Alcohol Use and Violence-Related Injury in Moshi, Tanzania: A Mixed Methods Study

Background: Harmful alcohol use and violence are both major contributors to global mortality and morbidity rates, despite being both predictable and preventable. This study seeks to quantitatively determine the scope of violence-related injury and Alcohol Use Disorders in a referral hospital in Moshi, and qualitatively determine 1) how violence-related injury patients perceive alcohol use influences the occurrence of violence and 2) how experiencing a violence-related injury influences patients’ subsequent alcohol use behavior.

Methods: This study was conducted at Kilimanjaro Christian Medical Center (KCMC). Survey data was obtained from a trauma registry including all injury patients ≥ 18 years admitted to the emergency room. Interview participants were included if they reported their injury was due to violence, tested positive for alcohol (by breathalyzer) upon admittance, medically stable, able to communicate and provide informed consent in Swahili or English, and clinically sober at the time of enrollment.

Results: From the 500 injury patients enrolled in the trauma registry from April 17, 2018 to January 12, 2019, 84 (16.8%) reported that their injury was due to violence. Patients with violent injuries were 2.21 times more likely to have a positive alcohol status compared to non-violent injuries (95% CI 1.36, 3.60, p<0.01). Among violent injuries, those with a positive alcohol status were 6.26 times more likely to have an Alcohol Use Disorder compared to those with a negative alcohol status (95% CI 2.13, 18.39, p<0.001). Interview respondents reported a perception that violent injuries were worse from other injuries, that the perpetrator was also under the influence of alcohol, that alcohol contributes to violence, and a desire to change alcohol use behavior following their injury.

Conclusion: Alcohol use and violence-related injury pose a significant threat to health and well-being globally. In Moshi, Tanzania, both issues are prevalent and contribute to a sufficient disease burden. This study has added to the data on alcohol-attributable harm, contributing to expanding information available on this issue from LMICs. To adequately reduce violence-related injuries in this setting, it is necessary to address harmful alcohol use as well.