 67%, 58%; alcohol 47%, 16%; tobacco 45% 21%; khat 33%,7%; cannabis 29%,11%; petrol 24%,5%; and pharmaceuticals 8%,<1% Factors associated with having any lifetime drug use were increasing age (adjusted odds ratio [AOR] = 1.47, 95% CI = 1.15–1.87), having a family member who used alcohol, tobacco, or other drugs (AOR = 3.43, 95% CI = 1.15–10.21), staying in a communally rented shelter (AOR = 3.64, 95% CI = 1.13–11.73), and being street-involved for greater than 2 years (AOR = 3.69, 95% CI = 1.22–11.18). |
| Kuria et al. 2012 [120] | Cross-sectional | Persons with alcohol use disorder in an informal settlement (community) | 188 | Mean age: 31.9 years Male 91.5% |
Alcohol | CIDI, ASSIST and AUDIT | Tobacco—50% of the
participants Cannabis—21.3% There was a statistically significant association (P value 0.002) between depression and the level of alcohol dependence at intake. And at 6 months |
| Menach et al. 2012 [136] | Case-control | Cases were adults with laryngeal cancer (Hospital) | 100 (50 cases, 50 controls) | Mean age: 61years in cases and 63years in
control group 96% males |
Alcohol, tobacco | None | Being a current smoker
increased laryngeal cancer risk with an odds ratio (OR) of 30.4 (P < 0.0001; 95% CI: 8.2–112.2). |
| Ndetei et al. 2012 [155] | Cross-sectional | Psychiatric Patients (Hospital) | 691 | Schizoaffective disorder: Mean age 33.1 years; Males 52.2% Schizophrenia mean age: 33.5 years; Males:62.9% Mood disorders: mean age 33.2 years; Males: 58.4% |
Alcohol, drugs (not specified) | SCID-I for DSM IV | Comorbidity with alcohol dependence disorder was more common in schizoaffective disorder than with schizophrenia (p = 0.008) |
| Ayah et al. 2013 [73] | Cross-sectional | Adults living in informal settlements (community) | 2061 | Mean age 33.4 years Males 50.9% |
Alcohol, tobacco | WHO STEPS survey instrument | Tobacco use Current smoking 13.1% of whom 84.8% were daily smokers. The mean age of smoking commencement and duration of smoking was 19.7 years and 16.5 years Respectively Alcohol use Lifetime prevalence 30%, of whom 74.9% used in past 12 months and 62.2% in the previous 30 days Daily use was 19.7% and use 1–6 days per week among 43.4% Duration of smoking (p = 0.001) and number of pack years(p = 0.049) associated with diagnosis of diabetes |
| Embleton et al. 2013 [86] | Mixed-methods (cross-sectional and qualitative) | Children living in the streets | 146 | Age range: 10–19 years males 85% |
Alcohol, glue, tobacco, khat, cannabis, petrol, prescription medication | None | Prevalence of substance use was as follows: glue 67%; alcohol 47%; tobaccos 45%; khat 33%; cannabis 29%; petrol 24%; and pharmaceuticals 8%; |
| khasakala et al. 2013 [108] | Cross-sectional | Youth attending an out-patient clinic (Hospital) | 250 | Mean age: 16.92 years Males 59.1 |
Alcohol, other substances (not specified) | MINI (DSM IV) | Any drug use prevalence was
62.4% Alcohol abuse prevalence was 47.8% associations between major depressive disorders and any drug abuse (OR = 3.40, 95% CI 2.01 to 5.76, p < 0.001), or alcohol use (OR = 3.29, 95% CI 1.94 to 5.57, p < 0.001), |
| khasakala et al. 2013 [109] | Cross-sectional | Youth and biological parents attending a youth clinic (Hospital) | 678 (250 youth, 226 biological mothers, 202 biological fathers) | Mean age youth 16.92years males 59.1% (youth) |
Alcohol, other substances (not specified) | MINI (DSM IV) | Alcohol use—46.8% of youth, 1.2% mothers
and 39.2% of fathers Multiple drug use identified in 9% of youth Significant statistical association between alcohol abuse (p <0.001), substance abuse (p < 0.001) and suicidal behaviour in youths. |
| Kinaynjui & Atwoli 2013 [115] | Cross-sectional | Inmates (Prison) | 395 | Mean age: 33.3 years Males 68.6% |
Alcohol, tobacco, cannabis, amphetamines, inhalants, sedatives, tranquillizers, cocaine, heroin. | WHO Model Core questionnaire | Lifetime prevalence of any substance use
was 66.1% Lifetime prevalence: alcohol 65.1%, tobacco use 32.7%, tobacco chewing 22.5% admitted to chewing tobacco, cannabis 21%, amphetamines (9.4%), volatile inhalants (9.1%), sedatives (3.8%), tranquillizers (2.3%), cocaine (2.3%), and heroin (1.3%). Substance use associated with male gender (p<0.001), urban residence (p<0.001). |
| Lo et al. 2013 [128] | Cross-sectional | Adults (Community) | 72292 | Modal age group: 18–29 years males 43.1% |
Alcohol, tobacco | None | Prevalence of ever smoking was 11.2% and of
ever drinking, 20.7%. Percentage of current smokers rose with the number of drinking days in a month (P < 0.0001). Tobacco and alcohol use increased with decreasing socio-economic status and amongst women in the oldest age group (P < 0.0001). |
| Mundan et al. 2013 [142] | Cross-sectional | Military personnel attending a clinic (Hospital) | 340 | Mean age: hypertensives 45.1(SD 7.7);
normotensive 40.8 (SD 7.3) Males 91.6% |
Alcohol, tobacco | None | Alcohol use in 63% of hypertensive patients and 52.07% of normotensive patients Smoking prevalence was 11% among those with hypertension and 4.2% among normotensives. hypertension associated with daily (P < 0.01) and 1–3 times per week (P < 0.05), consumption of alcohol daily Smoking duration is significantly (P < 0.05) longer among participants with hypertension compared to normotensives. |
