THE AUDIT-C: A BETTER SCREEN THAN THE AUDIT TO IDENTIFY PRIMARY CHILD CARERS AT RISK OF ALCOHOL ABUSE IN THE ASENZE STUDY, KWAZULU-NATAL, SOUTH AFRICA

Monday, 18 August 2014
Exhibit hall (Dena'ina Center)
Myra Taylor, PhD , University of KwaZulu-Natal, Durban, South Africa
Shuaib Kauchali, MD , Department of Health, Pretoria, South Africa
Meera Chhagan, PhD , UKZN, Durban, South Africa
Murray Craib, MD , UKZN, Durban, South Africa
Claude Mellins, PhD , Coumbia University, New York, NY
Leslie Davidson, PhD , Columbia, New York, NY
INTRODUCTION . Alcohol abuse is a problem in South Africa and primary carers who play a critical role in children’s health and development may be at risk.  Aim. To screen primary carers of 4-6 year old children in KwaZulu-Natal for alcohol abuse and investigate associated factors. 

METHODS . The 10 question AUDIT was used to screen for hazardous and harmful use of alcohol and the abbreviated AUDIT-C was used to identify  binge drinking. Correlates between a positive AUDIT and AUDIT-C screen and alcohol abuse were investigated using bivariate and multivariate analyses.  

RESULTS .  Of the 1434 carers, 97.8%  of whom were females 16.0% (228) reported alcohol consumption, with 12.7%,  (n=182) drinking  occasionally, 2.2% (n=32) reported hazardous use of alcohol and 1.0% (n=14)  indicated harmful use of alcohol. Screening using  the AUDIT-C s rather than the AUDIT increased the number of carers identified  at risk of alcohol abuse through binge drinking from 46 (3.2%) to 130 (9.1%) (p<0.005).   For both the AUDIT-C and AUDIT instruments protective factors against alcohol abuse included no child with a serious disability, OR 0.49, (95% CI: 0.27,0.89), and a  monthly food budget > $US 60, OR 0.39 (0.20,0.74).  A risk factor for alcohol abuse was cigarette smoking  OR 7.48, (95% CI: 3.27,17.11) Other protective factors for the AUDIT  were no alcohol consumption whilst pregnant, OR 0.40, (95% CI: 0.16,0.98)  and no psychiatric disorders amongst carers, OR 0.53, (95% CI 0.29,0.96). 

CONCLUSIONS  Although low rates of alcohol abuse were detected overall, the AUDIT-C detected higher rates of problem drinking and may be a more appropriate screen to adopt in screening carers of children for alcohol abuse.