Substance use among university students in Ethiopia: A systematic review and meta-analysis.
AbstractBackground: Problems arising from psychoactive substance use are among the major health and social challenges facing humanity across the globe. Young people in higher learning institutions are a particularly vulnerable group in terms of substance use, and Ethiopia is no exception. In fact, the problem is believed to be on the rise, and has become a source of concern for various stakeholders.Aim: To review the prevalence of substance use among university students in Ethiopia using reports from different institutions published over a 10-year period.Methods: Search of the literature on substance use reported from 2007 to 2017. Web resources searched included Pub Med, Psych INFO, AJOL and other relevant databases using various search terms, including: substance, alcohol, khat, tobacco, drugs, substance AND college, university, higher learning institution AND Ethiopia. The search strategy was organized using the Preferred Reporting Items for Systematic Reviews and Meta-Analysesmethod. A systematic review and meta-analysis was conducted.Results: The search yielded a total of 97 articles. Ninety-four were retrieved based on the title review, of which nine were included for full-text review. A further two were retrieved after reviewing the references used in the nine articles, and a further five were retrieved from a search of gray literature. A total of 16 articles were included in the review. Almost all studies reviewed reported a high level of substance use among university students in Ethiopia. Alcohol, tobacco and khat were the substances most commonly used by the university students. The current prevalence for drinking alcohol was 26.65% (CI: 25.73-27.56, range: 9.3%-54.9%); for smoking tobacco it was 6.83% (CI: 6.29-7.37, range: 1.8%-51.1%); and for khat chewing it was13.13% (CI: 12.53-13.72, range: 2.3%-62%). Although the prevalence of these substances was reported to be high, only few of the studies reviewed looked at the reasons for use which were very diverse, and the adverse consequences on the students, such as the impact on students??? academic performance, rates of absenteeism, and cumulative grade point averages.Conclusion and recommendation: The studies showed that students in Ethiopian higher learning institutions reported high levels of substance use, especially alcohol, tobacco and khat. Adverse impacts on students??? academic performance were observed. This finding warrants the attention of policy makers to design preventive, counseling and rehabilitative programs for these students. Further well-systematized studies that look at diverse problems associated with substance use are recommended. [Ethiop. J. Health Dev. 2018;32(4):265-277]Key words: Substance, alcohol, khat, tobacco, university students, Ethiopia