| Njoroge et al. 2017 [162] | Cross-sectional study | ART-naïve HIV-1 sero-discordant couples attending a clinic (Hospital) | 196 (99 HIV-infected and 97 HIV-uninfected) | Median age 32 years Males 50% |
Tobacco, smoking | None | Smoking: prevalence among those HIV positive was 10% current and past was 22%; among those HIV negative was 11% current and 9% past |
| Njuguna et al. 2013 [25] | Cross-sectional | Adults (Community) | 75 | Mean age: 28.3 Males 100% |
Khat | None | Overall prevalence of khat use was 68% Khat
use was associated with being employed (OR = 2.8, 95% CI
1.03–7.6) Reasons for starting to chew khat included peer influence (40.4%), idleness (23.1%), easy access to khat (19.2%), and curiosity (17.3%) |
| Okal et al. 2013 [164] | A combination of ‘multiplier method’, the ‘Wisdom of the Crowds’ (WOTC) method and a published literature review. | MSM, PWID, FSWs (Community) | Not reported | Age and gender distribution data not given | Injection drugs (not specified) | None | Approximately 6107 IDU and (plausibly 5031–10 937) IDU living in Nairobi. |
| Patel et al. 2013 [179] | Case-control | Cases were adults with oesophageal cancer (Hospital) | 159 cases and 159 controls | Mean age for males 56.09 years and females
was 54.5 years Males 57.9% |
Alcohol, snuff, tobacco smoking | None | Smoking, use of snuff and alcohol were associated with increased risk of esophageal cancer (OR = 2.51, 4.74 and 2.64 respectively) |
| Ploubidis et al. 2013 [184] | cross-sectional | Adults (Community) | 4314 | Mean age: 60.8 years Males 49.2%% |
Alcohol, tobacco smoking | None | Prevalence of alcohol was 17.7% and smoking prevalence was 6.8% |
| Balogun et al., 2014 [75] | cross-sectional | Pupils (Primary School) | 3666 | Age range: 13–15 years Males 49.1% |
Alcohol | None | Past 30-day alcohol use was
17.9% Lifetime drunkenness was 22.5% Past 30-day alcohol use associated with increased odd sleeplessness; Lifetime drunkenness associated with both depression and sleeplessness |
| Bengston et al., 2014 [77] | Cross-sectional | FSWs (Community) | 818 | Age distribution: 30% aged 18–23 All female |
Alcohol | AUDIT | Prevalence of hazardous drinking was 64.6%;
harmful drinking was 35.5% Higher levels alcohol consumption associated with having never tested for HIV (PR 1.60; 95% CI: 1.07, 2.40). |
| Chersich et al., 2014 [80] | Cross-sectional | FSWS (Community) | 602 | Mean age: 25.1 years Female 100% |
Alcohol | AUDIT | Prevalence of hazardous drinking was 17.3%
and harmful drinking was 9.3% Harmful drinking associated with increased odds sexual (95% CI adjusted odds ratio [AOR] = 1.9–8.9) and physical violence (95% CI AOR = 3.9–18.0); while hazardous drinkers had 3.1-fold higher physical violence (95% CI AOR = 1.7–5.6). |
| De Menil et al., 2014 [83] | Cross-sectional | Psychiatric patients (Hospital) | 455 | Mean age/range: 36.3 years Gender distribution: males 66.4 |
Alcohol, other substances (not specified) | None | Prevalence of alcohol use disorder was 21.2% and other drug use was 10.4% |
| Joshi et al., 2014 [98] | cross-sectional | Adults living in informal settlements (Community) | 2061 | Mean age: 33.4 (SD 11.6) years Males 50.9% |
Alcohol, tobacco | WHO STEPS | Alcohol use: 30.1% reported lifetime
alcohol use; 81% alcohol use in past 12 months; 76.8%
reported using alcohol in the past 30 days; harmful use
by 52% Tobacco: 13.1% reported current smoking (84% of whom used daily) Current smoking (p = 0.018), years of smoking (p = 0.001) associated with having hypertension |
| Medley et al., 2014 [135] | Cross-sectional | PLHIV (Hospital) | 1156 | Mean age: 37.2 Gender distribution not reported |
Alcohol | None | Overall, 14.6% of participants reported alcohol use in the past 6 months; 8.8% were categorized as non-harmful drinkers and 5.9% as harmful/likely dependent drinkers. Binge drinking reported in 5.4% |
| Othieno et al., 2014 [169] | Cross-sectional | Students (University) | 923 | Mean age: age 23 (SD4.0) males 56.9% | Alcohol, tobacco | None | Students who used tobacco (p = 0.0001) and engaged in binge drinking (p = 0.0029) were more likely to be depressed |
| Pack et al., 2014 [174] | Cross-sectional | FSW (Community) | 619 | 18 years and older Female 100% |
Alcohol | AUDIT Tool not specified for other drug use |
Hazardous alcohol use 36.0%; harmful alcohol use 64.0%; other drug use 34.1% |
| Were et al., 2014 [199] | Cross-sectional | PWID (Community) | 61 | Age range: 29–33 years Gender distribution: not reported |
Brown sugar, rohypnol, khat, tobacco, cocktail, alcohol, injection drugs (heroin, diazepam) | None | Prevalence of substance use was as follows: 43%, brown sugar 16%, rohypnol 61%, tobacco 61%, khat 26%, cocktail 39%, alcohol 52%; injection drugs heroin 100%, diazepam 18% |
| Widmann et al., 2014 [201] | Case-control | Cases were male khat chewers (Community) | 48 (cases = 33, controls = 15) | Mean age: 34 years for cases, 35.1 for
