Prevalence and factors associated with pre-injury exposure to alcohol among road traffic injury patients at Mulago National Referral Hospital, Kampala, Uganda
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Introduction: Road traffic injuries (RTIs) are one of the leading causes of death and disability worldwide. Uganda has alarmingly high RTIs with more than half of them occurring in Kampala city. Alcohol impairment increases the risk of RTIs and injury severity among all road user due to impairment in driving performance, road-use skills and hazard perception. However there is paucity of information on alcohol related RTIs in Uganda. Therefore, this study assessed the prevalence and factors associated with pre-injury exposure to alcohol among road traffic injury patients at Mulago National Referral Hospital, Kampala Uganda. Methods: This was a cross-sectional study making use of quantitative methods. Consecutive sampling was done to select 330 adult patients that presented at the emergency department in Mulago National Hospital with RTIs. Structured questionnaires were used to generate the required information and modified Poisson regression used for analysis. Results: Based on the breathe alcohol tests, clinical assessments and self-report, 27.9% of the patients had pre-injury exposure to alcohol. Factors independently associated with alcohol use included education level, where those who attained O-level and A-level education were less likely to have used alcohol compared to those that had no formal education (PR: 0.48, CI: 0.28 – 0.82, PR: 0.32, CI: 0.12 – 0.87) respectively. Moslems and Pentecostals were less likely to have used alcohol when compared to Catholics (PR: 0.31, CI: 0.16 – 0.60, PR: 0.22, CI: 0.09 – 0.59). The prevalence of pre-injury exposure to alcohol among patients injured at night was 3.74 times that among those injured in the morning (PR: 3.74, CI: 2.40- 5.75). Using GCS, Severe brain injuries were more likely to have used alcohol compared to those that sustained mild injuries (PRR: 1.72, CI: 1.04- 2.87) and using KTS II, moderate and severe injuries were more likely have used alcohol than those with mild injuries (PRR: 2.54, CI: 1.57 - 4.14, PRR: 3.61, CI: 2.20 – 5.92) respectively. Conclusion: Pre-injury exposure to alcohol was high among RTI patient. It was noted more among those with no formal education, Catholics and those injured at night. Pre-injury exposure to alcohol was also associated with increased severity of injuries and mortality at the emergency department. Improving the capacity to enforce current policies on alcohol and road safety is essential although, much more work needs to be done to develop multifaceted preventive approaches.