Substance use among adolescents in sub-Saharan Africa: A systematic review and meta-analysis

A Olawole-Isaac, O Ogundipe, E O Amoo, D Adeloye


Background. In sub-Saharan Africa, substance use among adolescents has continued to be a major public health concern, albeit poorly documented across many settings. 

Objective. To estimate the prevalence of substance use among adolescents in sub-Saharan Africa. 

Methods. We searched Pubmed, EMBASE, AJOL and Google Scholar for population-based studies on adolescents (age 10 - 19 years) and reporting on the prevalence of substance use across sub-Saharan Africa. Search dates were from January 2000 to December 2016. A random effects meta-analysis was conducted with pooled prevalence rates (and 95% confidence interval (95% CI)) of estimated substance abuse among adolescents in sub-Saharan Africa. 

Results. Twenty-seven studies across sub-Saharan Africa including 143 201 adolescents (mean age 15.6 years) were selected. The overall prevalence of ‘any substance use’ in sub-Saharan Africa was 41.6%, with the highest rate in Central Africa at 55.5%. The use of caffeine-containing products (including coffee or kola nut) was most predominant at 41.2% (95% CI 24.3 - 58.1) but limited to West Africa. These were followed by alcohol at 32.8% (95% CI 26.0 - 39.5), tobacco products 23.5% (95% CI 17.7 - 29.3), khat 22.0% (95% CI 12.5 - 31.5) and cannabis 15.9% (95% CI 12.2 - 19.1). Other abused substances included depressants at 11.3% (95% CI 6.5 - 16.1), amphetamines 9.4% (95% CI 6.0 - 12.9), heroin 4.0% (95% CI 3.5 - 4.5) and cocaine 3.9% (95% CI 1.4 - 6.5). 

Conclusion. Our study reflects a high use of psychoactive substances and drugs among adolescents in sub-Saharan Africa. It is important that interventions and rehabilitation programmes are comprehensive and targeted at adolescents and parents in these settings.

Authors' affiliations

A Olawole-Isaac, Demography and Social Statistics Programme, Covenant University, Ota, Nigeria

O Ogundipe, Department of Economics and Development Studies, Covenant University, Ota, Nigeria

E O Amoo, Demography and Social Statistics Programme, Covenant University, Ota, Nigeria

D Adeloye, Centre for Global Health Research, Usher Institute, University of Edinburgh, UK

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Cite this article

South African Journal of Child Health 2018;12(2b):79-83. DOI:10.7196/SAJCH.2018.v12i2b.1524

Article History

Date submitted: 2018-09-04
Date published: 2018-09-04

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