controls Males 100% |
Alcohol, khat, tobacco, tranquilizers | MINI | Khat chewers experienced more traumatic event types than non-chewers (p = 0.007), more PTSD symptoms than non-chewers (p = 0.002) and more psychotic symptoms (p = 0.044). |
| Goldblatt et al., 2015 [91] | Cross-sectional | Children living in the streets | 296 | Age range: 13-21years All males |
Alcohol, tobacco, khat, glue, fuel | None | Weekly alcohol use reported by 49%;93% reported weekly tobacco use; and 39% reported weekly Cannabis use; 46% reported lifetime use of glue; 8% reported lifetime inhalation of fuel |
| Hulzelbosch et al., 2015 [96] | Cross-sectional | Persons with hypertension in an informal settlement (Community) | 440 | Age: 35 years and above males 42% |
Alcohol, tobacco, khat, glue, fuel | WHO STEPS survey instrument | Tobacco use: current 8.4%, former
11.8% Alcohol use: low 84.8%, moderate 6.8%, high 8.4% |
| Kurth et al., 2015 [121] | Cross-sectional | PWID (Community) | 1785 | Mean age 31.7 years in Coast and 30.4 in
Nairobi Males 82.4–89.0% |
Injection drugs (heroin) | None | 93% injected heroin in the past 30 days. |
| Lukandu et al., 2015 [130] | Case-control | Cases were dental patients (Hospital) | 42 (34 cases, 8 controls) | mean age 28.9 years all males |
Alcohol, khat, tobacco, | None | Oral epithelium thicker in khat chewers compared non-chewers (p<0.05); |
| Maina et al., 2015 [132] | Cross-sectional | PLHIV (Hospital) | 200 | Modal age group 34–41 years
(27.4%) males 49.7% |
Alcohol, tobacco, cocaine, amphetamines, inhalants, sedatives, opioids, hallucinogens, others (not specified) | ASSIST, ASI | Lifetime prevalence of any substance use
was 63.1%; alcohol 94.4%; tobacco 49.7%; cocaine 6.7%;
amphetamine type stimulants 19.6%; inhalants 3.4%;
sedatives 1.7%; opioids 1.1%; hallucinogens 6.6%; others
4.2% 50.3% wrongly identified the alcohol use vignette problem as stress |
| Micheni et al., 2015 [33] | Cohort | MSM and FSW (Community) | 1425 | Median age was 25 for MSM and 26 for
FSW Males 50.9% |
Alcohol, injection drugs (not specified) | None | Recent alcohol use was associated with reporting of all forms of assault by MSM [(AOR) 1.8, CI 0.9–3.5] and FSW (AOR 4.4, CI 1.41–14.0), |
| Muraguri et al., 2015 [144] | Cross-sectional | MSM (Community) | 563 | MSM who did not sell sex: 30% in the 35 and
older age group; MSM who sell sex: 30.8% in the 25–29
age group Males 100% |
Alcohol, illicit drugs (not specified) |
AUDIT for alcohol use; tool not specified for illicit substances | 62.9% of MSM who did not sell sex had used illicit drugs in the past 12 months while those who sold sex were 78.7%. Possible alcohol dependence was 21.4% among those who did not sell sex while those who sold sex were 33%. |
| Olack et al., 2015 [165] | Cross-sectional | Adults living in informal settlements (Community) | 1528 | Mean age: 46.7 years Males 42% |
Alcohol, tobacco smoking | WHO STEPS survey questionnaire | Prevalence of smoking: Current smokers 8.5%
and past Smokers 5.1%; Alcohol: Ever Consumed was 30.4%; In the past 12 months was 17% and In the past 30 days was 6.5% |
| Onsomu et al., 2015 [167] | Cross-sectional | Adult women (Community) | 2227 | Age range not reported Females 100% |
Alcohol use in husband | None | 385 of women reported that husband uses alcohol |
| Othieno et al., 2015 [170] | Cross-sectional | Students (University) | 923 | Mean age: age 23 (SD4.0) Males 56.9% |
Alcohol, tobacco | None | Alcohol use (p<0.001), binge drinking (p<0.01), tobacco use (p<0.001), were significantly associated with increased odds of having multiple sexual partners. |
| Othieno et al., 2015b [171] | Cross-sectional | Students (University) | 923 | Mean age: age 23 (SD4.0) Males 56.9% |
Alcohol, tobacco | None | Prevalence of binge drinking was 38.85%;
Tobacco use prevalence not reported Binge drinking and tobacco use were significantly associated with injury in the last 12 months (AOR 5.87 and 4.02, p<0.05, respectively) |
| Secor et al., 2015 [189] | Cross-sectional | MSM Community) | 112 | Median age: 26 years Males 100% |
Alcohol, other drugs (not specified) | AUDIT, DAST | Prevalence of hazardous or harmful alcohol
use was 45%; prevalence harmful use of other drugs
59.8% Alcohol abuse associated with higher PHQ-9 scores (p = 0.02). |
| Syvertsen et al., 2015 [190] | Cross-sectional | PWID (Community) | 151 | Mean age: 28.8 (SD 6.2) years Males 84% |
Alcohol, cannabis, prescription pills, cocaine, heroin | None | Prevalence of substance use was: Alcohol at
92.4%; cannabis at 67.6%; prescription pills at 21.2%;
cocaine injection at 76.2%; Heroin injection at
29.1% The mean years of injecting was 6.2; |
| Tun et al., 2015 [197] | Cross-sectional | PWID (Community) | 269 | Median age 31 years Males 92.5% |
Injection drugs, cannabis, khat, cocaine, tranquilizers | None | Past month injecting drug use (white
heroin-97%; other 3%); past month use: cannabis -66.5%;
Khat- 10.8%; cocaine 3.7%; tranquilizers-
