Prevalence and factors associated with substance abuse by students in medical training colleges in south Nyanza region, Kenya

Abstract

Substance abuse is a worldwide public health challenge. Globally, 210 million people abuse drugs resulting in approximately 263,000 deaths annually. An estimated 10-15 % of medical students risk substance abuse in their lifetime as they are not immune to the predisposing factors associated with the abuse. Substance abuse by students in medical training colleges (MTCs) may impact negatively on their health, future professional conduct and consequently, safety of patients. In Kenya, substance abuse is prevalent among youth in secondary and tertiary institutions including those in MTCs, though data on substance abuse by students in MTCs in Kenya is scanty making the magnitude of the problem unclear. South Nyanza, the study area lies within marijuana transit route along Kisii - Migori road from Tanzania to Nairobi, Kenya. Risk potential evaluation would inform appropriate intervention. This was a cross-sectional study aimed at assessing the prevalence and factors associated with substance abuse by students in MTCs in South Nyanza Region. All the five colleges in the region were included in the study. A sample of 303 respondents was selected from a total population of 1950 students using stratified random sampling method. Self-administered questionnaires were used to collect on substance abuse. Descriptive statistics in percentages was used to determine prevalence of substance abuse. Chi-square tested for independence of variables and logistic regression analysis was used to test the association between selected variables. Odds ratio was calculated to determine the strength of associations between selected variables. It was established that the respondents who have ever used at least one substance were 52.5%. The study further established that those who have ever used and who sustained use of the substances respectively were as follows: alcohol 52.5%, 27.4%; tobacco 12.2%, 2.6%; khat 17.5%, 3.6% and marijuana, 9.2%, 2.0%. Sex was found to be associated with substance abuse amongst the students. Females were 54% (OR=0.46, P=0.001) less likely to use any of the substances compared to the males. The respondents who attended religious activities several times a week were also 78% (OR=0.22, P=0.007) less likely to abuse any of the substances. Besides, the respondents who perceived high stress were 3.64 (OR=3.64, P=0.045) times more likely to drink alcohol compared with those who perceived no stress. Nearly half (47.2%) of the respondents participated in sports, those participating in choir were 78% (OR=0.22, P=0.001) less likely to use alcoholic drinks compared with those who participated in sporting activities. The study established the most abused/ used substance was alcohol. Others were tobacco, marijuana, kuber and shisha. It is suggested that participation in religious activities and extracurricular activities such as choir by students of MTCs could reduce the risk of substance abuse.