Informal alcohol in Malawi: Stakeholder perceptions and policy recommendations

Limaye, Rupali J.; Rutkow, Lainie; Rimal, Rajiv N.; Jernigan, David H.

doi:10.1057/jphp.2013.43

Cited by 10 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A global review of the evidence on unrecorded alcohol (which includes informal) concluded ethanol was the most harmful ingredient of unrecorded alcohol, and health consequences due to other ingredients found in unrecorded alcohol were scarce . However, there is a perception, as unrecorded alcohol is usually the least expensive form of alcohol available in many countries, that it may contribute to higher rates of chronic and irregular heavy drinking . In this study we found the proportions of informal alcohol consumed in harmful drinking occasions was statistically significantly lower than commercial alcohol products.…”

Section: Discussionmentioning

confidence: 51%

Cross‐country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study

Cường

Casswell

Parker

et al. 2018

Drug and Alcohol Review

View full text Add to dashboard Cite

Introduction and AimsThis study examines the proportion of alcohol markets consumed in harmful drinking occasions in a range of high‐, middle‐income countries and assesses the implications of these findings for conflict of interest between alcohol producers and public health and the appropriate role of the alcohol industry in alcohol policy space.Design and MethodsCross‐sectional surveys were conducted in 10 countries as part of the International Alcohol Control study. Alcohol consumption was measured using location‐ and beverage‐specific measures. A level of consumption defined as harmful use of alcohol was chosen and the proportion of the total market consumed in these drinking occasions was calculated for both commercial and informal alcohol.ResultsIn all countries, sizeable proportions of the alcohol market were consumed during harmful drinking occasions. In general, a higher proportion of alcohol was consumed in harmful drinking occasions by respondents in the middle‐income countries than respondents in the high‐income countries. The proportion of informal alcohol consumed in harmful drinking occasions was lower than commercial alcohol.Discussion and ConclusionsInformal alcohol is less likely to be consumed in harmful drinking occasions compared with commercial alcohol. The proportion of commercial alcohol consumed in harmful drinking occasions in a range of alcohol markets shows the reliance of the transnational alcohol corporations on harmful alcohol use. This reliance underpins industry lobbying against effective policy and support for ineffective approaches. The conflict of interest between the alcohol industry and public health requires their exclusion from the alcohol policy space.

show abstract

Section: Discussionmentioning

confidence: 51%

Cross‐country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study

Cường

Casswell

Parker

et al. 2018

Drug and Alcohol Review

View full text Add to dashboard Cite

show abstract

“…Other conditions include post-traumatic disorder, anxiety, self-harm, sleep disorders, emotional distress, memory loss, poor self-esteem, fears, worries, and poor social relationships (8–11). IPV, poor mental health and its consequences in terms of low self-esteem have been linked to alcohol use, to HIV risk, and other sexual and reproductive health risks, since people may no longer care what happens to them (12–15). Women are disproportionately affected and a range of countries have reported a gender difference in the experience of mental health effects (6, 16, 17).…”

mentioning

confidence: 99%

Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

Chepuka¹,

Taegtmeyer

Chorwe‐Sungani³

et al. 2014

Global Health Action

View full text Add to dashboard Cite

Background and objectivesThis study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV) and the capacity of health services for addressing these.DesignIn-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes.ResultsThe significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for ‘counselling’. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity.ConclusionDespite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.

show abstract

“…Measuring a standard alcoholic drink in Malawi is challenging because consumption of home-brewed alcohol is extremely common (44), and the alcohol by volume of homebrew varies (45,46). Consequently, we assess excessive alcohol consumption according to two components of the WHO Patterns of Drinking Score that we can readily capture: daily or nearly daily drinking and proportion of drinking events when the drinker feels drunk (47).…”

Section: Variable Definitionsmentioning

confidence: 99%

Protocol for a Case-Control Study to Investigate the Association of Pellagra With Isoniazid Exposure During Tuberculosis Preventive Treatment Scale-Up in Malawi

Nabity

Mponda

Gutreuter

et al. 2020

Front. Public Health

View full text Add to dashboard Cite

Background: Pellagra is caused by niacin (vitamin B3) deficiency and manifested by a distinctive dermatitis. Isoniazid is critical for treating tuberculosis globally and is a component of most regimens to prevent tuberculosis. Isoniazid may contribute to pellagra by disrupting intracellular niacin synthesis. In 2017, Malawian clinicians recognized a high incidence of pellagra-like rashes after scale-up of isoniazid preventive treatment (IPT) to people living with HIV (PLHIV). This increase in pellagra incidence among PLHIV coincided with a seasonal period of sustained food insecurity in the region, which obscured epidemiological interpretations. Although isoniazid has been implicated as a secondary cause of pellagra for decades, no hypothesis-driven epidemiological study has assessed this relationship in a population exposed to isoniazid. We developed this case-control protocol to assess the association between large-scale isoniazid distribution and pellagra in Malawi.Methods: We measure the relative odds of having pellagra among isoniazid-exposed people compared to those without exposure while controlling for other pellagra risk factors. Secondary aims include measuring time from isoniazid initiation to onset of dermatitis, comparing niacin metabolites 1-methylnicotinamide (1-MN), and l-methyl-2-pyridone-5-carboxamide (2-PYR) in urine as a proxy for total body niacin status among subpopulations, and describing clinical outcomes after 30-days multi-B vitamin (containing 300 mg nicotinamide daily) therapy and isoniazid cessation (if exposed). We aim to enroll 197 participants with pellagra and 788 age- and sex-matched controls (1:4 ratio) presenting at three dermatology clinics. Four randomly selected community clinics within 3–25 km of designated dermatology clinics will refer persons with pellagra-like symptoms to one of the study enrollment sites for diagnosis. Trained study dermatologists will conduct a detailed exposure questionnaire and perform anthropometric measurements. A subset of enrollees will provide a casual urine specimen for niacin metabolites quantification and/or point-of-care isoniazid detection to confirm whether participants recently ingested isoniazid. We will use conditional logistic regression, matching age and sex, to estimate odds ratios for the primary study aim.Discussion: The results of this study will inform the programmatic scale-up of isoniazid-containing regimens to prevent tuberculosis.

show abstract

Informal alcohol in Malawi: Stakeholder perceptions and policy recommendations

Cited by 10 publications

References 11 publications

Cross‐country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study

Cross‐country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study

Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

Protocol for a Case-Control Study to Investigate the Association of Pellagra With Isoniazid Exposure During Tuberculosis Preventive Treatment Scale-Up in Malawi

Contact Info

Product

Resources

About