58.0% HIV infection was associated with having first injected drugs 5 or more years ago (aOR, 4.3, p = 0.002), and ever having practiced receptive syringe sharing (aOR, 6.2; p = 0.001) |
| Winston et al., 2015 [204] | Cross-sectional | Children living in the streets | 200 | Mean age: 16 years Males 59% |
Alcohol and other drugs (not specified) |
None | Prevalence of alcohol use was 45.5%; and
any drug use was 77.0% Among females, those with HIV infection more frequently reported drug use (91.7% vs 56.5%, p = 0.02), |
| Mokaya et al., 2016 [140] | Cross-sectional | Health care workers (Hospital) | 206 | Mean age: 35.3 years (SD 10.1) Males 36.9% |
Alcohol, tobacco, sedatives, cocaine, amphetamine-like stimulants, hallucinogens, inhalants, | ASSIST | Lifetime use was 35.8% for alcohol, 23.5%
for tobacco, 9.3% for sedatives, 8.8% for cocaine, 6.4%
for amphetamine-like stimulants, 5.4% for hallucinogens,
3.4% for inhalants, and 3.9% for opioids Being male associated with lifetime tobacco (p<0.01), alcohol (p<0.01) and cannabis (p<0.01) use. |
| Papas et al., 2016 [176] | Mixed methods | PLHIV (Hospital) | 127 | Median age 37.0 years (IQR
32.0–43.0) Males 48.2% |
Alcohol, kuber, tobacco, cannabis, khat, | AUDIT-C | Prevalence of substance use was as follows:
alcohol: ≥6 drinks per occasion at least monthly in the
past year was 51.2%; Past 30 days other drug use: Tobacco—25.2%; cannabis—3.9%; khat- 8.7%; kuber -10.2% No agreement between self-reported alcohol use and PETH |
| White et al., 2016 [200] | Cohort | FSW (community) | 405 | Modal age group 40–49 years All female |
Alcohol | AUDIT | Hazardous/harmful alcohol use significantly associated with a lower likelihood of self-reported sexual abstinence (aRR 0.58; 95% CI 0.45–0.74) |
| Wilson et al., 2016 [203] | Cross-sectional | FSWs who are PLHIV (hospital) |
357 | Age range: 20–61 years Females 100% |
alcohol | AUDIT | Any alcohol use was 48.7%; Among those using 59.1% had drinking behaviour consistent with minimal alcohol use problems, 32.8% moderate problems and 8% had severe alcohol problems or possible alcohol use disorder Women with severe alcohol problems (adjusted odds ratio 4.39, 1.16–16.61) were significantly more likely to report recent intimate partner violence. |
| Embleton et al., 2017 [87] | Cross-sectional | Orphaned and separated children (Community, charitable institutions) | 1365 | Mean age 13.9 years Males 52% |
Alcohol, drugs (not specified) | None | Prevalence of alcohol and drug use was 8.9% |
| Goodman et al., 2017 [92] | Cross-sectional | Mothers (Community) | 1976 | Mean age: 38.2 years Females 100% |
Alcohol | None | 7.95% reported any alcohol consumption and
5% reported weekly alcohol consumption Physical abuse (OR) = 2; 95% CI: (1–4.2)), emotional neglect (OR = 3.18; 95% CI: (1.47–6.91), and living with someone with a mental illness or depression (OR = 2.14; 95% CI: (1.05–4.34)) during the first 18 years of life significantly increased the odds of reporting weekly alcohol consumption. |
| Jenkins et al., 2017 [97] | Cross-sectional | Adults (Community) | 1147 | Age range: 18–60 years Gender distribution: not reported |
Alcohol | AUDIT | Lifetime alcohol use was 14.5% for men and
6.8% for women; Hazardous drinking was 9.5% of men and
2.9% of women. Risk of hazardous drinking was increased in men (OR 0.3, C.I. = 0.17 to 0.58 p < 0.001), people living in larger households (OR 1.8, C.I. = 1.09 to 2.97, p = 0.021), people who were single (OR 1.7, C.I. = 0.92 to 3.04, p = 0.093), and those who are self-employed (OR 1.8, C.I. = 1.04 to 2.99, p = 0.036). |
| Kamau et al., 2017 [101] | Cross-sectional | Children and adolescents attending a psychiatry out-patient clinic (Hospital) | 166 | mean age: 13.6 (SD 4.16) years males 56% |
Alcohol, tobacco, stimulants, cocaine | KSADS and DSM-IV Criteria | Substance use disorder (30.1%) most
prevalent presentation. Prevalence tobacco use -6.0%; Alcohol abuse & dependence—7.2%; cannabis abuse and dependence—14.5%; Stimulant abuse 1.8%; cocaine dependence 0.6% |
| Kimando et al., 2017 [111] | Cross-sectional | Patients with diabetes (Hospital) | 385 | Mean age 63.3 years Males 34.5% |
Tobacco smoking, alcohol | None | Tobacco smoking was 23.6%; alcohol
prevalence was 26.5% Alcohol influences cardiovascular risk factor control (p<0.001) |
| Kunzweiler et al., 2017 [118] | Cohort | MSM (Community) | 711 | Median age (IQR): 24[21–28] | Alcohol | AUDIT-C | Previously diagnosed HIV-positive and out-of-care status was more likely than HIV-negative status among men who did not report harmful alcohol use (p = 0.28) |
| Kwobah et al., 2017 [126] | Cross-sectional | Adults (Community) | 420 | Median age 34 years, IQR 27–46 Males 48.6% |
Alcohol and other substances (not specified) | MINI-7 | Alcohol/ Substance Use Disorders (11.7%). Other substances were not specified. |
| Muthumbi et al., 2017 [146] | Case-control | Cases were patients with pneumonia (Hospital) | 281 cases and 1202 controls | Among the 281 cases: 63% were male and 23% aged 15–24 years. |
Alcohol, tobacco, snuff, khat | None | Pneumonia associated current smoking (2.19,
95% CI 1.39–3.70), use of khat (OR 3.44, 95% CI 1.72–7.15), use of snuff (OR 2.67, 95% CI 1.35–5.49) |
| Papas et al., 2017 [177] | Cross-sectional | PLHIV with active alcohol use (Hospital) | 614 | Mean age: Male 40.3, Female
37.5 Male 48.5% |
Alcohol | AUDIT-C | Alcohol use not associated with physical and sexual violence among both men (p = 0.434) and women (p = 0.449) |
| Roth et al., 2017 [185] | Cross-sectional | Adult males who use alcohol (community) | 220 | Mean age: 35.2 years all males |
Alcohol | None | Drinking alcohol with FSWs associated with ever having commercial sex (p<0.001), fighting with FSWs (p<0.01), being physically hurt by FSWs (p<0.01), physically hurting FSWs (p<0.001), being robbed by FSWs (p<0.001) |
| Takahashi et al., 2017 [192] | Cross-sectional | Adults (Community) | 478 | Mean age: 41(SD 14) Males: females 41.4% |
Alcohol, tobacco | AUDIT | Alcohol: prevalence of current drinking was
31.7% and hazardous drinking was 28.7% Tobacco use prevalence was 14.4% Current (p<0.001) and hazardous alcohol use (p<0.001) associated with being male |
| Tsuei et al.,2017 [196] | Cross-sectional | Health care workers (Hospital) | 206 | Mean age: 35.0 years (SD 10.1) Males 37.2% |
Alcohol, tobacco | ASSIST | Prevalence moderate risk alcohol use
(3.0%); moderate and high risk tobacco use (11.8% and
0.5%) respectively; moderate risk cannabis use
(3.4%) Self-efficacy for SUD was lower in those practicing in public facilities and perceiving a need for AUD training; while higher self-efficacy correlated with a higher proportion of patients with AUD in one’s setting, access to mental health worker support, cannabis use at a moderate risk level, and belief that AUD is manageable in outpatient settings. |
| Asiki et al., 2018 [70] | Cross-sectional | Adults living in informal settlements (community) | 1942 | Mean age of women was 48.3 (SD 5.30), and
of men was 48.8(SD 5.6) Males 45.6% |
alcohol, tobacco, | CAGE | BMI among men negatively associated with current tobacco smoking, |
| Budambula et al., 2018 [78] | Cross-sectional | PWID use, non-injecting drug users, non-drug users, with and without HIV (Community) | 451 | Among PWID (HIV positive): Median age 30.6;
Males 45.2% Among PWID (HIV negative): Median age 26.8; Males 64.1% |
Injection drugs, non-injection drugs (not specified) | None | Occurrence of early age sexual debut, >1
sexual partners, unprotected sex and history of STIs
(all p<0.0001) was significantly higher in
HIV-infected PWID use than in non-injection drug users
and non-drug users Frequency of bisexuality, homosexuality, sex for police protection, sex for drugs was (all p<0.0001) significantly higher in HIV-infected PWIDs as compared to non-injection drug users and non-drug users |
| Cagle et al.,2018 [79] | Cohort | PLHIVV (Hospital) | 854 | Age: 15 years and above 61% females |
Alcohol | AUDIT | CD4 count increase was associated with alcohol use (p = 0.051) following ART initiation in ART naïve patients |
| Gathecha et al., 2018 [88] | Cross-sectional | Adults (community) | 4484 | Age range 18-69years Males 60.3% |
Alcohol, tobacco | WHO STEPS survey questionnaire | Smokers (p = 0.001) were significantly more likely to be injured in a road traffic crash. Heavy episodic drinking (p = 0.001) and smoking (p < 0.05) were associated with increased likelihood of occurrence of a violent injury. |
| Kaduka et al., 2018 [100] | Cohort | Patients with stroke (Hospital) | 691 | Median age 60 years Males 42.4% |
Tobacco, cocaine | WHO STEPS survey | Tobacco smoking risk factor for ischemic stroke (p < 0.001). |
| Kendagor et al., 2018 [107] | Cross-sectional | Adults (Community) | 4203 | Age range: 18–69 years Males 60% |
Alcohol, tobacco | WHO STEPS survey questionnaire | 12.7% reported heavy episodic
drinking, Respondents who were separated had three times higher odds of HED compared to married counterparts (OR 2.7, 95% CI 1.3–5.7). Tobacco consumption was associated with higher odds of HED (unadjusted OR 6.9, 95% CI 4.4–10.8) |
| Kiburi et al., 2018 [110] | Cross-sectional | Psychiatric in-patients (Hospital) | 134 | Modal age group 31–40 Males 88.1% |
Alcohol, tobacco, opioids, cocaine, amphetamines, inhalants, sedatives, khat | ASSIST | Lifetime: prevalence tobacco 84.3%, alcohol
91.8%, cannabis 64.2%, cocaine 5.2%, amphetamine 3%,
inhalants 5.2%, sedatives 22.4%, hallucinogens 3.7%,
opioids 8.2%, khat 55.2%; 90% had poly-substance
use Emotional abuse significantly predicted tobacco (A.O.R = 5.3 (1.2–23.9) and sedative (A.O.R = 4.1 (1.2–14.2) use. Childhood exposure to physical abuse was associated with cannabis use [A.O.R = 2.9 (1.0–7.9)]. |
| Kimbui et al., 2018 [113] | Cross-sectional | Pregnant adolescents (Hospital) | 212 | Mean age: 17.3 years Males 88.1% |
alcohol | AUDIT | 43.9% had used alcohol Depression was associated with ever use of alcohol (p = 0.038), and alcohol dependence (p = 0.004) |
| Korhonen et al., 2018 [117] | Cross-sectional | Gay, bisexual and other MSM (Community) | 1476 | Median age (IQR 22–29), Males 100% |
Alcohol, other substances (not specified) | AUDIT, DAST | Prevalence for hazardous alcohol use was
44% and for problematic substance use was
51% Transactional sex was associated with hazardous alcohol use [adjusted prevalence ratio (aPR) 1.34, 95% confidence interval (CI) 1.12–1.60]. Childhood abuse and recent trauma were associated with hazardous alcohol use (aPR 1.36, 95% CI 1.10–1.68 and aPR 1.60, 95% CI 1.33–1.93, respectively), and problematic substance use (aPR 1.32, 95% CI 1.09–1.60 and aPR 1.35, 95% CI 1.14–1.59, respectively). |
| Kunzweiler et al., 2018 [119] | Cross-sectional | MSM (Community) | 711 | Median age 24 years Males 100% |
Alcohol, other substances (not specified) | AUDIT, DAST | Prevalence of harmful alcohol use was 50.1%
and prevalence of moderate substance abuse was
23.8% Depressive symptoms were associated with harmful alcohol use (p<0.01) and moderate substance abuse (p = 0.02) |
| Magati et al., 2018 [131] | Cross-sectional | Adults & adolescents (community) | 43898 | Age range: 15–54 rears females 70.8% |
Tobacco | None | Overall smoking and smokeless tobacco prevalence rate was 17.3% and 3.10% respectively among men. Lower rates in women with smoking and smokeless tobacco prevalence at 0.18% and 0.93% |
| Mannik et al., 2018 [133] | Cross-sectional | Adults (Community) | 2865 | Median age 50 years Males 45% |
Tobacco | None | The point prevalence of tobacco use was 22%. |
| Mburu et al., 2018 [134] | Cohort | Patients with tuberculosis (Hospital) | 347 | Median age 31years Males 71.8% |
Alcohol, tobacco | None | Alcohol use and smoking were associated
with DM among TB patients (p<0.200) Number of cigarettes smoked per day and significant risk factors of developing DM among TB patients (p = 0.045) |
| Mkuu et al., 2018 [138] | Cross-sectional | Adults (Community) | 718 | Mean age 36.6 years Males 86% |
Alcohol, tobacco smoking | AUDIT | An average of 2.5 drinking events and 4.3
binge-drinking occasions per month. 37% consumed unrecorded alcohol. Those who completed primary education or above less likely to report consuming unrecorded alcohol compared to those with incomplete primary education or lower, (OR = 0.22, 95% CI: 0.12–0.43). Compared to poorest and poor respondents, those identifying as middle class or above were less likely to consume unrecorded alcohol (OR = 0.47, 95% CI: 0.29–.78). Current smokers (OR = 2.19, 95% CI: 1.34–3.60) and those with higher binge drinking occasions in the past month (OR = 1.03, 95% CI: 1.004–1.07) were significantly more likely to consume unrecorded alcohol. |
| Mohammed et al., 2018 [139] | Cross-sectional | Adults (Community) | 4484 | Modal age group 18–29 (46%); Gender distribution: not reported |
Alcohol, tobacco | WHO STEPS survey questionnaire | Prevalence of current tobacco use was 13.4%
and harmful alcohol use was 14.4%. Harmful alcohol use was associated with hypertension (p < 0.001). |
| Ng’ang’a et al., 2018 [157] | Case-control | Cases were women screened for cervical cancer (Community) | 1180 (194 cases, 986 controls) | Age range: 30–49 years Females 100% |
alcohol, tobacco | None | Those with binge drinking more likely to be
screened for cervical cancer [OR 5.94, 95%CI 1.52–23.15) p = 0.010] |
| Ngaruiya et al., 2018 [158] | Cross-sectional | Adults (Community) | 4484 | Age range: 18–69 years males 48.7% |
Alcohol, tobacco | WHO STEPS survey questionnaire | Prevalence of tobacco use: current use was
13.5%; Lifetime alcohol use was 43.1% Men had nearly seven times higher odds of being tobacco users as compared to women (OR 7.63, 95% CI 5.63–10.33). current tobacco use associated with ever use alcohol (p<0.001) |
| Oyaro et al., 2018 [173] | Cross-sectional | PWID (Community) | 673 | Majority between 20–34 years Males 93% |
Injection drugs (not specified) | None | IDU was positively associated with HCV (aOR = 5.37, 95% CI:2.61–11.06; p < 0.001) |
| Tang et al., 2018 [194] | Cross-sectional | Adult men (Community) | 12815 | Mean age: 30 (SD 10.9) Males 100% |
Tobacco | None | Trends in tobacco use: the rates declined from 22.9% in 2003 to 18.8% in 2008–2009 and 17% in 2014. |
| Wekesah et al., 2018 [198] | Cross-sectional | Adults (community) | 4066 | Age: 18 years and above Male: 48.6% |
Alcohol, tobacco | WHO STEPS survey questionnaire | Prevalence of smoking was 10.2% (17.9%
males, 2.9% of females) Prevalence of harmful alcohol use 13.8% (24.5% of males and 3.7% of females) |
| Akiyama et al., 2019 [68] | Cross-sectional | PWID and illicit drug use (NSP sites within the community) | 2188 | Median age (IQR): 32 years
(28–36) Males 91% |
Injection drugs, illicit drugs (not specified) | None | Median (1QR) age at first injection 27
years (24–31), Median (1QR) number of injections per day
in the past month: 2 (1–3); Median (1QR) years injecting
3(2–6) Needle sharing at last injection: receptive (3%); distributive (3%) More years of injecting and more injections in the past month was associated with increased odds of HIV–HCV co-infection (p>0.0001 in both cases) |
| Anundo 2019 [69] | Cross-sectional | Female PWID (Community) | 149 | Age range: 26–40 years Females 100% |
Alcohol, tobacco, khat, heroin amphetamines, cocaine, hallucinogens, sedatives. | ASSIST | The substance specific risk scores for frequently used substances were as follows: heroin 38, tobacco 37, alcohol 35, khat 28, rohypnol 1, cocaine 1 |
| Gitatui et al. 2019 [24] | Cross-sectional | Adults living in informal settlements (Community) | 215 | Age: above 18 years Males 80% |
Alcohol | None | Alcohol use reported on average 4.15 ± 2.8
(Mean ± SD) days per week. Respondents who consumed more than three drinks were more likely (p < 0.05) to be older (OR = 5.8, 95% CI:2.3–14.2 and OR = 2.6, 95% CI: 1.1–6.4), married (OR = 8.3, 95% CI: 3.3–21.1), separated/divorced/widowed (OR = 2.8, 95% CI: 1.3–6.5), had attained post primary education (OR = 2.1, 05% CI: 1.1–3.8), and of income above 50 USD (OR = 5.8, 95% CI: 2.5–13.8 and OR = 8.8, 95% CI: 3.1–25.5) |
| Haregu et al. 2019 [95] | Cross-sectional | Adults living in informal settlements (Community) | 5190 | Age: 18 years and above Males 53.8% |
Alcohol, tobacco | None | lifetime alcohol use was 16.4%; lifetime tobacco use 20.3% |
| Kaai et al. 2019 [99] | Cross-sectional | Adult smokers (Community) | 1103 | Age: 18 years and above males 91.5% |
Tobacco | None | Quit intentions: 28% had tried to quit in
past 12 months; 60.9% had never tried to quit, only
13.8% had ever heard of smoking cessation
medication Factors associated with quit intentions: being younger (AOR 3.29 [18–24 years]; AOR 1.98 [25–39 years]), having tried to quit previously (AOR 3.63), perceiving that quitting smoking is beneficial to health (AOR 2.23 [moderately beneficial]; AOR 3.72 [very/extremely beneficial]), worrying about future health consequences of smoking (AOR 3.10 [little/moderately worried]; AOR 4.05 [very worried]), and being low in nicotine dependence (AOR 0.74). |
| Kamenderi et al. 2019 [102] | Cross-sectional | Students (Secondary schools) | 3908 | Age data not stated males 60% |
Alcohol, khat, prescription medication, tobacco, cannabis, inhalants, heroin, cocaine | None | Lifetime use; alcohol (23.4%), khat (17.0%), prescription medication (16.1%), tobacco (14.5%), cannabis (7.5%), inhalants (2.3%), heroin (1.2%) and cocaine (1.1%); |
| Kamenderi et al. 2019 [103] | Cross-sectional | Adolescents and adults (Community) | 3362 households | Age range: 15–65 years Gender distribution not reported |
Alcohol, tobacco, cocaine, heroin, khat, | None | Lifetime prevalence of any substance was 62.5%; alcohol use disorder at 10.4%, tobacco use disorder at 6.8%, khat use disorder at 3.1 and heroin use disorder at 0.8% |
| Kamenderi et al. 2019 [104] | Cross-sectional | Adults and adolescents (community) | 2136 households | Mean age/age range: range
15–65 Males 48.8% |
Alcohol, tobacco, khat | DSM V Criteria | Prevalence of multi- substance use was
5.3%; Multiple substance use disorder pattern was as follows; alcohol and tobacco (2.5%); tobacco and khat (0.8%), alcohol and khat (0.7%); alcohol, tobacco and khat (0.5%); alcohol, tobacco, khat and bhang (0.3%), alcohol, khat and bhang (0.2%), alcohol, tobacco and bhang (0.2%); alcohol and bhang (0.1%). Predictors of multiple substance use disorder were: setting (more in urban versus rural area) p = 0.004 and gender (more in females) p = 0001 |
| Kimani et al. 2019 [112] | Cross-sectional | Patients with hypertension (Hospital) | 229 | Modal age group: <50 years
(40.2%) Males 44.5% |
Alcohol, tobacco smoking, | None | Prevalence of tobacco smoking 8.3% and
alcohol use 13.1% More males reported drinking alcohol and smoking (p<0.001). Higher BPs were observed in smokers and drinkers (p<0.05). |
| Kisilu et al. 2019 [29] | Cross-sectional | Persons on MMT (MMT clinics) | 388 | Age distribution not reported Males 93% |
Alcohol, tobacco, khat, heroin, benzodiazepine, amphetamines, cocaine, barbiturates. | None | Type of substance first used: Cannabis 35.9%, tobacco 29.1%, alcohol 12%, heroin 11.3%, khat 5.9%, benzodiazepine 3%; glue 1.5%, amphetamines 0.3%, cocaine 0.3% and barbiturates 0.2%. |
| Kurui & Ogoncho 2019 [122] | Cross-sectional | Students (College) | 303 | Mean age: 21.96 years Males 49.5% |
Alcohol, tobacco, khat, heroin, prescription drugs, emerging drugs (shisha, kuber, shashaman, others not specified) | None | Lifetime use of any substance 52.5%; alcohol 52.5%, Tobacco 12.2%, khat 17.5%, heroin 1.3%, prescription drug 12.5%, emerging drugs 11.2% |
| Menya et al. 2019 [137] | Case-control | Patients with esophageal cancer (Hospital) | 836 (422cases, 414 controls) | Mean age 60 years Males 65% in cases and 61% in control |
Alcohol, tobacco | None | For the same amount of ethanol intake, drinkers who had 10 percentage points more ethanol consumed as chang’aa had a 16% (95%CI: 7, 27) higher esophageal squamous cell carcinoma risk. |
| Mungai & Midigo 2019 [143] | Cross-sectional | Adults (Community) | 385 | Age range: 18–65 years Males 62.6% |
alcohol | AUDIT | Alcohol use: 65% had hazardous or harmful
drinking Harmful/hazardous alcohol use associated with having a family member struggling with alcohol use (p<0.001), alcohol being brewed in the home (p<0.001) |
| Mutiso et al. 2019 [147] | Cross-sectional | Students (Secondary schools) | 471 | Mean age was 16.33 Males 46.5% |
Substances not specified | DUSI-R | No significant differences in the mean scores for substance use problems across all the categories, though the lowest scores were reported among those who had not experienced bullying problems |
| Mwangi et al. 2019 [149] | Cross-sectional | PWID, women (Community) | 306 | Mean age 30 years (SD 5.7) Females 100% |
Injecting drugs (not specified) | DSM-5 Criteria | 88% of participants had severe injecting
drug use (IDU) IDU and depression were related to each other (P < 0.05) and each of them with risky sexual behavior (P < 0.05). |
| Nall et al. 2019 [150)] | Cross-sectional | Youth (Community) | 651 | Mean age: 16.7years Males 46.5% |
Alcohol, tobacco | CRAFFT | A mean score of 1.39 (SD = 0.81) with 30.4%
having a score of two or more on CRAFFT, which is the
threshold for intervention Substance use predicted intent to test for HIV, (OR = 1.41, p = 0.007.) |
| Ngure et al. 2019 [160] | Cross-sectional | Students (University) | 1438 | Age range: 17–33 years Males 53% |
Opioids, alcohol, tobacco, shisha, kuberb, khat, inhalants, amphetamines, cocaine, hallucinogens, sedatives | ASSIST | Lifetime prevalence of any substance was
48.6% and current prevalence was 37.9% Lifetime prevalence of tobacco -13%, shisha 17.8%, kuber 4.3%, alcohol 43.2%, 14.2%, cocaine 2.7%, amphetamines 1.7%, inhalants 0.8%, sedatives 0.8%, hallucinogens 1.4%, opioids 1.3%, khat 11.5%, muguka 8.1% |
| Ominde et al. 2019 [35] | Cross-sectional | In-patients with stroke (Hospital) | 227 | Mean age: 68.8(SD 6.8) Males 37.9% |
Alcohol, tobacco | None | Prevalence for alcohol use was 63% and tobacco use was 48% |
| Ongeri et al. 2019 [166] | Cross-sectional | Adults (Community) | 831 | Mean age: 30 years Males 47.6% |
Khat, tobacco, alcohol, other
drugs (not specified) |
ASSIST | Khat: lifetime use 44.6%, current use
36.8% Khat use associated with higher odds of reporting strange experiences (OR, 2.45; 95%CI, 1.13–5.34) and experiencing hallucinations (OR, 2.08; 95% C.I, 1.06–4.08) Khat use significantly associated with male sex (p < 0.001), younger age (less than 35 years) (p < 0001), higher level of income (p < 0.001) and comorbid alcohol (p = 0.001) and tobacco use (p < 0.001). |
| Owuor et al. 2019 [172] | Cross-sectional | Students (University) | 404 | Mean age: 22.42 (SD 2.45) Males 54.8% |
Alcohol, tobacco, sedatives, others (not specified) | ASSIST | Lifetime use of at least one substance was 76% and current use was 46.3%. |
| Pengpid & Peltzer 2019 [182] | Cross-sectional | Adults (Community) | 4469 | Median age (38 years) Males 39.7% |
Alcohol | WHO STEPS survey questionnaire | 12.8% reported past month binge-drinking
and 6.7% had hazardous or harmful alcohol use. Current tobacco and khat use was 12.8% and 6.8% respectively Being male (AOR 7.66 [3.92, 14.97]), tobacco use (AOR 6.72 [3.69, 12.2]), and having hypertension (AOR 2.28 [1.49, 3.48]) increased the odds for hazardous or harmful alcohol use. |
| Woldu et al. 2019 [206] | Cross-sectional | Adults living in informal settlements (community) | 413 | 18 years and older | Alcohol, tobacco, cannabis, khat, cocaine, opioids, sedatives, hallucinogens | ASSIST | Use of any substance in past three months
increased the odds of having concurrent sexual relationships (aOR 2.46; 95% CI 1.37–4.42, p < .01). |
| Kamenderi et al. 2020 | Mixed methods (cross-sectional and qualitative) | Pupils (Primary school) | 3307 | Age distribution not reported Males 51.8% |
Alcohol | None | Prevalence of alcohol use was 7.2% |
| Kurui & Ogoncho 2020 [123] | Cross-sectional | Students (College) | 303 | Mean age: 21.96 (SD 0.4) years Males 49.5% |
Alcohol | None | Prevalence of lifetime alcohol use was
52.5% and current alcohol use was 27.4% Reasons for using alcohol included curiosity 24.1%, fun 12.2%, peer influence 11.6%; Average use- 1 unit 15.2%, 3–4 units 13.2% |
| Mutai et al. 2020 [39] | Mixed methods (cross-sectional and qualitative) | Adults living in informal settlements (community) | 200 | Modal age group 18–24 (74%) Males 60% |
Alcohol, khat, kuber, heroin, tobacco | None | Prevalence of substance abuse: Cannabis 60%; alcohol 26.5%; khat 6%; kuber, heroin and tobacco 3% each |
| Ndegwa & Waiyaki 2020 [151] | Cross-sectional | Students (University) | 407 | Age range: 18–41 Males 41.3% |
alcohol, tobacco | ASSIST | Tobacco use was reported by 95.7% (77.9%
had low risk, 16.3% moderate risk and 1.5% high
risk); Alcohol was reported by 95.7% (77.2% low risk; (16.0%) moderate risk; (2.5%) high risk: |
| Winter et al. 2020 [205] | Cross-sectional | Adults living in an informal settlement (community) | 361 | Modal age group: 25–44 years
(80%) Female 100% |
Alcohol, tobacco | None | Alcohol prevalence was 21.1%, Tobacco
prevalence 7.8% Recent psychological IPV was associated with alcohol (OR = 2.6, p<0.05) and tobacco use (OR = 3.8, p<0.05) |
akhat (catha edulis) is a plant with stimulant properties and is listed by WHO as a psychoactive substance. Its use is common in East Africa
bkuber is a type of smokeless tobacco product.